Abstract
Background
The effect of immediate implant and autologous breast reconstruction on patient complication
rates has been studied extensively, but patient-reported outcomes for these procedures
during immediate, one-stage reconstruction has yet to be comprehensively investigated.
Objective
This study compares patient-reported outcomes for immediate implant reconstruction
with immediate autologous reconstruction to determine advantages and disadvantages
for each surgical modality from the patient’s perspective.
Methods
A literature search of PubMed between 2010 and 2021 was performed, and 21 studies
containing patient-reported outcomes were selected for analysis. Meta-analysis of
patient-reported outcome scores was performed separately for immediate breast reconstruction
using autologous tissue transfer and synthetic implants.
Results
Nineteen manuscripts were included in the analysis of breast satisfaction representing
data on a total of 1,342 patients across all studies. The pooled mean of patients’
satisfaction with their breasts was 70.7 (95% CI, 69.4-72.0) after immediate autologous
reconstruction and 68.5 (95% CI, 67.1-69.9) after immediate implant reconstruction,
showing a statistically significant difference in outcome (p<0.05). The pooled mean
of patients’ sexual well-being was 59.3 (95% CI, 57.8-60.8) after immediate autologous
reconstruction and 62.8 (95% CI, 60.7-64.8) after immediate implant reconstruction
(p<0.01). The pooled mean of patients’ satisfaction with their outcome was 78.8 (95%
CI, 76.2-81.3) after immediate autologous reconstruction and 82.3 (95% CI, 80.4-84.1)
after immediate implant reconstruction (p<0.05). The results of each meta-analysis
were summarized on forest plots depicting the distribution of patient-reported outcome
scores from each study.
Conclusions
Immediate reconstruction with implants may have a similar or greater capacity to achieve
patient satisfaction and improve QoL compared to immediate reconstruction with autologous
tissue transfer when both procedures are an option.
Keywords
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Article info
Publication history
Accepted:
May 15,
2023
Received in revised form:
May 12,
2023
Received:
December 5,
2022
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2023 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.
