Subcutaneous mastectomy with implant reconstruction: cosmetic outcome and patient satisfaction

Aims: To assess the cosmetic outcome and satisfaction of patients who have undergone subcutaneous mastectomy (SCM) with silicon implant reconstruction and to investigate the factors influencing cosmesis.Methods: A total of 101 patients who had had SCM implant reconstruction for treatment of primary breast cancer were assessed for cosmesis by a panel using photographic assessment. Satisfaction and sexuality were studied by a self-evaluation questionnaire. Results: A good to excellent cosmetic result was achieved in 71 (70.3%) patients (and in 85% of the group who had immediate insertion of the implant). Eighty-one patients (81%) were moderately or very satisfied (96% of the immediate reconstruction group were so). Factors found to influence cosmesis positively were submuscular insertion of the implant (P<0.001), the lateral incision approach (P<0.001) and immediate reconstruction (P<0.001). Conclusion: The findings of this study support the use of SCM with implant reconstruction as the simplest option in those advised to undergo mastectomy and who wish for reconstruction.