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The aim of this study was to compare the outcome of breast reconstruction after mastectomy, in the context of a breast cancer diagnosis or risk, between reconstruction with implants (alloplastic) and with own body tissue of the lower abdomen (autologous) based on 1. patient satisfaction, 2. quality of life and 3. postoperative complications.The results of this study concluded that women were more satisfied and experienced a higher quality of life after undergoing reconstruction with their own tissue compared to reconstruction with breast implants (70 versus 63, scale: 0-100). In addition, women who underwent reconstruction with their own tissue scored comparable on breast satisfaction with women from the same age group of the general population (Groningen, the Netherlands) who had never had their breasts operated on (70 versus 68 points, scale: 0-100). Women with a higher BMI are generally less satisfied with their own breasts. The removal of belly fat, resulting in changes in physique and fat distribution, then reconstructing it into a new breast, may possibly contribute to the significant increase in patient satisfaction and quality of life among women undergoing autologous reconstruction.Furthermore, several risk factors for developing complications after breast reconstruction were identified in this study. For example, in women who smoke, have a high BMI and/or a moderate muscle quality, the chance of getting complications after breast reconstruction is significantly increased. In these women, it must be considered whether breast reconstruction should be postponed until women have stopped smoking, have lost weight and are in better physical condition.

Background: This review aimed to meta-analyze the quality of life of alloplastic versus autologous breast reconstruction, when measured with the BREAST-Q. Methods: An electronic PubMed and EMBASE search was designed to find articles that compared alloplastic versus autologous breast reconstruction using the BREAST-Q. Studies that failed to present BREAST-Q scores and studies that did not compare alloplastic versus autologous breast reconstruction were excluded. Two authors independently extracted data from the included studies. A standardized data collection form was used. Quality was assessed using the Newcastle-Ottawa Scale. The mean difference and 95 percent confidence intervals between breast reconstruction means were estimated for each BREAST-Q subscale. Forest plots and the I2statistic were used to assess heterogeneity and funnel plot publication bias. The Z test was used to assess overall effects. Results: Two hundred eighty abstracts were found; 10 articles were included. Autologous breast reconstruction scored significantly higher in the five subscales than alloplastic breast reconstruction. The Satisfaction with Breasts subscale indicated the greatest difference, with a mean difference of 6.41 (95 percent CI, 3.58 to 9.24; I2= 70 percent). The Satisfaction with Results subscale displayed a mean difference of 5.52. The Sexual Well-Being subscale displayed a mean difference of 3.85. The Psychosocial Well-Being subscale displayed a mean difference of 2.64. The overall difference in physical well-being was significant, with high heterogeneity (mean difference, 3.33; 95 percent CI, 0.18 to 6.48; I2= 85). Conclusion: Autologous breast reconstruction had superior outcomes compared with alloplastic breast reconstruction as measured by the BREAST-Q.