Skip to main content

Advertisement

Log in

The influence of plastic surgeon age and gender on decision-making in breast reconstruction: a national survey of American plastic surgeons

  • Original Paper
  • Published:
European Journal of Plastic Surgery Aims and scope Submit manuscript

Abstract

There are numerous options for breast reconstruction after mastectomy, and the final reconstructive option is often influenced by patient preference. This study surveyed plastic surgeons regarding their personal preferences for breast reconstruction after mastectomy to identify the impact of gender and age on reconstructive preference. An anonymous online survey was distributed to plastic surgeons in the American Society of Plastic Surgeons member directory and current plastic surgery residents. Female surgeons were asked to select reconstructive options for themselves as patients, while male surgeons were asked to answer the same questions as if advising a loved one. After unilateral mastectomy, 60.2 % of respondents preferred implant-based reconstruction, increasing to 67.8 % after bilateral mastectomy. Top reasons for selecting implant-based reconstruction were recovery time (78.0 %) and hospital length of stay (54.5 %). In contrast, respondents who preferred abdominal flap-based autologous reconstruction cited the longevity (83.3 %) and the aesthetic appearance of the final result (82.7 %) as top reasons. Female surgeons were significantly more likely to choose implant-based reconstruction than male surgeons (68.7 vs. 56.6 %, p = 0.001). Younger male surgeons preferred autologous reconstruction (58.8 %). Plastic surgeons’ reconstructive choices parallel current patient-based surveys favoring breast reconstruction with implants. Respondents’ reasons for selecting one reconstructive method over another are consistent with prior patient-based surveys. Female plastic surgeons prefer implant-based reconstruction to a greater extent than male plastic surgeons. This survey identifies the need for further prospective study of physician perspectives of patient experiences.

Level of Evidence: Not ratable.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Lloyd AJ (2001) The extent of patients’ understanding of the risk of treatments. Qual Health Care 10(Suppl 1):i14–i18

    Article  PubMed  PubMed Central  Google Scholar 

  2. Weinstein ND (1989) Optimistic biases about personal risks. Science 246:1232–1233

    Article  CAS  PubMed  Google Scholar 

  3. Albornoz CR, Bach PB, Mehrara BJ, et al. (2013) A paradigm shift in U.S. Breast reconstruction: increasing implant rates. Plast Reconstr Surg 131(1):15–23

    Article  CAS  PubMed  Google Scholar 

  4. Reuben BC, Manwaring J, Neumayer L (2009) Recent trends and predictors in immediate breast reconstruction after mastectomy in the United States. Am J Surg 198(2):237–243

    Article  PubMed  Google Scholar 

  5. Hernandez-Boussard T, Zeidler K, Barzin A, et al. (2013) Breast reconstruction national trends and healthcare implications. Breast J 19(5):463–469

    PubMed  Google Scholar 

  6. Nelson J, Tchou J, Domchek S, et al. (2012) Breast reconstruction in bilateral prophylactic mastectomy patients: factors that influence decision making. J Plast Reconstr Aesthet Surg 65(11):1481–1489

    Article  PubMed  Google Scholar 

  7. Gopie JP, Hilhorst MT, Kleijne A, et al. (2011) Women’s motives to opt for either implant or DIEP-flap breast reconstruction. J Plast Reconstr Aesthetic Surg 64:1062–1067

    Article  Google Scholar 

  8. Leone MS, Priano V, Franchelli S, et al. (2011) Factors affecting symmetrization of the contralateral breast: a 7-year unilateral postmastectomy breast reconstruction experience. Aesthetic Plast Surg 35:446–451

    Article  PubMed  Google Scholar 

  9. Losken A, Carlson GW, Bostwick J, et al. (2002) Trends in unilateral breast reconstruction and management of the contralateral breast: the Emory experience. Plast Reconstr Surg 110:89–97

    Article  PubMed  Google Scholar 

  10. Vyas RM, Dickinson BP, Fastekjian JH, et al. (2008) Risk factors for abdominal donor-site morbidity in free flap breast reconstruction. Plast Reconstr Surg 121(5):1519–1526

    Article  CAS  PubMed  Google Scholar 

  11. Berry T, Brooks S, Sydow N, et al. (2010) Complication rates of radiation on tissue expander and autologous tissue breast reconstruction. Ann Surg Oncol 17(Suppl 3):202–210

    Article  PubMed  Google Scholar 

  12. Evans GR, Schusterman MA, Kroll SS, et al. (1995) Reconstruction and the radiated breast: is there a role for implants? Plast Reconstr Surg:1111–1115 discussion, 1116–1118

  13. Williams JK, Carlson GW, Bostwick J, et al. (1997) The effects of radiation treatment after TRAM flap breast reconstruction. Plast Reconstr Surg 100:1153–1160

    Article  CAS  PubMed  Google Scholar 

  14. Rogers NE, Allen RJ (2002) Radiation effects on breast reconstruction with the deep inferior epigastric perforator flap. Plast Reconstr Surg 109:1919–1924 discussion 1925-1926

    Article  PubMed  Google Scholar 

  15. Kronowitz SJ, Robb GL (2004) Breast reconstruction and adjuvant therapies. Semin Plast Surg 18(2):105–115

    Article  PubMed  PubMed Central  Google Scholar 

  16. Spear SL, Onyewu C (2000) Staged breast reconstruction with saline-filled implants in the irradiated breast: recent trends and therapeutic implications. Plast Reconstr Surg 105:930–942

    Article  CAS  PubMed  Google Scholar 

  17. Schwartz MD, Lerman C, Brogan B, et al. (2004) Impact of BRCA1/BRCA2 counseling and testing on newly diagnosed breast cancer patients. J Clin Oncol 22(10):1823–1829

    Article  PubMed  Google Scholar 

  18. Howard-Mcnatt M, Schroll RW, Hurt GJ, et al. (2011) Contralateral prophylactic mastectomy in breast cancer patients who test negative for BRCA mutations. Am J Surg 202:298–302

    Article  PubMed  Google Scholar 

  19. Weichman KE, Broer PN, Thanik VD, et al. (2015) Patient-reported satisfaction and quality of life following breast reconstruction in this patients: a comparison between microsurgical and prosthetic implant recipients. Plast Reconstr Surg 136(2):213–220

    Article  CAS  PubMed  Google Scholar 

  20. American Society of Plastic Surgeons (2014) Tracking operations and outcomes for plastic surgeons. https://tops.plasticsurgery.org/. Accessed 11 Mar 2014

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Shruti C. Tannan.

Ethics declarations

Conflict of interest

Shruti C. Tannan, Shawna R. Kleban, Wendy M. Novicoff, Chris A. Campbell declare that they have no conflict of interest.

Ethical standards

For this type of article formal consent from a local ethics committee is not required.

Funding

None

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Tannan, S.C., Kleban, S.R., Novicoff, W.M. et al. The influence of plastic surgeon age and gender on decision-making in breast reconstruction: a national survey of American plastic surgeons. Eur J Plast Surg 40, 103–110 (2017). https://doi.org/10.1007/s00238-016-1229-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00238-016-1229-z

Keywords

Navigation