Patient experience of implant loss after immediate breast reconstruction: An interpretative phenomenological analysis

Figures & data

Table 1. Participant demographics.

Pseudonym	1	2	3	4	5	6	7	8
Age (y)	42	59	30	43	56	36	48	48
Partner	No	Yes	No	Yes	No	Yes	No	Yes
Time since implant loss (y)	4	3	2	2	3	3	1	6
Breast cancer	Yes	Yes	No	No	Yes	No	Yes	Yes

Table 2. Themes, subthemes, and quotations.

Immediate breast reconstruction as the indisputable choice It is unquestionable that I have two breasts I never… I never doubted that I was going to have a reconstruction, that I can say. I was very sure of that from the beginning. (2) No, I really didn’t want to lose the breast. I wasn’t scared of the cancer at all, but… It was the loss of the breast that was my big concern. (8)
IBR was strongly recommended From the beginning, it was just about following their…, they had some kind of routine, so if you don’t ask they will follow it. (3) I didn’t know anything about those things [breast reconstruction]. I blindly trusted what they said… you trust the healthcare and you think that’s the right thing to do. So, I didn’t really object much. (7)
Insufficient information and the difficulty to grasp risks No, there wasn’t very much [information about complications]. It was only things that you like read on your own on the internet. (1) I didn’t demand any numbers [on complication frequencies]. But the way it was presented made me feel like it was very, very uncommon. (8)
A difficult experience
A dramatic and unexpected course I thought I was about to see the end of it when I first got the expander and knew that, ok, but it’s going to heal for a few months and then we’re just going to fill them and it won’t be long… Then it was really tough to realize that you were back to square one and had to wait another six months before you could put in a new [expander] and start the whole process again. (5) No it hadn’t crossed my mind that it could go this far, I never imagined I would have to go through this many operations, I’ve had a crazy amount of operations. God, no, I really didn’t know the risks were this big…I wasn’t aware of it. (4) A good, but not ideal, treatment I’m incredibly positive to what I’ve had [---] Everything, I think it’s been a positive experience. (2) I’m really happy I have done this, and grateful. Very grateful. I have nothing bad to say about the healthcare. It’s the best healthcare I have ever received. (4)
An altered body: redefining normality
Something is missing And it was kind of part of who I am in some way. You sort of…you choose your style of clothing, you choose everything based on it. It is what makes you “you” in some way… (2) When I was without it [the breast] for a period of time…That was when I realized how much they [the breasts] meant. When I lived an ordinary…Before the cancer, I didn’t think about what…what meaning the breasts had. They were kind of part of the deal [laughs]. When I was without [breasts], that’s when I started to think that…They are of big importance both for your womanhood [and] how you perceive your body and who you are as a person. (5) It is better to have “fake” breasts than no breasts at all ”Well, yes, partly it [breasts] has provided food to my children, I’ve nursed all four of them. But also to me as a woman…it has been a big part and a very erogenous zone to me…That, now, is completely gone. (7) There will always be minor things, there’s a lot of scarring after all the operations…It will never be totally natural. But I’m starting to feel that I can accept…Well, that this is what I look like. (3)
Trying to cope
Concealing the missing breast(s) And I have considerate colleagues who have bought two bras with padding [laughs] (…) She said, “I know you don’t want to go to work if you don’t have any boobs.” And well, you’re damn right about that. (1) Yes, it looks very weird. I definitely avoid going to the pool if I know that children will be there. (8)
The importance of being “strong” and “positive” I have never been… I haven’t cried once. Not once. No, not because of the cancer, nothing. (1) I have been working forward this entire time and have had difficulties to reflect on what I’ve been through. (5)
In need of support Everyone has always regarded me as a very strong person and that nothing can break me down… (…) Maybe they [her friends] would have listened and been the best listeners in the world, but maybe I didn’t give them the chance. Didn’t want to be a burden to people. (4) I have been through a lot in my life, so I’m quite strong [laughs]. I can work on myself a lot… I feel… How should I put it… I understand my own feelings quite well and can process them. But I also needed a lot of support. (3)

Data availability

The datasets generated during the current study are not publicly available due to the patients’ privacy but are available from the corresponding author on reasonable request.