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Which patients get postoperative photos? Is there a selection bias on the patients sent for final photos?
Eliana F R Duraes; Isis Scomacao; Pauline Vandijck; Graham Schwarz; Andrea Moreira; Risal Djohan; Raffi Gurunluoglu; Steven Bernard
Cleveland Clinic
2018-02-14
Presenter: Pauline Van Dijck
Affidavit:
This is an original work.
Director Name: Steven Bernard
Author Category: Fellow Plastic Surgery
Presentation Category: Clinical
Abstract Category: Breast (Aesthetic and Recon.)
Purpose: To evaluate factors that influence the availability of final post-operative photos after different types of breast reconstructions.
Methods: From 2009-2011, charts from patients that underwent breast reconstruction after total mastectomy were searched for post-operative photos, demographic data and treatment information.
Results: A total of 933 patients (1388 breasts) were identified. After exclusion of patients that had tissue expanders still in place, 27(2%), and patients that abandon reconstruction, 47(5%), 861 charts were analyzed. After univariate and multivariate analysis, type of reconstruction, presence of the nipple and patient age at the last surgery were associated with the likelihood of having photos (p=0.032; p=0.018; and p¡Ü0.001, respectively). Smoking status, ASA class, indication and type of mastectomy, BMI, minor and major complications, and mastectomy specimen weight did not influence significantly the post-operative photo availability. Bilaterality of the reconstruction and the occurrence of revision/symmetrization surgeries were identified as factors on the univariate analysis but were not confirmed on the multivariate analysis.
Conclusion: Younger patients after autologous breast reconstructions with preserved or reconstructed nipples were more likely to have their final post-operative photos taken. It is important to highlight the need for widespread photographic documentation of the reconstructed breasts to allow outcome evaluation of different reconstruction techniques and realistic patient expectation counseling. Considering the number of patients that opt out of nipple reconstruction, it would be advisable to systematically photograph the breasts once the mound reconstruction is concluded, as well as when the reconstruction fails.
