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PRMA Plastic Surgery

Implant VS “Flap” Breast Reconstruction: Patient Reported Outcomes from Thin and Obese Patients

July 21, 2020

Does weight impact quality of life and satisfaction rates after “flap” breast reconstruction?

Patients today have many options to consider for breast reconstruction following a mastectomy. Reconstruction options include implants and microsurgical “flap” procedures like the DIEP flap.

All options can provide patients with good results. However, it is important for patients to be fully informed of ALL options prior to reconstruction and the pros and cons of each so they can make an informed decision on which procedure is best for them based on their lifestyle and outcome expectations.

Studies show that patients undergoing microsurgical “flap” based breast reconstruction have higher long-term satisfaction rates compared with those undergoing implant reconstruction. This type of research is an excellent reference for patients considering breast reconstruction after mastectomy. Adding long-term studies with patient reported outcomes adds another import element for surgeons and patients to discuss when weighing all options.

Two studies further analyze patient reported satisfaction and quality of life rankings of implant and “flap” procedures based on patient’s weight classifications.

The first study was conducted in 2015 and focused on thinner patients. The research showed that microsurgical breast reconstruction options can provide higher satisfactory results for thin patients compared to implant surgery. However, the study did show that more secondary revision surgeries and fat grafting were necessary to achieve the best results.

The second study was conducted in 2019 and focused on patients with obesity. Obesity has been shown to increase post-surgery complications in both microsurgical “flap” and implant reconstruction procedures. Regardless, the study results show “flap” reconstruction produces higher patient reported satisfaction results compared to implant reconstruction.

The results of these two weight specific studies are further evidence that “flap” procedures (like the DIEP flap) are excellent options for patients to consider regardless of their weight classification.

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