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Autologous Reconstruction Following Nipple Sparing Mastectomy Achieves Equivalent Aesthetic Outcome as Natural Breasts

Received: 2 June 2021     Accepted: 15 June 2021     Published: 22 June 2021
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Abstract

We determined the aesthetic outcomes of autologous breast reconstruction in comparison to cosmetically altered or natural breasts. We also examined the effect of perceptions on aesthetic outcomes of breast reconstruction. Images of 10 patients (autologous breast reconstruction following bilateral nipple sparing mastectomy (NSM) (n=5), bilateral breast reduction (n=1), bilateral mastopexy (n=1), bilateral augmentation (n=1), unoperated natural breasts (n=2)), were compiled into a blind three-part survey. Part one asked participants to determine whether the presented breasts are reconstructed after mastectomy and measure aesthetic outcomes (1=poor and 4=excellent). Part two ranks breasts from most desirable to least desirable. Part three presents side-by-side unlabeled pre and postoperative images of patients who have undergone autologous breast reconstruction and asks to select the more aesthetically pleasing breasts. Two thousand images were quantified from 100 surveys (83.3% response rate). Age range of participants was 18-80. Response was not statistically different based on demographics. The rate of correctly identifying breasts as reconstruction after NSM was 62.8% and as natural was 64%. Mean aesthetic scores between the reconstructed and natural breasts were equivalent. Breasts perceived as reconstruction scored significantly lower in five aesthetic factors. The top 3 most desired breasts were augmentation, reconstruction after NSM, and unoperated natural breasts. In paired pre- and postoperative photo comparison, all responses favored postoperative breasts. Aesthetic outcomes after autologous breast reconstruction can be equivalent to natural breasts. Breasts perceived as reconstruction are ranked poorer in aesthetic factors compared to those perceived as natural breasts.

Published in Journal of Surgery (Volume 9, Issue 4)
DOI 10.11648/j.js.20210904.15
Page(s) 170-175
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2021. Published by Science Publishing Group

Keywords

Autologous Breast Reconstruction, Patient Expectations, Perceptions, Breast Reconstruction

References
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[3] Rochlin DH, Davis CR, Nguyen DH. Breast Augmentation and Breast Reconstruction Demonstrate Equivalent Aesthetic Outcomes. Plast Reconstr Surg Glob Open 2016; 4 (7) e811.
[4] Dikmans REG, van de Grift TC, Bouman MB, et al. Sexuality, a topic that surgeons should discuss with women before risk-reducing mastectomy and breast reconstruction. Breast 2019; 43: 120-122.
[5] Batenburg MCT, Gregorowitsch ML, Maarse W, et al. Patient-reported cosmetic satisfaction and the long-term association with quality of life in irradiated breast cancer patients. Breast Cancer Res Treat 2019 Oct 24 [ePub]. https://rdcu.be/b0NBt.
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[7] Pusic AL, Chen CM, Cano S, et al. Measuring Quality of Life in Cosmetic and Reconstructive Breast Surgery: A Systematic Review of Patient-Reported Outcomes Instruments. Plast Reconstr Surg 2007; 120 (4): 823-837.
[8] Villa MT. Patient-Reported Aesthetic Satisfaction with Breast Reconstruction during the Long-Term Survivorship Period. Plast Reconstr Surg 2009; 124 (1): 1-8.
[9] Yueh JH, Slavin SA, Adesiyun T, et al. Patient Satisfaction in Postmastectomy Breast Reconstruction: A Comparative Evaluation of DIEP, TRAM, Latissimus Flap, and Implant Techniques. Plast Reconstr Surg 2010; 125 (6): 1585-1595.
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[13] Raposio E, Belgrano V, Santi P, et al. Which is the Ideal Breast Size? Some Social Clues for Plastic Surgeons. Ann Plast Surg 2016; 76 (3): 340-345.
[14] Broer PN, Juran S, Walker ME, et al. Aesthetic Breast Shape Preferences Among Plastic Surgeons. Ann Plast Surg 2015; 74 (6): 639-644.
[15] Huisʼt Veld EA, Long C, Sue GR, et al. Analysis of Aesthetic Outcomes and Patient Satisfaction After Delayed-Immediate Autologous Breast Reconstruction. Ann Plast Surg 2018; 80 (5S Suppl 5): S303-S307.
[16] Azadgoli B, Gould DJ, Vartanian E, et al. The Public’s Perception on Breast and Nipple Reconstruction: A Crowdsourcing-Based Assessment. Aesthet Surg J 2019; 39 (9): NP370-NP376.
[17] Cordova LZ, Hunter-Smith DJ, Rozen WM. Patient reported outcome measures (PROMs) following mastectomy with breast reconstruction or without reconstruction: a systematic review. Gland Surg 2019; 8 (4): 441-451-451.
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Cite This Article
  • APA Style

    Peter Deptula, Youna Choi, Nhung Tran, Danielle Rochlin, Dung Nguyen. (2021). Autologous Reconstruction Following Nipple Sparing Mastectomy Achieves Equivalent Aesthetic Outcome as Natural Breasts. Journal of Surgery, 9(4), 170-175. https://doi.org/10.11648/j.js.20210904.15

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    ACS Style

    Peter Deptula; Youna Choi; Nhung Tran; Danielle Rochlin; Dung Nguyen. Autologous Reconstruction Following Nipple Sparing Mastectomy Achieves Equivalent Aesthetic Outcome as Natural Breasts. J. Surg. 2021, 9(4), 170-175. doi: 10.11648/j.js.20210904.15

