Aligning Patient and Surgeon Aesthetic Priorities in Autologous Breast Reconstruction: A Cross-Sectional Survey Study

Currently, there is no published evidence on the aesthetic and functional aspirations of women undergoing autologous breast reconstruction. Recognizing that not all surgical goals can always be achieved, we aimed to develop a priority scale based on patient preferences to guide intraoperative decision-making.

We conducted a cross-sectional survey targeting patients, plastic surgery specialists, and trainees. Participants ranked 10 aesthetic and functional aspects of breast reconstruction (volume, shape, symmetry, sensitivity, texture, scarring on the breast and abdomen, umbilicus appearance, nipple-areola complex reconstruction, and similarity to the original breast). Responses were analyzed using nonparametric statistical methods, using SPSS (IBM SPSS Statistics, IBM Corp., New York, United States.).

A total of 109 responses were collected (56 patients, 26 specialists, 27 trainees). Symmetry emerged as the top priority across all groups. Patients assigned higher importance than surgeons to sensitivity (6.77 vs. 4.38-4.50), nipple-areola complex reconstruction (8.18 vs. 7.72-7.78), and similarity to the original breast (6.55 vs. 4.63-4.89). Experienced surgeons valued breast texture more highly than less-experienced surgeons (8.67 vs. 6.70).

While symmetry is universally prioritized, patients place greater value on functional aspects like breast sensitivity. These insights highlight the importance of personalized preoperative counseling to align surgical planning with patient expectations.