title: Discussion: Breast reconstruction with free tissue transfer from the abdomen in the morbidly obese.
authors: Atlanta, Ga. From the Division of Plastic Surgery, Emory University School of Medicine.
authors: Grant W
authors: GW
authors: Carlson
references: Ogden CL, Carroll MD, Curtin LR, McDowell MA, Tabak CJ, Flegal KM. Prevalence of overweight and obesity in the United States, 1999-2004. JAMA 2006;295:1549–1555.
references: Prospective Studies Collaboration, Whitlock G, Lewington S, et al. Body-mass index and cause-specific mortality in 900 000 adults: Collaborative analyses of 57 prospective studies. Lancet 2009;373:1083–1096.
references: Brierley JD, Paterson IC, Lallemand RC, Rostom AY. The influence of breast size on late radiation reaction following excision and radiotherapy for early breast cancer. Clin Oncol (R Coll Radiol.) 1991;3:6–9.
references: Gray JR, McCormick B, Cox L, Yahalom J. Primary breast irradiation in large-breasted or heavy women: Analysis of cosmetic outcome. Int J Radiat Oncol Biol Phys. 1991;21:347–354.
references: Moody AM, Mayles WP, Bliss JM, et al. The influence of breast size on late radiation effects and association with radiotherapy dose inhomogeneity. Radiother Oncol. 1994;33:106–112.
references: Pezner RD, Patterson MP, Lipsett JA, et al. Factors affecting cosmetic outcome in breast-conserving cancer treatment: Objective quantitative assessment. Breast Cancer Res Treat. 1992;20:85–92.
references: Atisha DM, Alderman AK, Kuhn LE, Wilkins EG. The impact of obesity on patient satisfaction with breast reconstruction. Plast Reconstr Surg. 2008;121:1893–1899.
references: Kuduvalli M, Grayson AD, Oo AY, Fabri BM, Rashid A. The effect of obesity on mid-term survival following coronary artery bypass surgery. Eur J Cardiothorac Surg. 2003;23:368–373.
references: Mullen JT, Davenport DL, Hutter MM, et al. Impact of body mass index on perioperative outcomes in patients undergoing major intra-abdominal cancer surgery. Ann Surg Oncol. 2008;15:2164–2172.
references: Reeves BC, Ascione R, Chamberlain MH, Angelini GD. Effect of body mass index on early outcomes in patients undergoing coronary artery bypass surgery. J Am Coll Cardiol. 2003;42:668–676.
references: Berrino P, Campora E, Leone S, Zappi L, Nicosia F, Santi P. The transverse rectus abdominis musculocutaneous flap for breast reconstruction in obese patients. Ann Plast Surg. 1991;27:221–231.
references: Chang DW, Wang B, Robb GL, et al. Effect of obesity on flap and donor-site complications in free transverse rectus abdominis myocutaneous flap breast reconstruction. Plast Reconstr Surg. 2000;105:1640–1648.
references: Kroll SS, Netscher DT. Complications of TRAM flap breast reconstruction in obese patients. Plast Reconstr Surg. 1989;84:886–892.
references: Paige KT, Bostwick J III, Bried JT, Jones G. A comparison of morbidity from bilateral, unipedicled and unilateral, unipedicled TRAM flap breast reconstructions. Plast Reconstr Surg. 1998;101:1819–1827.
references: Janali S, Nelson J, Sonnad S, et al. Breast reconstruction with free tissue transfer from the abdomen in the morbidly obese. Plast Reconstr Surg. 2011;127:2206–2213.
references: Garvey PB, Buchel EW, Pockaj BA, Gray RJ, Samson TD. The deep inferior epigastric perforator flap for breast reconstruction in overweight and obese patients. Plast Reconstr Surg. 2005;115:447–457.
references: Vyas RM, Dickinson BP, Fastekjian JH, Watson JP, Dalio AL, Crisera CA. Risk factors for abdominal donor-site morbidity in free flap breast reconstruction. Plast Reconstr Surg. 2008;121:1519–1526.
references: Rao SS, Parikh PM, Goldstein JA, Nahabedian MY. Unilateral failures in bilateral microvascular breast reconstruction. Plast Reconstr Surg. 2010;126:17–25.
references: Guerra AB, Metzinger SE, Bidros RS, et al. Bilateral breast reconstruction with the deep inferior epigastric perforator (DIEP) flap: An experience with 280 flaps. Ann Plast Surg. 2004;52:246–252.