Document Detail

Patient satisfaction in unilateral and bilateral breast reconstruction [outcomes article].
MedLine Citation:
PMID:  21460649     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The goal of reconstruction after mastectomy is to provide a long-term and symmetric reconstruction. Providing symmetry entails different decision making when faced with a unilateral or bilateral reconstruction. In unilateral reconstruction, the goal is to match the contralateral breast; however, in bilateral reconstruction, symmetry between the reconstructed breasts is more important. The purpose of this study was to examine patient satisfaction between unilateral and bilateral reconstruction.
METHODS: All women at Beth Israel Deaconess Medical Center undergoing breast reconstruction between 1999 and 2006 were identified. Patient demographics and complications were collected. A survey was administered examining general and aesthetic satisfaction. Patients with unilateral reconstruction were identified and compared with patients with bilateral reconstruction. Additional analysis was performed based on the type of reconstruction, including autologous, autologous with implant, and tissue expander/implant-based reconstruction.
RESULTS: Overall, 702 women underwent 910 breast reconstructions (494 unilateral, 416 bilateral). Patients in the bilateral reconstruction group were more likely to have prophylactic mastectomy and immediate reconstruction. Complication rates were similar between unilateral and bilateral reconstruction. Patient satisfaction was highest in unilateral patients with autologous compared with implant reconstruction (general satisfaction, 73.9 versus 40.9 percent, p < 0.0001; aesthetic satisfaction, 72.3 versus 43.2 percent, p < 0.0001). Bilateral reconstruction had similar general and aesthetic satisfaction scores across autologous, autologous with implant, and implant-based reconstruction.
CONCLUSIONS: Patients undergoing unilateral reconstruction have the highest satisfaction with autologous reconstruction. As symmetry between reconstructed breasts is essential for patient satisfaction in bilateral reconstruction, it is important to use the same type of reconstruction, whether autologous or implant-based.
Randall O Craft; Salih Colakoglu; Michael S Curtis; Janet H Yueh; Britt S Lee; Adam M Tobias; Bernard T Lee
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Plastic and reconstructive surgery     Volume:  127     ISSN:  1529-4242     ISO Abbreviation:  Plast. Reconstr. Surg.     Publication Date:  2011 Apr 
Date Detail:
Created Date:  2011-04-04     Completed Date:  2011-05-26     Revised Date:  2014-10-13    
Medline Journal Info:
Nlm Unique ID:  1306050     Medline TA:  Plast Reconstr Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1417-24     Citation Subset:  AIM; IM    
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MeSH Terms
Breast Implants / adverse effects
Breast Neoplasms / genetics,  prevention & control,  surgery
Mammaplasty* / adverse effects,  methods,  psychology
Middle Aged
Outcome Assessment (Health Care)
Patient Satisfaction*
Surgical Flaps
Tissue Expansion Devices / adverse effects
Comment In:
Plast Reconstr Surg. 2012 Feb;129(2):359e-361e; author reply 361e   [PMID:  22286457 ]
Plast Reconstr Surg. 2011 Apr;127(4):1425-7   [PMID:  21460650 ]

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