{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T23:43:58Z","timestamp":1792107838387,"version":"4.4.0"},"reference-count":22,"publisher":"Georg Thieme Verlag KG","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Reconstr Microsurg"],"abstract":"Abstract<\/jats:title>\n As patients undergoing deep inferior epigastric perforator (DIEP) flap breast reconstruction frequently anticipate improved abdominal contour, they may also expect a degree of meaningful weight loss. This study aims to clarify whether patients undergoing mastectomy with DIEP flap breast reconstruction experience a significant and durable change in body mass index (BMI).<\/jats:p>\n A single-institution, retrospective cohort study was performed on patients who underwent DIEP flap breast reconstruction between 2020 and 2021. Patients were included if they had BMI data available from \u2264\u20093 months before mastectomy until \u2265\u20092 years after reconstruction. Every BMI data point within this timeframe was captured. Longitudinal BMI trends were analyzed using a mixed-effects model for the overall cohort and for subgroups of patients with immediate or delayed breast reconstruction.<\/jats:p>\n A total of 143 patients (median age at reconstruction, 51.6 years) were included. Most patients (55.5%) underwent unilateral mastectomy and reconstruction. The mean mastectomy tissue masses were 640.8\u2009g (SD 260.9) and 1,363.5\u2009g (SD 713.9) for unilateral and bilateral cases, respectively. In the overall cohort and delayed reconstruction subgroup, there were no significant changes in BMI between pre-mastectomy and post-reconstruction periods. In contrast, patients with immediate reconstruction experienced a BMI decrease of 0.445\u2009kg\/m2 between pre-procedure and post-procedure periods (p\u2009=\u20090.023), corresponding to a weight loss of 2.70 lbs.<\/jats:p>\n In a cohort of 143 patients, we did not find evidence of clinically significant BMI change associated with mastectomy and DIEP flap breast reconstruction. These results may improve the comprehensiveness and clarity of perioperative counseling, ensuring patients formulate evidence-based reconstructive preferences.<\/jats:p>","DOI":"10.1055\/a-2972-6100","type":"journal-article","created":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T22:46:22Z","timestamp":1792104382000},"source":"Crossref","is-referenced-by-count":0,"title":["BMI Changes Associated with DIEP Flap Breast Reconstruction"],"prefix":"10.1055","author":[{"given":"Denisse Cristina","family":"Porras Fimbres","sequence":"first","affiliation":[{"name":"Duke University Medical Center, North Carolina, United States","place":["Durham"],"department":["Department of Surgery, Division of Plastic and Maxillofacial Surgery"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-2236-4964","authenticated-orcid":false,"given":"Chanel Rachel","family":"Varney","sequence":"first","affiliation":[{"name":"Duke University School of Medicine, North Carolina, United States","place":["Durham"],"department":["Department of Surgery, Division of Plastic and Maxillofacial Surgery"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meredith","family":"Cox","sequence":"additional","affiliation":[{"name":"Duke University School of Medicine, North Carolina, United States","place":["Durham"],"department":["Department of Surgery, Division of Plastic and Maxillofacial Surgery"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tara","family":"Pillai","sequence":"additional","affiliation":[{"name":"Duke University School of Medicine, North Carolina, United States","place":["Durham"],"department":["Department of Surgery, Division of Plastic and Maxillofacial Surgery"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brett T.","family":"Phillips","sequence":"additional","affiliation":[{"name":"Duke University Medical Center, North Carolina, United States","place":["Durham"],"department":["Department of Surgery, Division of Plastic and Maxillofacial Surgery"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2026,10,15]]},"reference":[{"issue":"02","key":"ref1","doi-asserted-by":"crossref","first-page":"201e","DOI":"10.1097\/PRS.0b013e31829586a7","article-title":"Quality-of-life outcomes between mastectomy alone and breast reconstruction: comparison of patient-reported BREAST-Q and other health-related quality-of-life measures","volume":"132","author":"Y Eltahir","year":"2013","journal-title":"Plast Reconstr Surg"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"815498","DOI":"10.3389\/fonc.2022.815498","article-title":"Long-term patient satisfaction and quality of life following breast reconstruction using the BREAST-Q: a prospective cohort study","volume":"12","author":"M Shiraishi","year":"2022","journal-title":"Front Oncol"},{"issue":"12","key":"ref3","doi-asserted-by":"crossref","first-page":"1285","DOI":"10.1001\/jamasurg.2023.4432","article-title":"Patient preferences for postmastectomy breast reconstruction","volume":"158","author":"R L Shammas","year":"2023","journal-title":"JAMA Surg"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1016\/j.bjps.2025.05.029","article-title":"Time to final breast reconstruction: effect on quality of life and associated factors","volume":"106","author":"U Jaffry","year":"2025","journal-title":"J Plast Reconstr Aesthet Surg"},{"issue":"03","key":"ref5","doi-asserted-by":"crossref","first-page":"745","DOI":"10.1111\/j.1475-6773.2005.00383.x","article-title":"Satisfaction with surgery outcomes and the decision process in a population-based sample of women with breast cancer","volume":"40","author":"P M Lantz","year":"2005","journal-title":"Health Serv Res"},{"issue":"08","key":"ref6","doi-asserted-by":"crossref","first-page":"741","DOI":"10.1001\/jamasurg.2017.0977","article-title":"Quality of patient decisions about breast reconstruction after mastectomy","volume":"152","author":"C NH Lee","year":"2017","journal-title":"JAMA