Determinants of Aesthetic Satisfaction Following TRAM and Implant Breast Reconstruction

Shaikh-Naidu, Nina; Preminger, Beth Aviva; Rogers, Kenneth; Messina, Pamela; Gayle, Lloyd B.

doi:10.1097/01.sap.0000123901.06133.b7

Cited by 74 publications

(41 citation statements)

References 22 publications

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“…Numerous studies have shown that patients who undergo postmastectomy, implant-based reconstruction after the receipt of preoperative chest wall irradiation have a higher incidence of complications, including capsular contracture, 19,[24][25][26] and that the receipt of postmastectomy adjuvant radiotherapy is correlated with both the development of complications and increased patient dissatisfaction. [27][28][29][30] Thus, the determination of effect size herein allowed clinically meaningful comparisons to be made between the effects of a known entity (such as postmastectomy radiotherapy) versus other clinical variables (such as implant type) that may have an impact on patients' satisfaction with their reconstructed breasts.…”

Section: Discussionmentioning

confidence: 99%

Patient satisfaction with postmastectomy breast reconstruction

McCarthy¹,

Klassen²,

Cano³

et al. 2010

Cancer

116

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BACKGROUND. At a time when the safety and effectiveness of breast implants remains under close scrutiny, it is important to provide reliable and valid evidence regarding patient outcomes. In the setting of postmastectomy reconstruction, patient satisfaction and quality of life may be the most significant outcome variables when evaluating surgical success. The objective of the current study was to identify predictors of patient satisfaction with breast appearance, including implant type, in a large sample of women who underwent breast reconstruction surgery using implants. METHODS. A multicenter, cross-sectional study design was used. A total of 672 women who had completed postmastectomy, implant-based reconstruction at 1 of 3 centers in North America were asked to complete the BREAST-Q (Reconstruction Module). Multivariate linear regression modeling was performed. RESULTS. Completed questionnaire data were available for 482 of the 672 patients. In 176 women, silicone implants were placed and in 306, saline implants were used. The multivariate model confirmed that patients' satisfaction with their breasts was significantly higher in patients with silicone implants (P ¼ .016). The receipt of postmastectomy radiotherapy was found to have a significant, negative effect on breast satisfaction (P<.000) in both silicone and saline implant recipients. In addition, for women who received either silicone or saline implants, satisfaction diminished over time (P ¼ .017). CONCLUSIONS. In the setting of postmastectomy reconstruction, patients who received silicone breast implants reported significantly higher satisfaction with the results of reconstruction than those who received saline implants. This information can be used to optimize shared medical decision-making by providing patients with realistic postoperative expectations. Cancer 2010;116:5584-91.

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Section: Discussionmentioning

confidence: 99%

Patient satisfaction with postmastectomy breast reconstruction

McCarthy¹,

Klassen²,

Cano³

et al. 2010

Cancer

116

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“…Radiotherapy after mastectomy but before reconstruction has not been shown to increase complications after autologous reconstruction (25); however, not all studies are in agreement (26,27). Certain studies show that postoperative radiotherapy to the breast reconstructed with a deep inferior epigastric perforator flap (DIEP) or transverse rectus abdominis myocutaneous (TRAM) flap has no effect on the reconstruction (28,29), while several others show a considerable negative effect on the final results of autologous reconstruction (24,26,(30)(31)(32)(33)(34).…”

Section: The Effect Of Radiotherapy On Breast Reconstructionmentioning

confidence: 99%

Patient determinants as independent risk factors for postoperative complications of breast reconstruction

et al. 2017

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being, health-related quality of life and satisfaction (5,7-10).Patients' satisfaction and health-related quality of life are frequently used as parameters for outcome measurement in plastic surgery. Postoperative complications after breast reconstruction are common and affect patient satisfaction.Determining independent risk factors using patient characteristics could be advantageous for patient assessment and counseling. 2.05, 95% confidence interval (CI) 1.25-3.37, P=0.0005], followed by body mass index (BMI) (OR 1.07, 95% CI 1.01-1.13, P=0.017). High BMI was associated with the highest number of late overall postoperative complications (OR 1.06, 95% CI 1.00-1.11, P=0.042), followed by history of radiotherapy (OR 1.66, 95% CI 1.01-2.74, P=0.046). When the risk factors were combined, the risk for postoperative complications rose exponentially.Conclusions: Our results provide evidence that patients should cease smoking and overweight patients should lose weight before undergoing breast reconstruction. Additionally, if the patient has received radiotherapy, the reconstruction method should be carefully chosen. High BMI, history of radiotherapy, and smoking are independent risk factors for many types of both early and late postoperative complications in breast reconstructive surgery. Combining these risk factors multiplies the risk of postoperative complications.

