The effect of implant loss after immediate breast reconstruction on patient satisfaction with outcome and quality of life after five years – a case-control study

Abstract

Several advantages have been suggested for immediate breast reconstruction (IBR); however, there is little scientific high-quality evidence confirming those advantages. Disadvantages of IBR, compared to delayed breast reconstruction (DBR), include an increased risk for complications, such as implant loss (prevalence 5–10% vs. 1%). Little is known on how women experience implant loss and how it affects patients’ long-term satisfaction and quality of life (QoL). The primary aim of our study was to compare patient satisfaction and QoL of women with implant loss after IBR, with that of women with a successful IBR. Breast-Q, Body Esteem Scale for Adults and Adolescents (BESAA) and Hospital Anxiety and Depression Scale (HADS) were sent to women who had experienced implant loss during the last 10 years. Women of a similar age who were reconstructed, without complications, during the same period were controls. The results suggest that there might be a more permanent negative effect on satisfaction and QoL following implant loss. The proportion of possible cases of depression was higher among patients who had experienced implant loss. The findings could indicate that in patients with an elevated risk for implant loss, the possible benefits with IBR should be carefully balanced against the effects of implant loss.

Keywords:

• Breast reconstruction
• implant loss
• plastic surgery
• psychology
• quality of life
• patient-reported outcomes
• body image

Acknowledgements

We are grateful for the invaluable contributions from the women who participated in this study. We also want to thank statisticians Thomas Karlsson and Adnan Noor Baloch, Akademistatistik, for fruitful statistical discussions.

Disclosure statement

The authors declare no conflicts of interest.

Additional information

Funding

The study was funded by grants from the Swedish Cancer Society (Cancerfonden), the Federal Government under the ALF Agreement (ALFGBG-724171), The Percy Falk Foundation for Research into Prostate Cancer and Breast Cancer and the Swedish Breast Cancer Association (Bröstcancerförbundet).