Analysis of Symmetry Stability Following Implant-Based Breast Reconstruction and Contralateral Management in 582 Patients with Long-Term Outcomes

Abstract

Introduction

This study aimed to analyse the long-term outcomes following breast reconstruction and contralateral management to evaluate the stability of breast symmetry and patient satisfaction.

Materials and Methods

The study population consisted of women who had undergone implant-based monolateral breast reconstruction and contralateral management. Patients answered the BREAST-Q reconstruction module. Two reviewers analysed the post-operative outcomes of the patients included and compiled the Kroll Scale. Patients were divided into three groups: implant-based contralateral management, breast reduction and mastopexy tendency between the groups. The Fisher's exact test was applied to the results.

Results

From the BREAST-Q analysis, the group of patients undergoing contralateral breast augmentation (Figs. 1, 2) achieved significantly better results regarding the ability to wear clothing (p ≪ 0.001), symmetry (p ≪ 0.001), psychosocial well-being (p ≪ 0.001) and physical well-being (p ≪ 0.001). From the analysis of the Kroll Scale, the group of implant-based contralateral management received the highest score for symmetry (p ≪ 0.001), shape (p ≪ 0.001) and aesthetic result overall (p ≪ 0.001). Fig. 1

Patient submitted to right mastectomy and implant-based breast reconstruction with contralateral symmetrisation with implant. Preoperative (a, c) and three years post-operative (b, d) views

Fig. 2

Patient submitted to left mastectomy and implant-based breast reconstruction with contralateral symmetrisation with implant. Preoperative (a, c) and five years post-operative (b, d) views

Conclusions

This study was the first to use BREAST-Q to analyse the stability of breast symmetry following breast reconstruction with long-term results. The implant-based contralateral management was the most effective procedure for achieving a stable and lasting result to obtain the high satisfaction of patients.

Level of Evidence IV

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