Clinical Determinants of Patient Satisfaction with Breast... : Plastic and Reconstructive Surgery (original) (raw)
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Andrade, William N. M.D., Ph.D.; Baxter, Nancy M.D., Ph.D.; Semple, John L. F.R.C.S.(C), F.A.C.S.
Toronto, Ontario, Canada
From the Division of Plastic Surgery, Sunnybrook and Women's College Health Sciences Centre, University of Toronto. Received for publication June 16, 1999; revised March 10, 2000.
Presented at the 53rd Annual Meeting of the Canadian Society of Plastic Surgeons, in Montreal, Quebec, Canada, on June 24, 1999.
The authors have no commercial associations or affiliations that could pose a conflict of interest with this research. This work was not supported by grant funds.
John L. Semple, F.R.C.S.(C), F.A.C.S.
Division of Plastic Surgery Sunnybrook and Women's College Health Sciences Centre 2075 Bayview Avenue, Room M1, 522 Toronto, Ontario, Canada M4N 3M5[email protected]
Abstract
The main objective of this study was to examine the relationship between specific treatment variables and patient satisfaction with breast reconstruction. A questionnaire was developed that included questions on population demographics and satisfaction with the reconstruction. Of 206 women who completed the questionnaire, 23 (11.2 percent) responded that they were not satisfied, whereas 183 (88.8 percent) indicated that they were satisfied overall. A detailed retrospective chart review permitted a comparison of the treatment received by these two groups. Variables analyzed included patient age, time since surgery, reason for surgery, method and timing of reconstruction, additional surgical procedures received (mound revisions and nipple-areola complex reconstruction), and postoperative complications. Data analysis showed that the treatment received by the two groups was similar in many respects. There was no statistical association between the method or timing of reconstruction and a patient's satisfaction with the results. Furthermore, there was no difference in the number of mound revisions or nipple reconstructions performed on satisfied versus dissatisfied patients. However, the latter group experienced a substantially higher incidence of postsurgical complications (27 percent versus 61 percent, p = 0.0015).
Patients were also asked to provide a written response explaining their feelings on breast reconstruction. Satisfied patients described benefits from reconstruction such as improved appearance or feelings of normalcy and wholeness. Conversely, unsatisfied patients were displeased because of poor cosmetic results, complications with the reconstructed breast, or abdominal problems. Although overall satisfaction with breast reconstruction is undoubtedly determined by multiple and complex clinical, emotional, and psychological factors, this study suggests that postoperative complications are a particularly important indicator of dissatisfaction with reconstruction. (Plast. Reconstr. Surg. 107: 46, 2001.)
©2001American Society of Plastic Surgeons
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