Obese Patients Undergoing Implant-based Breast Reconstruction: A Propensity Score–Matched Analysis

Background

Breast reconstruction following oncologic mastectomy is an integral component of comprehensive breast cancer care, with implant-based reconstruction consistently being reported to be the most commonly performed worldwide. Although immediate reconstruction offers the clear benefit of reducing the number of necessary surgical procedures and providing immediate aesthetic results, concerns persist regarding its feasibility in high-risk patient populations. Obesity has been suggested to be a potential contributor to lymphatic dysfunction and impaired lymphatic vasculature; both mechanisms can predispose patients to the development of postmastectomy lymphedema. Postmastectomy lymphedema is a chronic, debilitating condition with significant implications on quality of life, functional capacity, and healthcare utilization. Established risk factors include axillary lymph node dissection, radiation therapy, and the extent of mastectomy resection. Timing of reconstruction, however, especially in obese patients undergoing implant-based reconstruction, has not been clearly delineated.