Response to letter commenting on Upgrading the BREAST-Q questionnaire

We read with interest the reply from Klassen and colleagues1 to our publication2 and we fully agree about the lack of methodological validity related to our suggestion of a BREAST-Q expansion. In fact, our aim was meant to focus the attention on the need for an update of the already existing autologous BREAST-Q, according to the evolution in breast reconstruction and flap choice. This was the reason why we wanted to highlight and in parallel put the accent on this topic.