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Updated: Jun 7, 2026
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Endoscopic Bilateral Nipple-sparing Mastectomy via a Single Axillary Incision with Immediate Pre-pectoral Implant-based Breast Reconstruction
Published on: May 17, 2024
[Which breast reconstruction procedure provides the best long-term satisfaction?]
1Service de chirurgie plastique reconstructrice et esthétique, hôpital civil, hôpitaux universitaires de Strasbourg, BP 426, 1, place de l'Hôpital, 67091 Strasbourg cedex, France. frederic.bodin@chru-strasbourg.fr
Annales De Chirurgie Plastique Et Esthetique
|November 2, 2010
Summary
Autologous flap breast reconstruction offers superior long-term patient satisfaction compared to implants. Flap-based methods, particularly TRAM flaps, yield better outcomes, while implants show decreased satisfaction over time and with radiation history.
Area of Science:
- Plastic Surgery
- Oncology
- Reconstructive Surgery
Background:
- Patient satisfaction is a key metric for evaluating breast reconstruction success.
- This study compares long-term satisfaction across four distinct breast reconstruction techniques.
Purpose of the Study:
- To compare long-term patient satisfaction following four breast reconstruction methods.
- To identify factors influencing satisfaction, including surgical technique, follow-up duration, reconstruction timing, and radiation history.
Main Methods:
- 147 patients evaluated satisfaction using a four-point scale (very disappointed to very satisfied).
- Follow-up averaged 5.3 years (range: 1-21.5 years).
- Techniques analyzed: Transverse Rectus Abdominis Myocutaneous (TRAM) flap (15%), Autologous Latissimus Dorsi (ALD) flap (14%), Latissimus Dorsi with Implant (LDI) (32%), and Implant Alone (39%).
Main Results:
- 89% of patients reported satisfaction (satisfied or very satisfied).
- Autologous flaps demonstrated significantly better long-term results (P<0.001).
- TRAM flaps were preferred over ALD and LDI. Implant-alone reconstructions had the lowest satisfaction rates, decreasing with time and preoperative radiation.
Conclusions:
- Flap-based breast reconstructions provide consistent long-term patient satisfaction, despite initial surgical demands.
- Free perforator flaps align with current trends, offering good satisfaction and minimal donor-site morbidity.
- Autologous reconstruction techniques are associated with higher patient satisfaction.