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Breast Surgery Complications Multiply When Patients Are Obese

Cheryl Clark, for HealthLeaders Media, June 30, 2011

Breast surgeons should take special care with obese patients because they are 12 times more likely to suffer complications, a Johns Hopkins study of elective breast surgery, has found.

That fact alone may prompt some surgeons to avoid accepting obese patients, since reporting and financial reward may be reduced if higher complications in their patients result, the authors said.

The study used claims data from seven Blue Cross and Blue Shield Plans to identify cohorts of 2,403 obese versus 5,597 non-obese patients who underwent elective, medically indicated breast procedures, such as breast reduction, breast reconstruction (mastopexy,) or breast lift surgery.

The researchers found that 18.3% of obese patients had a complication compared with 2.2% of the non-obese cohort.

Also, the average age of the obese patient was about six years younger than the age of the controls, further strengthening the finding in this report.

The study was led by Marty Makary, MD, associate professor of surgery at the Johns Hopkins University School of Medicine. It was published in the journal Plastic and Reconstructive Surgery.

Highest rates of complications included breast pain, deformities such as scars, delayed wound healing, and infection, all of which were much more frequent in obese patients compared with non-obese patients. Also more frequent were seromas, inflammation, capsular contractures, necrosis, implant removal, hematomas, flap failures, bleeding and revisions.

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