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Multicenter Study
. 2023 Oct 1;152(4S):55S-68S.
doi: 10.1097/PRS.0000000000010496. Epub 2023 Sep 28.

Short-Term Quality of Life after Autologous Compared with Alloplastic Breast Reconstruction: A Prospective Study

Nadia Sadok  1 , Irene S Krabbe-Timmerman  2 , Nina H Buisman  1 , Vera C van Aalst  1 , Geertruida H de Bock  3 , Paul M N Werker  1
Affiliations
Multicenter Study

Short-Term Quality of Life after Autologous Compared with Alloplastic Breast Reconstruction: A Prospective Study

Nadia Sadok et al. Plast Reconstr Surg. .

Abstract

Background: The aim of this prospective multicenter study was to evaluate whether autologous breast reconstruction (BR) leads to lower short-term quality of life (QoL) compared with alloplastic BR, due to the more physically demanding surgery and increased risk of severe complications of autologous BR.

Methods: Changes in QoL after BR were measured in this prospective multicenter study using the BREAST-Q questionnaire, which was administered preoperatively and at 6 weeks and 6 months postoperatively. Characteristics and complications, classified according to Clavien-Dindo, were compared between alloplastic and autologous groups. Profile plots and generalized linear regression models were constructed to analyze the BREAST-Q subscales over time for both BR groups.

Results: Preoperatively, women undergoing autologous BR scored lower on all BREAST-Q scales compared with women undergoing alloplastic BR, regardless of whether they underwent immediate or delayed BR. Women undergoing autologous BR scored higher at 6 weeks and 6 months postoperatively on the Satisfaction with Breasts ( P = 0.001), Psychosocial Well-Being ( P = 0.024), and Sexual Well-Being ( P = 0.007) subscales. Postoperative Physical Well-Being: Chest score was similar between the groups ( P = 0.533). Clavien-Dindo grade III or higher complications occurred more often among women in the autologous group (27% versus 12%, P = 0.042). Complications were not associated with worse BREAST-Q scores on any of the subscales.

Conclusions: In contrast to the authors' expectations, and despite the higher incidence of severe complications and lower preoperative breast satisfaction and QoL scores, women undergoing autologous BR had higher levels of breast satisfaction and psychosocial and sexual well-being, both at 6 weeks and 6 months after BR, compared with women undergoing alloplastic BR.

Clinical question/level of evidence: Therapeutic, II.

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Conflict of interest statement

Prof. Werker is SERB member for Fidia Ltd., Milan, Italy. All the other authors have no financial interest to declare in relation to the content of this article.

Figures

Fig. 1.
Fig. 1.
Flowchart of study participants who completed the BREAST-Q over time.
Fig. 2.
Fig. 2.
BREAST-Q Satisfaction with Breasts subscale scores per BR group (autologous and alloplastic) preoperatively and at 6 weeks and 6 months postoperatively.
Fig. 3.
Fig. 3.
BREAST-Q Psychosocial Well-Being subscale scores per BR group (autologous and alloplastic) preoperatively and at 6 weeks and 6 months postoperatively.
Fig. 4.
Fig. 4.
BREAST-Q Sexual Well-Being subscale scores per BR group (autologous and alloplastic) preoperatively and at 6 weeks and 6 months postoperatively.
Fig. 5.
Fig. 5.
BREAST-Q Physical Well-Being: Chest subscale scores per BR group (autologous and alloplastic) preoperatively and at 6 weeks and 6 months postoperatively.
Fig. 6.
Fig. 6.
BREAST-Q Physical Well-Being: Abdomen subscale scores for the autologous group preoperatively and at 6 weeks and 6 months postoperatively.
See this image and copyright information in PMC

References

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