Each 100-gram increase in flap weight raises the risk of fat necrosis by 50% in women undergoing breast reconstruction after mastectomy, according to a study published in Plastic and Reconstructive Surgery. Including more than one perforator might decrease the risk of necrosis in large flaps, researchers said. "Perforator flap breast reconstruction can be performed safely," they said. "However, considerations concerning race, body mass index, staging with tissue expanders and flap weight may optimize outcomes."

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