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A Retrospective Analysis of Patient Satisfaction with Immediate Postmastectomy Breast Reconstruction: Comparison of Three Common Procedures

Saulis, Alexandrina S. M.D.; Mustoe, Thomas A. M.D.; Fine, Neil A. M.D.

Plastic and Reconstructive Surgery: May 2007 - Volume 119 - Issue 6 - p 1669-1676
doi: 10.1097/01.prs.0000258827.21635.84
Breast: Original Articles

Background: The authors aimed to quantify overall patient satisfaction with three breast reconstruction techniques and identify factors that have influenced satisfaction.

Methods: Two hundred sixty-eight questionnaires were mailed at least 6 months after immediate breast reconstruction to consecutive breast reconstruction patients over a 3-year period. A second questionnaire was sent out 9 months later to the tissue expander/implant group of patients.

Results: The initial questionnaire demonstrated that overall satisfaction was significantly greater in the transverse rectus abdominis myocutaneous (TRAM) flap patients as compared with the tissue expander/implant patients (p < 0.05). However, the number of patients willing to repeat the procedure and recommend their procedure to a friend was similar among all three reconstructive techniques. A significantly greater number of tissue expander/implant patients as compared with TRAM flap patients felt they had not received sufficient information to make an educated decision (p < 0.05). This finding correlated with the lower satisfaction rate among the tissue expander/implant patients. The second questionnaire sent only to the tissue expander/implant patients revealed that the majority felt uninformed about the final aesthetic outcome and the frequency and pain associated with the expansion process.

Conclusions: All three groups may claim to be satisfied with their own personal choices. Many patients will continue to choose tissue expander/implant reconstruction in an effort to avoid scars and more extensive surgery. Being less satisfied is not wrong or bad, provided it is known. Tissue expander/implant patients should be thoroughly informed in the preoperative setting about the final aesthetic outcomes and the immediate perioperative expansion period, which may involve a considerable amount of patient commitment and discomfort in some women.

Chicago, Ill.

From the Division of Plastic and Reconstructive Surgery, Northwestern University, Feinberg School of Medicine.

Received for publication July 16, 2005; accepted November 17, 2005.

Presented at the 71st Annual Scientific Meeting of the American Society of Plastic Surgeons, in San Antonio, Texas, November 2 through 6, 2002, and at the 41st Annual Scientific Meeting of the Midwestern Association of Plastic Surgeons, in Chicago, Illinois, April 20 through 21, 2002.

Neil A. Fine, M.D., 676 North St. Clair Street, Suite 19-250, Chicago, Ill. 60611,

©2007American Society of Plastic Surgeons