Heavier tissue flaps increase risk of fat necrosis after breast reconstruction

The weight of tissue flap used for women undergoing breast reconstruction after mastectomy affects the risk of fat necrosis, according to recent study results.

Researchers analyzed risk factors for fat necrosis in 123 women undergoing breast reconstruction after mastectomy for breast cancer and evaluated surgical and patient-related factors affecting the risk of fat necrosis after reconstruction.

Of the 179 flaps analyzed, fat necrosis occurred in 7.5% of flaps. The risk was significantly higher for women with heavier tissue flaps. According to study results, for each 100-gram increase in flap weight the risk of fat necrosis increased by 50%. The risk of fat necrosis was also affected by the number of supplying blood vessels. Among all women, African American women had a risk of fat necrosis nearly 12 times higher than white women. However, risk was not significantly affected by patient age, body weight and various medical and surgical factors.

“Flaps with increasing weight have increased risk of fat necrosis,” the researchers concluded. “These data suggest that inclusion of more than one perforator may decrease odds of fat necrosis in large flaps. Perforator flap breast reconstruction can be performed safely; however, considerations concerning race, body mass index, staging with tissue expanders and flap weight may optimize outcomes.”

For more information:

Mulvey C. Plastic and Reconstructive Surgery – Global Open. 2013doi: 10.1097/GOX.obo13e318294e41d.

Disclosure: The researchers have no relevant financial disclosures.

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