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CC BY 4.0 · Arch Plast Surg 2024; 51(06): 542-548
DOI: 10.1055/a-2407-9183
Breast/Trunk
Original Article

Comparison of Patient-Reported Quality of Life Following Direct-to-Implant Prepectoral and Subpectoral Breast Reconstruction Using BREAST-Q: A Randomized Controlled Trial

Diana L Dyrberg 
1   Department of Plastic Surgery, Odense Universitetshospital, Odense, Denmark
,
Farima Dalaei 
1   Department of Plastic Surgery, Odense Universitetshospital, Odense, Denmark
,
Martin Sollie 
1   Department of Plastic Surgery, Odense Universitetshospital, Odense, Denmark
,
Camilla Bille 
1   Department of Plastic Surgery, Odense Universitetshospital, Odense, Denmark
,
Vibeke Koudahl 
1   Department of Plastic Surgery, Odense Universitetshospital, Odense, Denmark
,
Jens A Sørensen 
1   Department of Plastic Surgery, Odense Universitetshospital, Odense, Denmark
,
Jørn B Thomsen 
1   Department of Plastic Surgery, Odense Universitetshospital, Odense, Denmark
› Author Affiliations Funding The first author (D.L.D.) received a 1-year salary sponsor fee from Group Sebbin. Apart from this none of the authors have any disclosures in terms of financial and/or personal relationships with people or organizations that could influence this published work. No funding was received for this article.
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Abstract

Background Direct-to-implant breast reconstruction (DIR) is becoming more and more accepted. There is a lack of high-quality studies assessing differences in patient-reported quality of life (QoL) between different implant placement methods. The aim of this randomized controlled (clinical) trial was to compare QoL between women reconstructed by sub- or prepectoral implant placement.

Methods We included women over 18 years eligible for DIR. Patients were randomly assigned to reconstruction by subpectoral or prepectoral implant placement. Assessment of QoL and patient satisfaction was made using the BREAST-Q questionnaire for postmastectomy breast reconstruction and compared between the sub- and prepectoral reconstructed groups preoperatively and after 3 and 12 months of follow-up.

Results A total of 42 women were allocated to sub- or prepectoral reconstruction with 21 patients in each group. There were no differences in patient characteristics between groups. Regarding all the selected BREAST-Q scales: (1) satisfaction with the reconstructed breast, (2) satisfaction with the breast implant, (3) satisfaction with the overall outcome, (4) psychosocial well-being, (5) sexual well-being, and (6) physical well-being—we found no significant differences between the two groups. Assessing each group independently we found, that in both groups sexual well-being improved after surgery postoperatively compared to the preoperative scores.

Conclusion We found high satisfaction and QoL following both sub- and prepectoral breast reconstruction. We found no significant differences between groups suggesting both methods for DIR can be used. Despite our high-quality data, a larger sample size and longer postoperative follow-up are needed to further investigate the differences in QoL between sub- and prepectoral breast reconstruction.

Keywords

breast reconstruction - quality of life - BREAST-Q - breast implant - patient-reported outcome

Note

The study has been prospectively registered at clinicaltrials.gov (NCT03143335) and the protocol has been published in Trials.[21]


Authors' Contributions

Writing original draft: D.L.D., F.D., M.S., J.B.T. Methodology: J.B.T., C.B. Formal analysis: D.L.D., F.D. Project administration: J.B.T., J.A.S., V.K. Data curation: D.L.D. Writing- review and editing: D.L.D., J.B.T., C.B., J.A.S., V.K. Visualization: D.L.D. and J.B.T.


Ethical Approval

The study was approved by the Regional Committees on Health Research Ethics for Southern Denmark (S-20160160) and performed in accordance with the principles of the Declaration of Helsinki.


Patient Consent

Written informed consent was obtained from the included participants.




Publication History

Received: 18 May 2022

Accepted: 11 July 2024

Accepted Manuscript online:
02 September 2024

Article published online:
13 November 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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