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“…Por lo tanto, es muy difícil evaluar de forma científica estos aspectos en lo relativo a los resultados obtenidos en una reconstrucción mamaria, si bien en la actualidad, muchos estudios tienden a centrarse en la valoración de este aspecto. En este sentido, la tendencia actual de los estudios sobre el tema centran la atención en valorar los índices de satisfacción logrados con la reconstrucción realizada (6)(7)(8)(9)(10)(11).…”

Section: Discussionunclassified

Reconstrucción mamaria con colgajo músculo-cutáneo transverso de recto abdominal (TRAM) y simetrización simultánea

Giachero-Castaño¹,

Jacobo-Bastreri²,

Grattarola-Rizzo³

et al. 2010

Cir. plást. iberolatinoam.

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Palabras clave Reconstrucción mamaria, Colgajo TRAM, Simetrización mamaria. Código numérico 5214-52140-158332En la literatura es escasa la información enfocada al análisis de los resultados de la reconstrucción postmastectomía con simetrización simultánea de la mama contralateral. El objetivo de nuestro trabajo es revisar la experiencia de la Cátedra de Cirugía Plástica y Quemados de la Facultad de Medicina de la Universidad de la República en Montevideo, Uruguay, en reconstrucción de mama con colgajo músculocutá-neo transverso de recto abdominal (TRAM) pediculado y simetrización simultánea mediante mamoplastia contralateral.Evaluamos en forma prospectiva 5 pacientes, con mamas excesivamente grandes o ptósicas. El método de mamoplastia utilizado incluyó pexia o reducción, tanto a pedículo superior como inferior, utilizando siempre un patrón de incisiones en T invertida. El tiempo quirúrgico de la mamoplastia contralateral fue superpuesto al de otras etapas del mismo acto quirúrgico, ya sea a la mastectomía, en los casos en que se realizó reconstrucción simultánea, o a la elevación del colgajo abdominal, cuando la reconstrucción fue diferida.Los resultados se evaluaron a largo plazo, considerando tanto el grado de satisfacción general logrado con el procedimiento, como el grado de satisfacción en cuanto a aspectos estéticos específicos. Constatamos altos índices de satisfacción en las pacientes tratadas. El número de complicaciones no fue mayor al descrito en la literatura para la reconstrucción mamaria sin simetrización. El tiempo de recuperación para desarrollar las actividades habituales fue siempre inferior a 2 meses.Como conclusión, la reconstrucción mamaria con colgajo TRAM y simetrización simultanea mediante plastia de la mama contralateral en un solo tiempo operatorio, es un procedimiento que logra buenos resultados a largo plazo y permite emplear colgajos menos voluminosos, sin aumentar la morbilidad ni el tiempo operatorio y con menor número de cirugías mayores complementarias en diferido.Reconstrucción mamaria con colgajo músculo-cutáneo transverso de recto abdominal (TRAM) y simetrización simultánea Resumen AbstractBreast reconstruction with transverse rectus abdominis miocutaneous (TRAM) flap and simultaneous symmetrization Giachero-Castaño, V.*, Jacobo-Bastreri, O.**, Grattarola-Rizzo, G.***, Carriquiry-Kayel, C.**** Scientific reports analyzing the outcome of postmastectomy with simultaneous symmetrization of the opposite breast are scarce. The purpose of this study is the analysis of the experience with breast reconstruction with the pedicled transverse rectus abdominis myocutaneous (TRAM) flap and simultaneous symmetrization with opposite mammoplasty, at the Cátedra de Cirugía Plástica y Quemados, Facultad de Medicina de la Universidad de la República, Montevideo, Uruguay.A retrospective review was performed on 5 patients. Mammoplasty technique used was either mastopexy or breast reduction, with superior or inferior based pedicle, always with the T-inverted incisions. The contralateral mammoplast...

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Determinants of Aesthetic Satisfaction Following TRAM and Implant Breast Reconstruction

Cited by 74 publications

References 22 publications

Patient satisfaction with postmastectomy breast reconstruction

Patient satisfaction with postmastectomy breast reconstruction

Patient determinants as independent risk factors for postoperative complications of breast reconstruction

Reconstrucción mamaria con colgajo músculo-cutáneo transverso de recto abdominal (TRAM) y simetrización simultánea

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