PREFERENCES IN CHOOSING BETWEEN BREAST RECONSTRUCTION OPTIONS: A SURVEY OF FEMALE PLASTIC SURGEONS
*Hani Sbitany, Ashley N Amalfi, *Howard N Langstein
University of Rochester, Rochester, NY
BACKGROUND: Female Plastic Surgeons are well suited to make a personal choice regarding breast reconstruction options, based on their knowledge of the actual procedures, and first hand experience with results. We surveyed this group, to elicit their personal views on various modalities of breast reconstruction, and to ascertain which types of reconstruction they would choose if faced with such a decision.
METHODS: All board-certified female plastic surgeons in the United States and Canada were surveyed via electronic mail. This survey included questions regarding basic demographic and practice data. Respondents were requested to rank desired methods of reconstruction for themselves, and cite reasons for these choices.
RESULTS: A total of 435 surveys were sent, and 143 were returned (response rate of 33%). Overall, 66% of respondents chose implant-based reconstruction, 25% chose autologous reconstruction, and 9% chose no reconstruction. Respondents selecting autologous reconstruction cited cosmetic outcome as the most important factor considered in 47% of cases, compared with 14% of those choosing implant-based breast reconstruction (p=.0001). Invasiveness of the procedure/recovery time was cited as most important factor by 83% of those surgeons opting for no breast reconstruction, and 51% of those choosing implant-based breast reconstruction (p=.0175).
CONCLUSIONS: Board-certified female plastic surgeons exhibit a strong desire to pursue implant-based breast reconstruction over autologous reconstruction. When chosen, autologous reconstruction was felt to offer improved aesthetic outcomes. When making such a decision, patients can use female Plastic Surgeons as a resource for information, thus helping them to make an informed decision.
| BREAST RECONSTRUCTION PRACTICED CLINICALLY | WANT NO RECONSTRUCTION | WANT IMPLANT-BASED RECONSTRUCTION | WANT AUTOLOGOUS-BASED RECONSTRUCTION | P-VALUE (Fisher's Exact Test) |
| <30 cases/year, any type | 7 | 51 | 26 | .1745 |
| >30 cases/year, primarily implant-based | 5 | 33 | 5 | .0324 |
| >30 cases/year, primarily autologous-based | 0 | 3 | 3 | .3981 |
| MOST IMPORTANT FACTOR IN DECISION | WANT NO RECONSTRUCTION | WANT IMPLANT-BASED RECONSTRUCTION | WANT AUTOLOGOUS-BASED RECONSTRUCTION | P-VALUE (Fisher's Exact Test) |
| Number In Cohort | 12 | 85 | 32 | |
| Cosmetic Outcome | 0 | 12 | 15 | .00014 |
| Recovery Time | 3 | 20 | 1 | .0175 |
| Least Invasive Procedure | 7 | 23 | 0 | .00001 |
| Removal Of Tissue From Other Sites In The Body | 0 | 0 | 10 | .0001 |
| Post-Surgical Level of Functioning | 1 | 25 | 6 | .222 |