Smoking increases donor site complications in breast reconstruction with DIEP flap

Objective: Reconstruction with deep inferior epigastric perforator flap (DIEP) is considered to be the first choice for autologous breast reconstruction. The primary aims of this retrospective study were to find out if differences in smoking habits and BMI are useful predictors for postoperative complications in DIEP surgery. Methods: Three hundred and one patients were included. Data regarding smoking habits, BMI, age at surgery, total and final flap weight, abdominal scars, parity, number of perforators, chemotherapy, post mastectomy radiation therapy, and preoperative mapping of perforators with either Computer Tomography Angiography or hand-held ultra sound Doppler were collected. Complications that occurred in the first 30 postoperative days were taken into account. Results and conclusions: It was found that former smokers had a risk for donor site complication more than double that of never smokers (OR =2.12, CI =1.10–4.10, p = 0.025). Differences in BMI within the range from 18–33.7 did not have any significant impact on complication rates, neither at the donor site nor at the breast.