Comparing autologous breast reconstruction in high

Background: Breast reconstruction has been shown to significantly improve quality of life (QoL) for women who must undergo mastectomy. Between the implant-based and autologous-based reconstruction, autologous-based reconstruction has demonstrated better outcomes in both QoL and overall satisfaction as reported by the BREAST-Q. For patients desiring autologous reconstruction, a woman's weight and body habitus can affect not only the pre-operative planning, but also outcomes in terms of both complications as well as overall satisfaction. Here, we present our cohort that has been stratified by body mass index (BMI) and compare how BMI can influence flap selection as well as complications. Methods: After institutional review board approval, a retrospective review in a REDCap database-guided analysis was conducted of patients who underwent autologous reconstruction with longitudinal follow-up at a single academic institution from 2013 to 2024. Patients were then stratified into BMI categories as outlined by the Centers for Disease Control (CDC) including healthy (18.5≤ BMI <25 kg/m Results: A total of 957 patients were identified who fit the inclusion criteria, with 239 patients sorted into the healthy (18.5≤ BMI <25 kg/m Conclusions: In this retrospective cohort study, we found that patients with healthy BMI are more likely to undergo multi-flap or non-abdominally based flap reconstruction and less frequently rely on DIEP flaps than women of overweight or obese BMI. Furthermore, patients with obese BMI are more likely to have post-operative complications at either the breast or donor site. A deeper look into perioperative data and complications will help understand other differences between the subgroups in terms of surgical efficacy and safety.