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Which Breast Is the Best? Successful Autologous or Alloplastic Breast Reconstruction: Patient-Reported Quality-of-Life Outcomes

Eltahir, Yassir M.D.; Werners, Lisanne L. C. H.; Dreise, Marieke M.; Zeijlmans van Emmichoven, Ingeborg A. Ph.D.; Werker, Paul M. N. M.D., Ph.D.; de Bock, Geertruida H. Ph.D.

Plastic and Reconstructive Surgery: January 2015 - Volume 135 - Issue 1 - p 43–50
doi: 10.1097/PRS.0000000000000804
Breast: Outcomes Article
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Background: Breast reconstruction is an appropriate option offered to women who are diagnosed with breast cancer or gene mutations. It may be accomplished with implants or autologous procedures. This cross-sectional study evaluated the satisfaction and quality of life in addition to complications and secondary corrections in women after successful autologous or alloplastic (implant) breast reconstruction.

Methods: Women were included after successful breast reconstruction. The BREAST-Q instrument and standardized questionnaires on depression, recurrence concerns, and anxiety were sent by mail to the participants. In addition, data were collected on complications and secondary corrections. Multiple regression analysis and chi-square tests were applied to evaluate differences between the autologous breast reconstruction group (n = 47) and the implant breast reconstruction group (n = 45).

Results: Women with a successful autologous reconstruction were significantly more satisfied with their reconstructed breasts than women with successful alloplastic breast reconstruction as measured with the BREAST-Q satisfaction with breasts module (p = 0.023). More women with an autologous breast reconstruction required secondary correction than women with an implant breast reconstruction (p = 0.012). Other findings did not differ between the two groups.

Conclusions: Autologous breast reconstruction leads to more satisfaction than does implant breast reconstruction, notwithstanding that women with an autologous breast reconstruction more often required a secondary correction. The study found no ideal breast reconstruction suitable for all patients. However, this study may inform patients and medical teams in making decisions about breast reconstruction. This pilot study indicated several questions that we plan to further investigate in a larger prospective study.

CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, III.

Groningen, The Netherlands

From the Department of Plastic Surgery, University Medical Centre Groningen.

Received for publication April 5, 2014; accepted June 27, 2014.

Disclosure: All authors declare they have no conflicts of interest regarding financial, personal, or other matters that might affect the information, research, analysis, or interpretation of this article.

Yassir Eltahir, M.D., Department of Plastic Surgery, University Medical Center Groningen, Hanzeplein 1, BB81, 9700 RB Groningen, The Netherlands, y.eltahir@umcg.nl

©2015American Society of Plastic Surgeons