Researchers looked at 147 patients who had breast reconstruction surgery using their own body tissue to see if vitamin D levels before surgery affected their recovery. They found that patients with low vitamin D were more likely to develop infections, fluid buildup at the donation site, and other medical problems after surgery. While this doesn’t prove vitamin D causes these issues, it suggests that checking and optimizing vitamin D levels before surgery might help patients heal better and have fewer complications.

The Quick Take

  • What they studied: Whether having low vitamin D before breast reconstruction surgery increases the risk of healing problems and infections after surgery
  • Who participated: 147 patients who had autologous breast reconstruction (surgery using their own abdominal tissue to rebuild the breast) at an academic medical center, all of whom had vitamin D blood tests within three months before surgery
  • Key finding: Patients with low vitamin D (below 30 ng/mL) were nearly 3 times more likely to get surgical site infections, 13 times more likely to develop fluid collections at the donation site, and 4 times more likely to have other medical complications compared to those with adequate vitamin D
  • What it means for you: If you’re planning breast reconstruction surgery, getting your vitamin D checked beforehand and correcting any deficiency may help reduce your risk of complications. However, this study shows an association, not proof of cause-and-effect, so talk with your surgeon about your individual situation.

The Research Details

This was a retrospective study, meaning researchers looked back at medical records of patients who had already undergone surgery. They reviewed 147 patients who had autologous breast reconstruction (using their own abdominal tissue) and had vitamin D blood tests done within three months before their surgery. The researchers compared outcomes between patients with low vitamin D levels (below 30 ng/mL, considered insufficient) and those with adequate levels, looking at complications like infections, fluid buildup, and other medical problems that occurred after surgery.

The researchers used standard statistical methods to analyze the data and determine whether the differences between groups were likely due to vitamin D levels or just random chance. They looked at both simple comparisons and more complex analyses that accounted for other factors that might affect healing, like age, weight, smoking status, and other health conditions.

This research approach is important because it allows researchers to study real-world surgical outcomes and identify patterns that might not be obvious. By looking at actual patient data, they can see whether vitamin D status truly relates to healing problems. This type of study is often the first step in identifying potential risk factors that doctors should pay attention to before surgery.

This study has some strengths: it looked at a reasonable number of patients (147) at an academic medical center with good record-keeping, and the researchers used proper statistical methods. However, because it’s retrospective, the researchers couldn’t control all the factors that might affect outcomes. Some patients may have had other unmeasured differences that affected their healing. Additionally, the study was done at a single institution, so results might not apply to all populations. The findings suggest an association but don’t prove that low vitamin D directly causes complications.

What the Results Show

The main finding was that patients with vitamin D insufficiency (levels below 30 ng/mL) had significantly higher rates of complications after surgery. Specifically, these patients were 2.8 times more likely to develop surgical site infections—meaning bacteria got into the incision area. They were 13.2 times more likely to develop seromas at the donor site, which are collections of fluid that can form where tissue was removed from the abdomen. They were also 4 times more likely to experience other medical complications during their hospital stay or recovery.

These associations remained significant even when researchers accounted for other factors that could affect healing, such as patient age, weight, smoking status, and other health conditions. This suggests that vitamin D status itself may be an important factor, rather than these complications being caused by other differences between the groups.

The study included 147 patients total, and the researchers had complete vitamin D measurements and outcome data for all of them, which strengthens the reliability of the findings.

While the study focused primarily on infections and fluid collections, the finding that low vitamin D was associated with general medical complications (4-fold increased risk) suggests broader impacts on recovery. This could include things like delayed wound healing, increased inflammation, or other systemic effects. The researchers noted that vitamin D plays important roles in immune function and wound healing, which helps explain why these complications might be more common in deficient patients.

This study builds on previous research showing that vitamin D deficiency is linked to worse surgical outcomes in other types of surgery. Animal studies have shown that vitamin D is important for proper wound healing. Other clinical studies in different surgical populations have found connections between low vitamin D and infections, longer hospital stays, and more complications. This breast reconstruction study extends those findings to a specific surgical population and confirms that the pattern holds true in this group.

The study has several important limitations. First, it’s retrospective, meaning researchers looked back at existing data rather than planning a study in advance and carefully controlling conditions. Second, it was conducted at a single academic medical center, so the results might not apply to all hospitals or all patient populations. Third, the researchers couldn’t randomly assign patients to have low or high vitamin D—they just observed what happened naturally—so they can’t prove that low vitamin D directly causes the complications. Other unmeasured factors could explain the connection. Fourth, the study doesn’t tell us whether correcting vitamin D deficiency before surgery would actually prevent these complications. Finally, the study is relatively small, and some of the findings (especially the very high odds ratio for seromas) might be less stable with a larger sample.

The Bottom Line

Based on this research, it appears reasonable for patients planning breast reconstruction surgery to have their vitamin D levels checked before surgery. If levels are low, discussing vitamin D supplementation with your doctor may be worthwhile. However, this is a moderate-strength recommendation based on observational evidence showing an association, not proof of benefit. Patients should discuss vitamin D status with their surgical team as part of pre-operative planning. The evidence suggests potential benefit, but larger studies are needed to confirm whether correcting deficiency actually prevents complications.

This research is most relevant to people planning autologous breast reconstruction surgery (using their own tissue). It may also be relevant to people having other types of surgery, though the findings are specific to breast reconstruction. People with known vitamin D deficiency or risk factors for deficiency (limited sun exposure, dark skin in northern climates, dietary restrictions, certain medical conditions) should particularly consider getting tested. However, this study doesn’t apply to people not having surgery or those having implant-based reconstruction rather than autologous reconstruction.

If you’re planning surgery, vitamin D supplementation typically takes several weeks to months to raise levels meaningfully. Ideally, vitamin D status should be optimized several months before elective surgery if possible. If surgery is urgent, there may not be time to correct deficiency, but it’s still worth discussing with your surgical team. Benefits in terms of reduced complications would be expected during the immediate post-operative period and the first few months of recovery.

Want to Apply This Research?

  • If you’re planning surgery, track your vitamin D supplementation doses and timing, and log your vitamin D blood test results (25-OH vitamin D level in ng/mL) with target goal of at least 30 ng/mL. Record the date of testing and any changes your doctor recommends.
  • Users planning breast reconstruction surgery can use the app to set a reminder to discuss vitamin D testing with their surgeon during pre-operative consultations. If supplementation is recommended, set daily reminders for taking vitamin D supplements and track compliance. Log any symptoms of deficiency (fatigue, muscle weakness, bone pain) to discuss with your healthcare provider.
  • For long-term tracking, monitor vitamin D levels through periodic blood tests (typically every 2-3 months during supplementation, then annually once adequate levels are achieved). Track any post-operative complications and correlate with vitamin D status. After surgery, continue monitoring vitamin D levels as part of overall wellness, since adequate levels support bone health and immune function beyond just surgical recovery.

This research shows an association between low vitamin D and surgical complications, but does not prove that vitamin D deficiency directly causes these problems. This information is educational and should not replace professional medical advice. If you are planning surgery or have concerns about vitamin D levels, consult with your surgeon or primary care physician before making any changes to supplementation or medical care. Individual vitamin D needs vary based on age, health status, medications, and other factors. Do not start, stop, or change any supplements without discussing with your healthcare provider first.