Background: Decision-making in breast reconstruction is complicated as women are offered an increasingly large range of options. Alloplastic surgery continues to evolve with the introduction of new prostheses to the breast reconstruction market but with limited patient-reported outcomes data. Evaluating the outcomes of surgical interventions and their impact on patients is imperative to improve the patient decision-making process and to improve quality of care. The authors evaluated the effect of the two most commonly used silicone prostheses on patient-reported satisfaction and health-related quality of life following alloplastic breast reconstruction.
Methods: Patients were deemed eligible if they had completed alloplastic reconstruction at least 1 year before study initiation. Patients were contacted by mail with the BREAST-Q questionnaire, a contact letter, and an incentive gift card. BREAST-Q scores were compared between shaped cohesive and round cohesive silicone gel implant recipients.
Results: Sixty-five round, cohesive, non–form-stable and 63 shaped, cohesive, form-stable silicone gel implant recipients responded, for an overall response rate of 75 percent. BREAST-Q responses showed no difference on any scale, including overall satisfaction with breast and outcome. Item-wise analysis revealed that implant recipients find shaped cohesive form-stable implants to be significantly firmer than cohesive round implants. No difference was found in implant rippling.
Conclusion: Although previous studies have shown silicone implant recipients to be more satisfied overall than saline implant recipients after alloplastic breast reconstruction, this study showed that patients do not differ in terms of satisfaction with outcome when compared regarding reconstruction using round versus shaped cohesive silicone gel implants.
CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, III.
Vancouver, British Columbia, Canada; and New York, N.Y.
From the Department of Surgery, Division of Plastic and Reconstructive Surgery, University of British Columbia, and the Plastic and Reconstructive Surgery Service, Memorial Sloan-Kettering Cancer Center.
Received for publication June 1, 2012; accepted September 17, 2012.
Disclosure: Dr. Pusic is a co-developer of the BREAST-Q, which is owned by Memorial Sloan-Kettering Cancer Center and the University of British Columbia. She receives a share of any license revenues based on the inventor sharing policies of these two institutions. Dr. Lennox is a paid consultant for McGhan/Inamed (Allergan Inc., Irvine Calif.). None of the other authors has any disclosures.
Sheina A. Macadam, M.D., M.H.S.; Plastic and Reconstructive Surgery, University of British Columbia, Suite 1000, 777 West Broadway, Vancouver, British Columbia V5Z 4J7, Canada, firstname.lastname@example.org