A retrospective analysis of patient satisfaction with immediate postmastectomy breast reconstruction: Comparison of three common procedures

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.