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    AMA Style

    Peter Deptula, Youna Choi, Nhung Tran, Danielle Rochlin, Dung Nguyen. Autologous Reconstruction Following Nipple Sparing Mastectomy Achieves Equivalent Aesthetic Outcome as Natural Breasts. J Surg. 2021;9(4):170-175. doi: 10.11648/j.js.20210904.15

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  • @article{10.11648/j.js.20210904.15,
      author = {Peter Deptula and Youna Choi and Nhung Tran and Danielle Rochlin and Dung Nguyen},
      title = {Autologous Reconstruction Following Nipple Sparing Mastectomy Achieves Equivalent Aesthetic Outcome as Natural Breasts},
      journal = {Journal of Surgery},
      volume = {9},
      number = {4},
      pages = {170-175},
      doi = {10.11648/j.js.20210904.15},
      url = {https://doi.org/10.11648/j.js.20210904.15},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.js.20210904.15},
      abstract = {We determined the aesthetic outcomes of autologous breast reconstruction in comparison to cosmetically altered or natural breasts. We also examined the effect of perceptions on aesthetic outcomes of breast reconstruction. Images of 10 patients (autologous breast reconstruction following bilateral nipple sparing mastectomy (NSM) (n=5), bilateral breast reduction (n=1), bilateral mastopexy (n=1), bilateral augmentation (n=1), unoperated natural breasts (n=2)), were compiled into a blind three-part survey. Part one asked participants to determine whether the presented breasts are reconstructed after mastectomy and measure aesthetic outcomes (1=poor and 4=excellent). Part two ranks breasts from most desirable to least desirable. Part three presents side-by-side unlabeled pre and postoperative images of patients who have undergone autologous breast reconstruction and asks to select the more aesthetically pleasing breasts. Two thousand images were quantified from 100 surveys (83.3% response rate). Age range of participants was 18-80. Response was not statistically different based on demographics. The rate of correctly identifying breasts as reconstruction after NSM was 62.8% and as natural was 64%. Mean aesthetic scores between the reconstructed and natural breasts were equivalent. Breasts perceived as reconstruction scored significantly lower in five aesthetic factors. The top 3 most desired breasts were augmentation, reconstruction after NSM, and unoperated natural breasts. In paired pre- and postoperative photo comparison, all responses favored postoperative breasts. Aesthetic outcomes after autologous breast reconstruction can be equivalent to natural breasts. Breasts perceived as reconstruction are ranked poorer in aesthetic factors compared to those perceived as natural breasts.},
     year = {2021}
    }
    

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  • TY  - JOUR
    T1  - Autologous Reconstruction Following Nipple Sparing Mastectomy Achieves Equivalent Aesthetic Outcome as Natural Breasts
    AU  - Peter Deptula
    AU  - Youna Choi
    AU  - Nhung Tran
    AU  - Danielle Rochlin
    AU  - Dung Nguyen
    Y1  - 2021/06/22
    PY  - 2021
    N1  - https://doi.org/10.11648/j.js.20210904.15
    DO  - 10.11648/j.js.20210904.15
    T2  - Journal of Surgery
    JF  - Journal of Surgery
    JO  - Journal of Surgery
    SP  - 170
    EP  - 175
    PB  - Science Publishing Group
    SN  - 2330-0930
    UR  - https://doi.org/10.11648/j.js.20210904.15
    AB  - We determined the aesthetic outcomes of autologous breast reconstruction in comparison to cosmetically altered or natural breasts. We also examined the effect of perceptions on aesthetic outcomes of breast reconstruction. Images of 10 patients (autologous breast reconstruction following bilateral nipple sparing mastectomy (NSM) (n=5), bilateral breast reduction (n=1), bilateral mastopexy (n=1), bilateral augmentation (n=1), unoperated natural breasts (n=2)), were compiled into a blind three-part survey. Part one asked participants to determine whether the presented breasts are reconstructed after mastectomy and measure aesthetic outcomes (1=poor and 4=excellent). Part two ranks breasts from most desirable to least desirable. Part three presents side-by-side unlabeled pre and postoperative images of patients who have undergone autologous breast reconstruction and asks to select the more aesthetically pleasing breasts. Two thousand images were quantified from 100 surveys (83.3% response rate). Age range of participants was 18-80. Response was not statistically different based on demographics. The rate of correctly identifying breasts as reconstruction after NSM was 62.8% and as natural was 64%. Mean aesthetic scores between the reconstructed and natural breasts were equivalent. Breasts perceived as reconstruction scored significantly lower in five aesthetic factors. The top 3 most desired breasts were augmentation, reconstruction after NSM, and unoperated natural breasts. In paired pre- and postoperative photo comparison, all responses favored postoperative breasts. Aesthetic outcomes after autologous breast reconstruction can be equivalent to natural breasts. Breasts perceived as reconstruction are ranked poorer in aesthetic factors compared to those perceived as natural breasts.
    VL  - 9
    IS  - 4
    ER  - 

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Author Information
  • Division of Plastic and Reconstructive Surgery, Stanford University, Stanford, USA

  • Division of Plastic and Reconstructive Surgery, Stanford University, Stanford, USA

  • Division of Plastic and Reconstructive Surgery, Stanford University, Stanford, USA

  • Division of Plastic and Reconstructive Surgery, Stanford University, Stanford, USA

  • Division of Plastic and Reconstructive Surgery, Stanford University, Stanford, USA

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