Impact of Body Mass Index on Surgical Outcomes After Delayed Breast Reconstruction.

BACKGROUND AND OBJECTIVES: Obesity is associated with increased postoperative morbidity in surgery. However, its specific impact on complications following delayed breast reconstruction (DBR) remains insufficiently documented. METHODS: We conducted a retrospective single-center study including patients who underwent first-time delayed breast reconstruction between 2018 and 2023. The primary objective was to evaluate the association between Body Mass Index (BMI) and the occurrence of postoperative complications. RESULTS: A total of 310 patients were included and categorized into three BMI groups (<25, N = 143; [25-30 [N = 97; ≥30 kg/m2, N = 70). The proportion of complications increased significantly with BMI: 29% in patients with BMI < 25, 39% in overweight patients, and 59% in obese patients. Surgical site infections, antibiotic use, and wound-healing disorders were significantly more frequent in obese patients. In multivariable analysis, higher BMI and autologous reconstruction were significantly associated with postoperative complications. A higher BMI was not significantly associated with an increased risk of reconstructive failure or hospital readmission. CONCLUSION: Higher BMI is associated with increased postoperative complications after DBR without a significantly higher rate of reconstructive failure, supporting the feasibility of delayed breast reconstruction in obese patients.