Patient Reported Outcome In Breast Reconstruction Patients With And Without Prior Aesthetic Experience
Ruya Zhao, MD1, Yi-Hsueh Lu, MD PhD2, Peter Shamamian, BS1, Kayla Leibl, MD1, Katie Weichman, MD1.
1Montefiore Medical Center, The Bronx, NY, USA, 2Montefiore Medical Center, New york, NY, USA.
PURPOSE: Patient satisfaction after breast reconstructions is multifactorial. How prior cosmetic experience affects patient-reported outcomes has not been reported. This study investigates the influence of prior aesthetic surgery on patients undergoing breast reconstruction.
METHODS: Patients who underwent post-mastectomy reconstruction from 2014-2020, with completed Breast-Q preoperatively and 6 months postoperatively were included. Patient demographics, comorbidities, overall complications, number of revisions, and patient-reported outcomes were compared between patients with and without prior cosmetic experience (including any surgical and non-invasive procedures).
RESULTS: We identified 17 out of 87 patients with prior cosmetic experience (20.7%). Patients with prior cosmetic experience had lower Breast-Q scores in breast aesthetics (defined as the average score of satisfaction with breasts and nipples, 46.0±18.4 vs 61.2±23.1, p=0.010) and breast wellbeing (defined as the average score of satisfaction with breasts, nipples, and sexual well-being, 46.0±16.7 vs 58.9±23.9, p=0.019), whereas there is no difference in other patient-reported outcomes including psychosocial, abdominal wellbeing, and satisfaction with surgeon or staff (FIGURE1). Among those patients who had completed their reconstruction, patients with prior aesthetic history underwent more revision procedures, although the difference is not significant (3.7 vs 2.8 procedures, p=0.09).
CONCLUSION: Patients with prior aesthetic surgery experience have worse patient-reported outcomes in breast aesthetics and breast well-being after breast reconstruction, and undergo more revision procedures. Careful discussions focusing on patient expectations are warranted prior to reconstructions. 
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