Surg"},{"issue":"07","key":"ref7","doi-asserted-by":"crossref","first-page":"e6011","DOI":"10.1097\/GOX.0000000000006011","article-title":"Long-term donor site-related quality of life after deep inferior epigastric perforator flap breast reconstruction","volume":"12","author":"A Svee","year":"2024","journal-title":"Plast Reconstr Surg Glob Open"},{"issue":"06","key":"ref8","doi-asserted-by":"crossref","first-page":"789","DOI":"10.1016\/j.bjps.2014.02.008","article-title":"DIEP flap for breast reconstruction: retrospective evaluation of patient satisfaction on abdominal results","volume":"67","author":"J Niddam","year":"2014","journal-title":"J Plast Reconstr Aesthet Surg"},{"issue":"08","key":"ref9","doi-asserted-by":"crossref","first-page":"1062","DOI":"10.1016\/j.bjps.2011.03.030","article-title":"Women's motives to opt for either implant or DIEP-flap breast reconstruction","volume":"64","author":"J P Gopie","year":"2011","journal-title":"J Plast Reconstr Aesthet Surg"},{"issue":"01","key":"ref10","doi-asserted-by":"crossref","first-page":"51e","DOI":"10.1097\/PRS.0000000000011959","article-title":"What happens to weight following abdominoplasty: an analysis of 188 consecutive cases","volume":"156","author":"J Bricker","year":"2025","journal-title":"Plast Reconstr Surg"},{"issue":"02","key":"ref11","doi-asserted-by":"crossref","first-page":"238e","DOI":"10.1097\/PRS.0b013e3182778649","article-title":"Weight reduction following abdominoplasty: a retrospective case review pilot study","volume":"131","author":"J C Fuller","year":"2013","journal-title":"Plast Reconstr Surg"},{"issue":"02","key":"ref12","doi-asserted-by":"crossref","first-page":"314e","DOI":"10.1097\/PRS.0b013e3182958bcc","article-title":"Weight reduction following abdominoplasty: a systematic review","volume":"132","author":"E Demiri","year":"2013","journal-title":"Plast Reconstr Surg"},{"issue":"02","key":"ref14","doi-asserted-by":"crossref","first-page":"727","DOI":"10.1007\/s10549-012-2085-6","article-title":"Weight change associated with anastrozole and tamoxifen treatment in postmenopausal women with or at high risk of developing breast cancer","volume":"134","author":"I Sestak","year":"2012","journal-title":"Breast Cancer Res Treat"},{"issue":"09","key":"ref15","doi-asserted-by":"crossref","first-page":"2381","DOI":"10.1200\/JCO.2001.19.9.2381","article-title":"Changes in weight, body composition, and factors influencing energy balance among premenopausal breast cancer patients receiving adjuvant chemotherapy","volume":"19","author":"W Demark-Wahnefried","year":"2001","journal-title":"J Clin Oncol"},{"issue":"01","key":"ref16","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1186\/s13058-025-02079-6","article-title":"Long-term weight change among breast cancer patients treated with chemotherapy: a longitudinal study over 13 years","volume":"27","author":"M His","year":"2025","journal-title":"Breast Cancer Res"},{"issue":"01","key":"ref17","doi-asserted-by":"crossref","first-page":"259","DOI":"10.1186\/s12885-017-3242-4","article-title":"Weight change during chemotherapy in breast cancer patients: a meta-analysis","volume":"17","author":"M MGA van den Berg","year":"2017","journal-title":"BMC Cancer"},{"issue":"02","key":"ref18","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1007\/s10549-006-9442-2","article-title":"Weight gain and recovery of pre-cancer weight after breast cancer treatments: evidence from the women's healthy eating and living (WHEL) study","volume":"105","author":"N Saquib","year":"2007","journal-title":"Breast Cancer Res Treat"},{"issue":"08","key":"ref19","doi-asserted-by":"crossref","first-page":"2444","DOI":"10.1245\/s10434-019-07251-9","article-title":"Psychosocial functioning in women with early breast cancer treated with breast surgery with or without immediate breast reconstruction","volume":"26","author":"H Retrouvey","year":"2019","journal-title":"Ann Surg Oncol"},{"issue":"28","key":"ref21","doi-asserted-by":"crossref","first-page":"3169","DOI":"10.1200\/JCO.2015.61.1095","article-title":"Results of the Exercise and Nutrition to Enhance Recovery and Good Health for You (ENERGY) trial: a behavioral weight loss intervention in overweight or obese breast cancer survivors","volume":"33","author":"C L Rock","year":"2015","journal-title":"J Clin Oncol"},{"key":"ref22","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1038\/s41523-017-0040-8","article-title":"Randomized phase III trial evaluating the role of weight loss in adjuvant treatment of overweight and obese women with early breast cancer (Alliance A011401): study design","volume":"3","author":"J A Ligibel","year":"2017","journal-title":"NPJ Breast Cancer"},{"issue":"10","key":"ref23","doi-asserted-by":"crossref","first-page":"1194","DOI":"10.1001\/jamaoncol.2025.2738","article-title":"Impact of a weight loss intervention on 1-year weight change in women with stage II\/III breast cancer: secondary analysis of the Breast Cancer Weight Loss (BWEL) trial","volume":"11","author":"J A Ligibel","year":"2025","journal-title":"JAMA Oncol"},{"issue":"01","key":"ref24","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1002\/oby.23287","article-title":"The Breast Cancer Weight Loss trial (Alliance A011401): a description and evidence for the lifestyle intervention","volume":"30","author":"L M Delahanty","year":"2022","journal-title":"Obesity (Silver Spring)"}],"container-title":["Journal of Reconstructive Microsurgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2972-6100.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T22:46:35Z","timestamp":1792104395000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2972-6100"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,15]]},"references-count":22,"URL":"https:\/\/doi.org\/10.1055\/a-2972-6100","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0743-684X","1098-8947"],"issn-type":[{"value":"0743-684X","type":"print"},{"value":"1098-8947","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,15]]}}}