Background and objective

Breast reconstruction after bilateral mastectomy plays an essential role in guaranteeing psychological health and social and sexual life of women. The techniques used can be autologous, alloplastic or a combination of both, being autologous techniques of choice in most cases.

We conducted this study in order to elucidate whether there are differences in satisfaction regarding the final result of the reconstruction by comparing the 3 techniques.

Methods

This study compares a series of 35 patients operated on breast reconstruction after bilateral mastectomy at La Paz University Hospital in Madrid, Spain, both immediate and deferred: 21 operated on with alloplastic technique, 4 with autologous technique and 10 with mixed technique. Two surveys have been used: a Likert type survey to assess morphological and functional result and a Visual Analogue Scale for the assessment of the overall result. In addition, we reviewed the proportion of complications associated with each technique and the study of confounding factors on the outcome of the reconstruction.

Results

The most commonly used technique in this series was the aloplastic one. The autologous technique was the one that received the best score in all the satisfaction scales used. However, statistically significant differences are only found when the evaluation is performed by the surgeon (p=0.02). Regarding the study of complications, the autologous technique had the highest proportion of complications (20%). Nevertheless, when comparing the appearance of complications in the 3 techniques, only statistically significant differences were found in the appearance of skin necrosis (p=0.033), at the expense of the mixed technique.

Conclusions

In general, greater satisfaction was observed with the autologous technique compared to the rest of them, in all the surveys, both in the surgeon’s assessments and those of the patients, with no differences in the proportion of complications.

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