Highlights
- •BMI and operative time have a positive correlation for nipple-sparing mastectomy.
- •Higher BMI marginally increased risk of nipple-areola ischemic complications.
- •Longer operative time did not impact morbidity.
- •Other patient factors did not impact ischemic complications.
Abstract
Background
Nipple-sparing mastectomy (NSM) use is increasing. We investigated the relationships
between body mass index (BMI), operative time (OT), and ischemic complications.
Methods
A single center, retrospective review was performed of NSMs from 2006 to 2018. Analysis
included descriptive statistics, Wilcoxon rank-sum test and logistic regression.
Results
Among 294 patients, 510 breast reconstructions were performed (216 bilateral). Median
OTs in the prosthetic-based (266 patients, 90.5%) and autologous tissue groups (28
patients, 9.5%) were 266 and 529 min, respectively. Median OTs ranged from 236 to
358 min for those with BMI <20 and ≥ 40, respectively. Increasing BMI correlated with
OT (r = 0.33, p < 0.001) and was associated with slightly higher odds of major NAC ischemic complications
(OR = 1.09, p = 0.02).
Conclusion
Higher BMI is associated with up to 50% longer OT, but is not a contraindication to
NSM with reconstruction. Surgeons should recognize increased time and resource utilization.
Keywords
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Article info
Publication history
Published online: December 17, 2019
Accepted:
December 5,
2019
Received in revised form:
November 25,
2019
Received:
May 15,
2019
Identification
Copyright
© 2019 Elsevier Inc. All rights reserved.
