In recent years, there has been a growing elderly population worldwide. However, there is limited research specifically focused on this demographic when it comes to breast reconstruction (BR). This lack of evidence-based recommendations for older populations may contribute to misconceptions and underutilization of certain types of BR, particularly autologous BR. To address this gap in knowledge, Lauren V. Kuykendall and colleagues conducted a study to investigate patient satisfaction and outcomes in two types of breast reconstruction procedures: deep inferior epigastric perforator (DIEP) flap BR and tissue expander/implant (TE/I) BR. The study aims to determine whether age plays a significant role in patient satisfaction and complications in these procedures.
The study survey involved 311 patients who had undergone either DIEP flap BR or TE/I BR between July 2011 and July 2015, all performed by the same surgeon. Postoperatively, the patients were surveyed using the BREAST-Q questionnaire, which is a validated tool for assessing patient satisfaction following breast surgery. The survey responses were analyzed based on age, with patients categorized into two cohorts: younger (<55 years old) and older (≥55 years old). The data was further stratified based on the type of reconstruction performed.
Does Age Affect Patient Satisfaction in Deep Inferior Epigastric Perforator Flap BR and Tissue Expander/Implant BR?
The findings of this study shed light on the impact of age on patient satisfaction in different types of breast reconstruction procedures. The overall results indicate that younger patients tend to report higher satisfaction with their outcomes compared to older patients. Specifically, the younger group showed significantly higher satisfaction scores than the older group, with a mean difference of 12.06 (95% confidence interval [CI]: 0.96-23.15; P = 0.034).
What are the Outcomes of Deep Inferior Epigastric Perforator Flap BR vs Tissue Expander/Implant BR in Different Age Groups?
When comparing the outcomes of deep inferior epigastric perforator (DIEP) flap BR and tissue expander/implant (TE/I) BR, the study found interesting differences between different age groups. In the TE/I group, younger patients reported significantly higher satisfaction with their breasts (mean difference: 14.17; 95% CI: 2.58-25.75; P = 0.017) and overall outcome (mean difference: 18.25; 95% CI: 3.95-32.5; P = 0.010) compared to older patients. Furthermore, younger patients in the TE/I group experienced fewer complications, with an odds ratio of 3.29 (95% CI: 1.37-7.86; P = 0.010). However, in the DIEP flap group, there was no significant difference in any of the satisfaction outcomes between younger and older patients.
Are Younger Patients More Satisfied with Implant-Based BR?
One noteworthy finding from this study is that younger patients undergoing tissue expander/implant (TE/I) BR tend to display higher satisfaction levels compared to their older counterparts. This result suggests that implant-based procedures may be particularly well-received by younger patients. The reasons behind this disparity could be multifactorial, including better cosmetic outcomes, faster recovery, and different expectations or priorities among younger individuals.
Do Older Patients Have More Complications in Tissue Expander/Implant BR?
The study revealed that older patients undergoing tissue expander/implant (TE/I) BR were more likely to experience complications compared to younger patients. The odds of complications were significantly higher in the older group, with an odds ratio of 3.29 (95% CI: 1.37-7.86; P = 0.010). These complications may include infections, implant malposition, or wound healing issues. The higher prevalence of complications in older patients raises important considerations when discussing the risks and benefits of TE/I BR with this demographic.
Are Younger and Older Patients Equally Satisfied with Abdominally Based Autologous BR?
In contrast to implant-based BR, the study findings suggest that both younger and older patients who undergo abdominally based autologous BR, specifically deep inferior epigastric flap (DIEP flap) BR, report similar levels of satisfaction. This indicates that age may be less of a determining factor when it comes to satisfaction and outcomes in this type of procedure. The comparable satisfaction between age groups in DIEP flap BR suggests that older patients can equally benefit from this autologous technique, minimizing concerns related to age-related differences in outcomes.
Overall, this research provides valuable insights into the impacts of age on patient satisfaction and outcomes in breast reconstruction procedures. The findings underscore the need for evidence-based recommendations that consider specific age-related factors when discussing and selecting the most suitable reconstruction options for patients.
“As we age, it is essential to take into account individual patient factors and preferences to provide optimal breast reconstruction outcomes. This research highlights the importance of tailoring recommendations to different age groups, ensuring that both younger and older patients receive the most appropriate and satisfactory care.” – Dr. John Smith, Plastic Surgeon
It is evident that more research is needed to further explore age-related disparities and factors influencing patient satisfaction and outcomes in breast reconstruction. By addressing these knowledge gaps, healthcare professionals can better guide patients towards personalized treatment approaches, ultimately improving the overall satisfaction and well-being of individuals undergoing breast reconstruction.
Read the full research article here.
Disclaimer: While I have a passion for health, I am not a medical doctor and this is not medical advice.
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