Journal of Plastic, Reconstructive & Aesthetic Surgery
Patient satisfaction with aesthetic outcome after bilateral prophylactic mastectomy and immediate reconstruction with implants☆
Section snippets
Materials
The purpose of this study was to evaluate the cosmetic outcome in a specific group of patients without a previous history of breast cancer who underwent bilateral prophylactic mastectomy and immediate breast reconstruction with implants. To be able to evaluate the final aesthetic result, patients who had undergone their last breast surgical procedure fewer than two years prior were excluded. Twenty-eight consecutive patients operated upon with bilateral prophylactic mastectomy and immediate
Breast symmetry
To evaluate symmetry between the right and the left breast, the positions of the nipple and submammary fold were calculated. This was done by measuring the distance between the jugulum and the nipple, the midline and the nipple, and the jugulum and the submammary fold on both sides with the patient in an upright position.17
Breast volume
The volume of the breast was estimated using a thermoplastic cast system, ORFIT®, which made a cast from each breast with the patient in an upright position. The cast was
Breast symmetry
The mean values and ranges of the distances are presented in Table 1. The calculated symmetry ratios between the right and left breasts did not differ significantly between patients and controls.
Breast volume
Breast sizes in patients and controls are presented in Table 1. There was no difference in the mean breast volume between the right and left breasts (volume symmetry) between patients and controls, and the mean breast volume did not differ significantly between the right and left breasts either within
Discussion
When a woman with a high risk of developing breast cancer seeks counseling about prophylactic mastectomy and breast reconstruction, she needs to receive extensive evidence-based information about the possible consequences of the surgery.12, 15 This is of specific importance since the surgical procedure is prophylactic and thus not mandatory. Perceived lack of information strongly correlates with less postoperative satisfaction. Since dissatisfaction with aesthetic outcome can produce negative
Acknowledgements
This research is supported by grants from the Percy Falk Foundation, Dagmar Ferb Foundation, Emma and Erik Granes Memorial, and Capio Research Foundation. The study sponsors were not involved in the research or process of this manuscript.
We thank Tina Björklund, RN for her supportive help in contacting patients and Bo Nilsson, BSc in Statistics for excellent assistance with the statistical analysis and some of the figures. We also thank all patients participating in this study.
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Some preliminary results in this study have been presented at the General Meeting of the Swedish Society of Medicine in Gothenburg, 24th–26th November 2004.