PMID- 28379284
OWN - NLM
STAT- MEDLINE
DCOM- 20180601
LR  - 20220409
IS  - 1527-330X (Electronic)
IS  - 1090-820X (Linking)
VI  - 37
IP  - 9
DP  - 2017 Oct 1
TI  - Patient-Reported Outcomes of Aesthetics and Satisfaction in Immediate Breast 
      Reconstruction After Nipple-Sparing Mastectomy With Implants and Fat Grafting.
PG  - 999-1008
LID - 10.1093/asj/sjx048 [doi]
AB  - BACKGROUND: Direct-to-implant (DTI) and tissue expander/implant (TE/I) 
      reconstructions are the most common implant-based reconstructions after 
      nipple-sparing mastectomy (NSM). However, there are little data beyond 
      complication rates comparing these options. Fat grafting has emerged as an 
      adjunct in NSM reconstructions to improve aesthetic results; however, its impact 
      on patient perceptions of aesthetic outcomes remain unknown. To improve 
      patient-centered care, aesthetic outcomes must be considered from the patients' 
      perspective. OBJECTIVES: To evaluate patient-reported outcomes of aesthetic 
      satisfaction and quality of life in patients undergoing immediate DTI vs TE/I 
      reconstruction after NSM and to assess the role of fat grafting on these 
      outcomes. METHODS: This is a prospective cohort study comparing NSM patients 
      undergoing DTI or TE/I reconstruction. Patient-reported outcomes were evaluated 
      using the BREAST-Q. Continuous and categorical variables were analyzed using t 
      test and Fisher's exact test, respectively. RESULTS: Fifty-nine patients 
      underwent 113 reconstructions with either DTI (n = 41) or TE/I (n = 18). Mean 
      follow up was 12.1 months. DTI and TE/I patients had comparable satisfaction with 
      outcome, though TE/I patients had significantly larger final implant sizes. TE/I 
      who underwent fat grafting also had significantly higher satisfaction with 
      outcome and psychosocial wellbeing. CONCLUSIONS: Patient-reported outcomes are 
      comparable between DTI and TE/I reconstructions after NSM. In order for TE/I 
      patients to achieve a similar level of satisfaction, they may require a larger 
      final implant and additional operations compared to DTI patients. Additionally, 
      fat grafting improves overall satisfaction. TE/I patients may have different 
      aesthetic expectations than DTI patients, emphasizing patient-centered 
      discussions are essential to optimizing outcomes after NSM. LEVEL OF EVIDENCE: 3.
CI  - (c) 2017 The American Society for Aesthetic Plastic Surgery, Inc. Reprints and 
      permission: journals.permissions@oup.com
FAU - Qureshi, Ali A
AU  - Qureshi AA
AD  - Division of Plastic and Reconstructive Surgery, Department of Surgery, Washington 
      University School of Medicine, St. Louis, MO.
FAU - Odom, Elizabeth B
AU  - Odom EB
AD  - Division of Plastic and Reconstructive Surgery, Department of Surgery, Washington 
      University School of Medicine, St. Louis, MO.
FAU - Parikh, Rajiv P
AU  - Parikh RP
AD  - Division of Plastic and Reconstructive Surgery, Department of Surgery, Washington 
      University School of Medicine, St. Louis, MO.
FAU - Myckatyn, Terence M
AU  - Myckatyn TM
AD  - Division of Plastic and Reconstructive Surgery, Department of Surgery, Washington 
      University School of Medicine, St. Louis, MO.
FAU - Tenenbaum, Marissa M
AU  - Tenenbaum MM
AD  - Division of Plastic and Reconstructive Surgery, Department of Surgery, Washington 
      University School of Medicine, St. Louis, MO.
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PL  - England
TA  - Aesthet Surg J
JT  - Aesthetic surgery journal
JID - 9707469
SB  - IM
CIN - Aesthet Surg J. 2017 Oct 1;37(9):1009-1011. PMID: 29025228
MH  - Adipose Tissue/*transplantation
MH  - Adult
MH  - Breast Implants
MH  - Breast Neoplasms/surgery
MH  - Cohort Studies
MH  - Female
MH  - Humans
MH  - Mammaplasty/*methods
MH  - Mastectomy/*methods
MH  - Middle Aged
MH  - Nipples/*surgery
MH  - Patient Reported Outcome Measures
MH  - Patient Satisfaction
MH  - Patient-Centered Care/methods
MH  - Prospective Studies
MH  - Quality of Life
MH  - Tissue Expansion Devices
MH  - Treatment Outcome
EDAT- 2017/04/06 06:00
MHDA- 2018/06/02 06:00
CRDT- 2017/04/06 06:00
PHST- 2017/04/06 06:00 [pubmed]
PHST- 2018/06/02 06:00 [medline]
PHST- 2017/04/06 06:00 [entrez]
AID - 3096756 [pii]
AID - 10.1093/asj/sjx048 [doi]
PST - ppublish
SO  - Aesthet Surg J. 2017 Oct 1;37(9):999-1008. doi: 10.1093/asj/sjx048.