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The Impact Of Prior Aesthetic Surgery On Patients Undergoing Immediate Breast Reconstruction: A Comparison Of Patient-reported Outcomes And Quality Of Life
Ruya Zhao, MD, Yi-hsueh Lu, MD, PhD, Peter Shamamian, Jr., BS, Kayla Leibl, MD, Katie Weichman, MD.
Montefiore Medical Center, Bronx, NY, USA.

Purpose: Patient satisfaction after breast reconstruction is multifactorial. How prior aesthetic surgery affects patient reported outcome has not been reported. This study investigates the influence of prior aesthetic surgery on patients who undergo breast reconstruction.
Methods:We retrospectively reviewed all patients who underwent breast reconstruction from 2014-2020. Patients were included in this study if they had completed the Breast-Q survey preoperatively, then 6 month, 1 year, and 2 years postoperatively. Patient demographics, comorbidities, overall complications, and patient reported outcomes were compared between patients with and without prior cosmetic experience.
Results:We identified 29 out of 149 patients with prior aesthetic surgery (19.5%). There were no differences in patient demographics and overall complications. Patients with prior aesthetic surgery had lower Breast-Q scores with breast satisfaction at 6 month postoperatively (61.322.2 vs 49.816.3, p=0.018, Figure 1), whereas there is no difference in other patient reported outcomes including psychosocial, abdominal wellbeing, and satisfaction with surgeon or staff. Furthermore, patients with prior aesthetic surgery underwent more elective revision procedures unrelated to complications (2.9 vs 2.1 OR trips, p = 0.038; 4.3 vs 3.1 elective procedures, 0.037). However, the differences in patient satisfaction with breasts are no longer evident at 1-year (60.721.4 vs 58.121.0, p=0.63), and 2-years postoperatively (62.620.5 vs 5413.3, p=0.18).
Conclusion:Patients who had prior aesthetic surgery are more likely to have lower patient reported outcomes in breast satisfaction after reconstruction and undergo more revision procedures. However, long term satisfaction is comparable between patients with and without prior surgeries. Careful discussions focusing on patient expectation are warranted prior to reconstructions.


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