Interobserver variation and cosmetic result of submuscular breast reconstruction

Four experienced plastic surgeons judged the results of 6 different variables in 99 breast reconstructed women. In the range good to poor the observers assessed symmetry of size, position of the submammary fold, symmetry of shape, nipple-areola reconstruction and scars. The grand mean for total cosmetic results was 2.16 (2 = good, 3 = acceptable). Our material shows a great variance between patients in the total cosmetic result. We considered that no variable here shown has unacceptable reliability in terms of interobserver within patients and interpatients within observers variance ratio. The strongest correlations to the total cosmetic result were shown by symmetry of shape, position of the submammary fold and symmetry of size. Thus, in order to improve the total cosmetic result it is important to focus attention on these three aspects.