Measuring patient-reported outcomes has become increasingly important in cosmetic and reconstructive breast surgery. The objective of this study was to develop a new outcome measure assess the unique surgery patients.Patient interviews, focus groups, expert panels, literature review were used conceptual framework list questionnaire items. Three procedure-specific questionnaires (augmentation, reduction, reconstruction) developed cognitive debriefing interviews pilot each questionnaire....

Background: Despite its benefits in body image, self-esteem, sexuality, and quality of life, historically fewer than 25 percent patients undergo immediate breast reconstruction. After passage the Women Health Cancer Rights Act, studies failed to demonstrate changes reconstructive rates. A recent single-year report suggests significant shifts U.S. reconstruction patterns. The authors' goal was assess long-term trends rates types Methods: serial cross-sectional study performed using Nationwide...

Background: Microvascular free tissue transfer is a reliable method for reconstruction of complex surgical defects. However, there still small risk flap compromise necessitating urgent reexploration. A comprehensive study examining the causes and methods avoiding or treating these complications has not been performed. The purpose this was to review authors' experience with large number microvascular over an 11-year period. Methods: This retrospective all flaps performed from 1991 2002 at...

Background: Complications following postmastectomy reconstruction can cause significant morbidity. The compound effect of individual risk factors on the development complications expander/implant has not, however, been well delineated. This study evaluated impact clinical to predict reconstruction. Methods: From 2003 through 2004, 1170 reconstructions were performed at a single center. A prospectively maintained database was reviewed. Variables including age, smoking status, body mass index,...

Free-flap reconstruction of oncologic mandibular defects has become the modern standard care. However, no previous studies have established long-term results such reconstructions. The objective this study was to review functional and aesthetic outcomes in patients a decade after free-flap reconstruction.A single surgeon's experience with mandible retrospectively reviewed. Eighty-two consecutive who underwent from January 1987 December 1990 were identified. Of 34 still alive, 20 agreed...

Chest wall irradiation is becoming increasingly common for mastectomy patients who have opted immediate breast reconstruction with tissue expanders and implants. The optimal approach such has not yet been defined. This study assesses the outcomes of a protocol require after expander/implant reconstruction. charts all underwent at Memorial Sloan-Kettering Cancer Center between January 1995 June 2001 had previously undergone were retrospectively reviewed. A subgroup required chest was...

Previous outcome studies comparing implant and autologous breast reconstruction techniques have been limited by short-term follow-up, single-center design, a lack of rigorous patient-reported data. An understanding the expected satisfaction breast-related quality life associated with each type procedure is central to decision-making process.To determine outcomes reported patients undergoing postmastectomy using or 2 years after surgery.Patients were recruited from 11 centers (57 plastic...

Purpose The goals of immediate postmastectomy breast reconstruction are to minimize deformity and optimize quality life as perceived by patients. We prospectively evaluated patient-reported outcomes (PROs) in women undergoing implant-based or autologous reconstruction. Methods Women for invasive cancer and/or carcinoma situ were enrolled at 11 sites. underwent tissue Patients completed the BREAST-Q, a condition-specific PRO measure surgery patients, Patient-Reported Outcomes Measurement...

To support the development of new techniques and technology in facial aesthetics, sophisticated ways measuring outcomes are needed. The objective this study was to develop content a set patient-reported outcome (PRO) scales for use with aesthetic patients. A literature review, patient interviews, input from experts working patients were used conceptual framework deemed important construct items preliminary PRO scales. includes following themes: satisfaction appearance; health-related quality...

Background: The BREAST-Q is a new patient-reported outcome instrument for cosmetic and reconstructive breast surgery. For it to be used appropriately in clinical research, important that its validity demonstrated. aim of this study was test property. Methods: authors evaluated the subscales by using Rasch measurement methods traditional psychometric with focus on construct (including comparisons existing breast-related, measures) hypothesis-driven questions subsamples). Results: A total 817...

Expander/implant and autogenous tissue breast reconstructions have different aging processes, the time when these processes stabilize is unclear. The authors' goal was to evaluate long-term patient-reported aesthetic satisfaction with expander/implant reconstruction.The authors surveyed a cross-section of University Michigan women who underwent postmastectomy reconstruction (response rate, 73 percent) between 1988 2006 [110 109 transverse rectus abdominis myocutaneous (TRAM)...

In 2002, an international advisory panel was convened to assess the scientific literature and develop evidence-based guidance for prevention treatment of pathologic scarring. Emerging clinical data, new options, technical advances warranted a renewed search review initial recommendations.To update management algorithm scarring reflect best practice standards at present.Management recommendations were derived from evidence amassed during comprehensive experience consensus opinion members.A...

Background: The aims of the current study were to (1) measure trends in type mastectomy performed, (2) evaluate sociodemographic/hospital characteristics patients undergoing contralateral prophylactic versus unilateral mastectomies, and (3) analyze reconstruction rates method used following different types. Methods: Mastectomies from 1998 2008 analyzed using Nationwide Inpatient Sample database. (n = 178,603) classified as either unilateral, prophylactic, or bilateral prophylactic....

Background: Little information exists on the incidence of complications after acellular human dermis implantation in two-stage tissue expander breast reconstruction. The purpose this study was to evaluate postoperative adverse events and identify significant predictors Methods: This accrued all patients from January 2004 through April 2008 undergoing immediate reconstruction using dermis. A total 153 expanders were placed. Complications assessed. Univariate multivariate logistic regression...

Patients considering postmastectomy radiation and reconstruction require information regarding expected outcomes to make preference-concordant decisions. A prospective multicenter cohort study of women diagnosed with breast cancer at 11 centers between 2012 2015 compared complications patient-reported 622 irradiated 1625 unirradiated patients who received reconstruction. Patient characteristics were analyzed using ttests for continuous variables chi-square tests categorical variables....

An ever-growing range of facial cosmetic products and treatments are available, but little clinical research is being performed to determine treatment outcomes from the patient's perspective. The FACE-Q a patient-reported outcome instrument composed more than 40 independently functioning scales checklists. aim this article describe development psychometric evaluation five new scales.

In breast reconstruction, it is critical for patients and surgeons to have comprehensive information on the relative risks of available options. However, previous studies that evaluated complications were limited by single-center designs, inadequate follow-up, confounding.To assess 2-year complication rates across common techniques postmastectomy reconstruction in a multicenter patient population.This longitudinal, multicenter, prospective cohort study conducted from February 1, 2012,...

In postmastectomy reconstruction, procedure choice is heavily influenced by the relative risks of various options. This study sought to evaluate complications in a large, multicenter patient population.Previous studies have reported widely varying complication rates, but been limited their single center designs and inadequate controlling for confounders analyses.Eleven sites enrolled women undergoing first time, immediate, or delayed reconstruction following mastectomy cancer treatment...