Comparing patient satisfaction in bilateral and unilateral breast reconstruction

Current literature in breast reconstruction continues to provide answers to questions regarding patient satisfaction in the areas of autologous vs alloplastic reconstruction and silicone vs saline implants. There are no studies, however, that specifi cally address patient satisfaction with bilateral vs unilateral breast reconstruction. Our goal was to assess patient satisfaction with bilateral compared with unilateral breast reconstruction.

Over a 4-year period, 108 patients completed either unilateral or bilateral breast reconstruction from a single surgeon. Patient satisfaction in these patients was assessed using a questionnaire developed focusing on clinical outcome measures of aesthetic and functional satisfaction.

A total of 72 anonymous surveys were returned. Statistically significant differences were seen with respect to overall symmetry, aesthetics without clothing, and overall satisfaction between unilateral and bilateral reconstructions. In each of these categories, the average patient satisfaction score was higher for bilateral reconstructions. Furthermore, when comparing unilateral vs bilateral reconstruction in the different reconstruction types, parallel differences in patient satisfaction were noted.

The results of this study suggest that patients were more satisfied with bilateral reconstruction because of improved symmetry, superior aesthetic appearance without clothing, and overall satisfaction with the reconstructive process. Future studies with larger subsets of patients are needed.