Relationship Between BMI and Quality of Life after DIEP Flap Breast Reconstruction

By: Courtney Floyd


For many patients, breast reconstruction plays an important role in recovery after breast cancer treatment. Thanks to the introduction of the BREAST-Q (a patient reporting tool aimed to measure breast reconstruction results), patient reported outcomes and quality of life can now be measured and better understood.

Prior research from PRMA found DIEP flap breast reconstruction was a safe option for patients with a high BMI (body mass index). However, until now, there was little evidence-based information regarding the effects of BMI on patient-reported outcomes and satisfaction after DIEP flap surgery.

The research from PRMA published in Plastic and Reconstructive Surgery shows that patients report significant improvements in breast satisfaction, psychosocial and sexual well-being after DIEP flap reconstruction, including those patients with a high BMI of 30 or over.

The study included 73 patients who underwent 130 DIEP flap breast reconstructions between July of 2012 and August of 2016. Each patient completed BREAST-Q questionnaires before their surgery, at one month after their surgery, and after their revision (or stage 2) surgery. The survey scores were compared at all time points and separated by BMI index group (≤25, >25 to 29.9, 30 to 34.9, and ≥35).

The survey results found that breast satisfaction, psychosocial and sexual well-being scores increased significantly after DIEP flap reconstruction across the board. Chest and abdominal physical well-being scores returned to baseline. But most noteworthy was the breast satisfaction and psychosocial well-being scores of patients with a BMI greater than 30. Prior to DIEP flap surgery the scores were low, but after reconstruction, these scores significantly improved.

So what’s the takeaway? DIEP flap is a great option for most patients who desire breast reconstruction. It has been shown to improve breast satisfaction and overall quality of life for patients, especially those with higher BMIs.

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