Tianyi Liu1, Christoffer Freijs2, Holger J Klein3, Anna Feinbaum2, Andreas Svee2, Andres Rodriguez Lorenzo2, Anders Liss2, Rafael Acosta4, Maria Mani2. 1. Department of Plastic and Maxillofacial Surgery, Uppsala University Hospital, Uppsala, Sweden. Electronic address: drtialiu@gmail.com. 2. Department of Plastic and Maxillofacial Surgery, Uppsala University Hospital, Uppsala, Sweden. 3. Department of Plastic and Maxillofacial Surgery, Uppsala University Hospital, Uppsala, Sweden; Division of Plastic Surgery and Hand Surgery, Zurich University Hospital, Zurich, Switzerland. 4. Plastic and Reconstructive Surgery, Deakin University, Geelong, Australia.
Abstract
BACKGROUND: Abdominal-based free flap has increasingly become the gold standard for breast reconstruction, however long-term evidence of the aesthetic outcome and quality of life is lacking. The present study aims to gain an overview of patients with abdominal-based free flap breast reconstructions in a long-term perspective. METHODS: Seventy-five patients who received abdominal-based free flap breast reconstructions between 2000-2007 in Uppsala, Sweden were invited back for photographs, 3D imaging and questionnaires. A retrospective chart review was conducted. Patient satisfaction with appearance and quality of life were assessed using the Breast-Q questionnaire. A layman panel and a professional panel rated the aesthetic appearance of the reconstructed breast from photographs and 3D images. RESULTS: Fifty-five patients participated with a mean age of 52 ± 8 years at the time of reconstruction and a mean follow-up time of 11.4 ± 1.8 years completed the study. The majority of the patients had received unilateral (85%), delayed reconstructions (73%) with prior radiation (55%). There were 53 patients with DIEP flaps, one with free TRAM flap and one with SIEA flap. Breast-Q scores in the cohort were comparable to normative values of women without breast cancer (p < 0.001). There was a high level of agreement for the aesthetic results of the reconstructions between patient, professionals and layman panels (0.89 ICC, 95% CI: 0.83 - 0.93). CONCLUSION: Abdominal-based free flap reconstructions were effective in achieving a lasting positive aesthetic result and a high quality of life in patients a decade after surgery.
BACKGROUND: Abdominal-based free flap has increasingly become the gold standard for breast reconstruction, however long-term evidence of the aesthetic outcome and quality of life is lacking. The present study aims to gain an overview of patients with abdominal-based free flap breast reconstructions in a long-term perspective. METHODS: Seventy-five patients who received abdominal-based free flap breast reconstructions between 2000-2007 in Uppsala, Sweden were invited back for photographs, 3D imaging and questionnaires. A retrospective chart review was conducted. Patient satisfaction with appearance and quality of life were assessed using the Breast-Q questionnaire. A layman panel and a professional panel rated the aesthetic appearance of the reconstructed breast from photographs and 3D images. RESULTS: Fifty-five patients participated with a mean age of 52 ± 8 years at the time of reconstruction and a mean follow-up time of 11.4 ± 1.8 years completed the study. The majority of the patients had received unilateral (85%), delayed reconstructions (73%) with prior radiation (55%). There were 53 patients with DIEP flaps, one with free TRAM flap and one with SIEA flap. Breast-Q scores in the cohort were comparable to normative values of women without breast cancer (p < 0.001). There was a high level of agreement for the aesthetic results of the reconstructions between patient, professionals and layman panels (0.89 ICC, 95% CI: 0.83 - 0.93). CONCLUSION: Abdominal-based free flap reconstructions were effective in achieving a lasting positive aesthetic result and a high quality of life in patients a decade after surgery.
Authors: Johan Zötterman; Dries Opsomer; Simon Farnebo; Phillip Blondeel; Stan Monstrey; Erik Tesselaar Journal: Plast Reconstr Surg Glob Open Date: 2020-01-20