Current literature on reconstruction after head and neck cancer (HNC) focusses on short‐term patient‐reported outcomes (PROs), while there is a need for knowledge on long‐term consequences. Embase, Medline, Web of Science, and Cochrane were searched for studies on health‐related quality of life (HRQoL) after HNC reconstruction, using validated PROMs in at least 50 patients, and a follow‐up of more than 1 year. Thirty studies were included, comprising 2358 patients with a follow‐up between one and 10 years. The most used questionnaire was the UW‐QoL v4. Reconstructive surgery was generally followed by diminished oral function, worsened by radiotherapy. Patients experienced anxiety and fear of cancer recurrence. However, there was a progressive decrease in pain over time with some flaps having more favorable HRQoL outcomes. Age and bony tumor involvement were not related to postoperative HRQoL. These results may lead to better patient counseling and expectation management of HNC patients.

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Background Implants and DIEP flaps have different outcomes regarding postoperative breast sensation. When compared to the preoperative healthy breast, implant-based breast reconstruction (IBBR) negatively influences postoperative breast sensation. However, it is currently unknown whether a prior IBBR also influences postoperative sensation of a replacing DIEP flap. The goal of this cohort study is to evaluate the influence of an IBBR on the postoperative sensation of a replacing DIEP flap. Methods Women were included if they received a DIEP flap reconstruction after mastectomy, with or without prior tissue expander (TE) and/or definitive breast implant. Sensation was measured at four intervals in 9 areas of the breast with Semmes-Weinstein monofilaments: T0 (preoperative, implant/no reconstruction), T1 (2–7 months postoperative, DIEP), T2 (± 12 months postoperative, DIEP), Tmax (maximum follow-up, DIEP). Linear mixed models were used to investigate the relationship between an implant/TE prior to the DIEP flap and recovery of breast sensation. Results 142 women comprising 206 breasts were included. 48 (23.3%) breasts did, and 158 (76.7%) breasts did not have a TE/IBBR prior to their DIEP. No statistically significant or clinically relevant relationships were found between a prior implant/TE and recovery of DIEP flap breast sensation for the flap skin, native skin, or total breast skin at T1, T2, or Tmax. There were also no relationships found after adjustment for the confounders radiation therapy, BMI, diabetes, age, flap weight, follow-up, and nerve coaptation. Conclusions An implant/TE prior to a DIEP flap does not influence the recovery of postoperative breast sensation of the DIEP flap.