Abstract
Background There is little data examining the psychosocial characteristics of women who choose
a type of autologous postmastectomy reconstruction. This study sought to investigate
the role of personality on decision making and postoperative satisfaction in autologous
breast reconstruction.
Patients and Methods A retrospective survey of 120 consecutive patients who had undergone transverse
rectus abdominis myocutaneous (TRAM) or perforator flap (PF) reconstruction over a
4-year period by a single surgeon at a single academic institution. All patients underwent
similar preoperative consultations and were categorized into one of four groups based
on surgical procedure they chose and their PF candidacy as determined by body mass
index, age, and laterality. The survey packet included three validated measures of
personality indices and a quality-of-life questionnaire. Intergroup analysis was performed
using the Wilcoxon rank sum test.
Results The overall survey response rate was 52.5%. PF patients were younger (p = 0.007) and more likely to undergo bilateral reconstruction (p = 0.0009) relative to TRAM patients. Comparisons between the two most clinically
extreme groups showed significant results with regard to personality testing. Patients
who were deemed not ideal PF candidates but nevertheless chose PF reconstruction were
shown to be more narcissistic (p = 0.033), extroverted (p = 0.024), and having a higher postoperative quality of life (p = 0.021) than those who were deemed ideal PF candidates but ended up choosing pedicled
TRAM reconstruction.
Conclusion Specific personality traits play a role in the patients' choice of a reconstructive
option and their overall postoperative satisfaction. Clinicians should be aware of
the possible influence of personality type on surgery selection.
Keywords
personality - perforator flaps - quality of life - outcomes
