Impact of Obesity on Breast Surgery Complications

Sir:FigureWe read the article by Chen et al.1 with interest. The authors performed a retrospective review of a substantial data set obtained from insurance claims. The point is well taken that a procedure with a higher complication rate will have revenue implications. However, one has to consider surgical outcome in terms of patient satisfaction and improvement in quality of life, particularly in this breast surgery group. In two studies measuring quality of life in breast surgical procedures,2,3 the subset with a body mass index greater than 30 was as likely to gain as much benefit as other patients with lower or normal body mass index. Cost does increase in line with longer hospital stay, but fully informed patients with higher body mass indexes may choose to accept the increased risk associated with this to achieve symptom relief and improvement in quality of life. The decision to operate in some of these cases should not be unduly influenced by the presence of obesity. Ben Khoda, M.R.C.S.(Eng.) Richard P. Cole, F.R.C.S.(Ed.&Eng.), F.R.C.S.(Plast.) Wessex Center for Burns and Plastic Surgery Salisbury NHS Foundation Trust Salisbury, United Kingdom DISCLOSURE The authors have no financial interest to declare in relation to the content of this communication.