Patients' Satisfaction After Breast Reconstruction Surgery Using Autologous versus Implants: A Meta-Analysis

Area of Science:

• Oncology
• Plastic Surgery
• Reconstructive Surgery

Background:

• Breast cancer significantly impacts women globally, necessitating reconstructive surgery post-mastectomy.
• Autologous (tissue-based) and implant-based reconstruction are primary surgical options.
• Autologous reconstruction is cost-effective but may yield less aesthetic results, while implants offer better aesthetics at a higher cost.

Purpose of the Study:

• To compare patient satisfaction between autologous and implant-based breast reconstruction techniques.
• Utilized the validated Breast-Q questionnaire for patient-reported outcomes.

Main Methods:

• A meta-analytic study systematically reviewed literature from PubMed, EMBASE, and Cochrane Library (2014-2023).
• Analysis was performed using Revman 5.4, presenting results in a forest plot diagram.

Main Results:

• The meta-analysis included 16 studies with 7284 participants, revealing significantly higher patient satisfaction with autologous reconstruction.
• Key areas of improved satisfaction included overall breast appearance (MD=0.55), reconstruction outcomes (MD=0.48), sexual satisfaction (MD=0.27), and satisfaction with plastic surgeons (MD=0.52).
• Nipple shape satisfaction showed a trend towards improvement with autologous reconstruction (MD=0.22, p=0.06).

Conclusions:

• Autologous breast reconstruction demonstrates superior patient satisfaction compared to implant-based techniques across multiple domains.
• Breast cancer survivors opting for autologous reconstruction report higher satisfaction with their breast, outcomes, sexual well-being, and surgical results.
• The Breast-Q questionnaire confirms the advantages of autologous reconstruction for enhancing patient-reported satisfaction.