September 2019 #PRSJournalClub Wrap-Up: Microsurgical Breast Reconstruction in the Obese: A Better Option Than Tissue Expander/Implant Reconstruction?

by Karan Mehta, MD
Plastic Surgery Resident
Montefiore Medical Center

The September #PRSJournalClub discusses the important issue of autologous breast reconstruction in the obese population in the article entitled “Microsurgical breast reconstruction in the obese: A better option than tissue expander/implant reconstruction?” by Klement et al.

In this study, the authors discuss that given the rise of obese breast cancer patients interested in breast reconstruction, plastic surgeons must make an important decision regarding which mode of reconstruction can be safely employed for these patients. Although several studies have documented higher risks of complications in obese patients, few studies have directly compared autologous to prosthetic reconstruction in this patient population. Therefore, the purpose of this study was to investigate the complications of these procedures and patient satisfaction in obese patients. The authors found that prosthetic breast reconstruction had statistically significantly higher risks of major complications including infection, mastectomy necrosis and overall reconstructive failure compared to autologous reconstruction. In addition, patients who underwent autologous reconstruction expressed significantly greater satisfaction on several parameters of the BREAST Q. These findings are important since autologous reconstruction may not only be a safe option in obese patients, but also may be the preferred option with higher rates of patient satisfaction. 

This article was discussed by the current Resident Ambassadors to the PRS Editorial Board Raj Parikh, MD, Lily Mundy, MD, and Kyle Sanniec, MD, and special guest moderator Scott Hollenbeck, MD, FACS. Listen to the podcast discussion below:

In addition, Raj Parikh, MD and Terence M. Myckatyn, MD provide an exciting discussion in the PRS Journal which can be read here.

An engaging and thought-provoking online discussion also took place on the #PRSJournal Facebook page over a two-day period (September 14 – 15), where established plastic surgeons and residents were able to ask questions and get answers from the authors of the article themselves! Don’t worry if you missed it! A summary of the interesting discussion is provided here. 

We hope you enjoy the top highlights from the discussion and look forward to seeing you at the next #PRSJournalClub on Facebook! 


This September #PRSJournalClub article (as well as other Journal Club selections from September), selected classic pairings and videos, and the entire Facebook Q&A are archived on here.

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