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Impact of Unilateral versus Bilateral Breast Reconstruction on Procedure Choices and Outcomes
- Source :
- Plast Reconstr Surg
- Publication Year :
- 2019
-
Abstract
- BACKGROUND: In choosing between implant-based and autologous breast reconstruction, surgeons and patients must weigh relative risks and benefits. However, differences in outcomes across procedure types may vary between unilateral versus bilateral reconstructions. Procedure-related differences in complications and patient-reported outcomes (PROs) were evaluated for unilateral and bilateral reconstruction. METHODS: Complications and PROs were assessed at two years for patients undergoing autologous (TRAM, DIEP, SIEA) or implant-based (TE, DTI) reconstructions. Overall complications and major complications (requiring re-admission and/or re-operation) were recorded, while PROs were measured with BREAST-Q and PROMIS surveys. Stratified regression models compared outcomes between autologous and implant-based reconstructions, separately for unilateral and bilateral cohorts. RESULTS: Among 2125 patients, 917 underwent unilateral (600 implant, 317 autologous) and 1208 underwent bilateral (994 implant, 214 autologous) reconstructions. Controlling for patient characteristics, complication rates were significantly higher in the autologous versus implant-based group with both unilateral (overall: OR 2.50, p
- Subjects :
- medicine.medical_specialty
Breast Implants
Mammaplasty
Clinical Decision-Making
Breast Neoplasms
030230 surgery
Mean difference
Article
Surgical Flaps
03 medical and health sciences
0302 clinical medicine
Postoperative Complications
medicine
Humans
Patient Reported Outcome Measures
Prospective Studies
Prospective cohort study
Autografts
Mastectomy
business.industry
Bilateral breast reconstruction
Middle Aged
United States
Surgery
Treatment Outcome
Clinical question
030220 oncology & carcinogenesis
Relative risk
Nipples
Female
Implant
Complication
business
Breast reconstruction
Organ Sparing Treatments
Subjects
Details
- Language :
- English
- Database :
- OpenAIRE
- Journal :
- Plast Reconstr Surg
- Accession number :
- edsair.doi.dedup.....1d4cfcd07573da2e43d9a7fec106ea8e