title: Body mass index as a predictor of postoperative complications in reduction mammaplasty.
abstract: BACKGROUND
  Obesity, determined by body mass index, is known to be associated with surgical complications. This study was performed to evaluate a correlation between body mass index and postoperative complications in reduction mammaplasty.
  
  
  METHODS
  The authors performed a retrospective analysis of consecutive reduction mammaplasties performed at the Brigham and Women's Hospital by eight surgeons between 1995 and 2007. Data regarding demographics, comorbidities, body mass index, reduction specimen weight, reduction technique, and complications were collected. Univariate and multivariate analyses were used to assess the association between body mass index and complication rates. Multivariate logistic regression analysis was used to determine the threshold body mass index value at which differential complication rates were maximal.
  
  
  RESULTS
  A total of 675 bilateral reduction mammaplasties were analyzed; 75 complications (11 percent) were observed, including hematoma, infection, necrosis, and reoperation. Mean body mass index was 31.0 ± 6.2. A significant association was noted between body mass index and complication rate on the basis of both univariate (p = 0.036) and multivariate (p = 0.037) analyses. Trend analysis of body mass index as a categorical variable relative to complication rate was also statistically significant (p = 0.01). A cutoff point was suggested whereby patients with a body mass index of more than 35.6 experienced a significantly higher complication rate than did patients below this threshold (odds ratio = 2.002; p = 0.004).
  
  
  CONCLUSIONS
  Body mass index is significantly associated with increased complications following reduction mammaplasty. An index value greater than 35.6 is associated with a twofold-higher risk of complications. Patients with a body mass index of 36 or above should be cautioned regarding a potential increased risk of complications.
  
  
  METHODS
  Risk, IV.
authors.affiliation: Boston, Mass. From the Division of Plastic Surgery, Department of Surgery, Harvard Medical School, Brigham and Women's Hospital; Boston University School of Medicine; and Brigham and Women's Hospital/Center for Surgery and Public Health.
authors.forename: Yoon S
authors.initials: YS
authors.lastname: Chun
authors.forename: Marissa A
authors.initials: MA
authors.lastname: Schwartz
authors.forename: Xiangmei
authors.initials: X
authors.lastname: Gu
authors.forename: Stuart R
authors.initials: SR
authors.lastname: Lipsitz
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Carty
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015992:Body Mass Index; D005260:Female; D006801:Humans; D016462:Mammaplasty / Q000009:adverse effects*; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology; D011379:Prognosis; D012189:Retrospective Studies; D055815:Young Adult