Oncoaesthetic Breast Reconstruction After Mastectomy Improves Patient Satisfaction and Aesthetic outcomes.

Authors

Michele Riccio, Nicola Zingaretti, Angelica Aquinati, Andrea Giuseppe Ferraro, Enrico Lenti, Andrea Marchesini, Giuseppe Andrea Ferraro, Pier Camillo Parodi, Francesco De Francesco

Published in

Clinical breast cancer. Volume 26. Issue 10. Pages 134-146. Aug 30, 2026. Epub Aug 30, 2026.

Abstract

Immediate implant-based breast reconstruction has evolved toward an onco-aesthetic strategy integrating oncologic safety, aesthetic optimization, bilateral balance, and patient-centered outcomes. This study evaluated the clinical, aesthetic, and patient-reported outcomes of an integrated onco-aesthetic reconstructive approach following mastectomy.
This retrospective single-center cohort included consecutive patients undergoing immediate implant-based breast reconstruction within a standardized onco-aesthetic framework. Surgical planning incorporated individualized skin-envelope management, implant selection, and selective contralateral symmetrization. Patient-reported outcomes were assessed using the BREAST-Q Reconstruction Module, while aesthetic results were independently evaluated using the Harris photographic scale. Bilateral aesthetic outcomes and postoperative complications were also analyzed.
Fifty-six patients were included; 24 (42.9%) underwent immediate contralateral symmetrization. Significant improvements were observed in BREAST-Q Satisfaction with Breasts (+ 34.9 points), Psychosocial Well-being (+ 20.7), Sexual Well-being (+ 33.5), and Physical Well-being: Chest (+ 19.0) (all P < .001) Good-to-excellent physician-rated aesthetic outcomes were achieved in 35/56 patients (62.5%), and Harris aesthetic quality strongly correlated with postoperative Satisfaction with Breasts (Spearman's ρ = 0.904, P < .001) Contralateral symmetrization was not independently associated with postoperative satisfaction after accounting for achieved aesthetic quality. Postoperative complications occurred in 12/56 patients (21.4%), with implant removal in 3/56 (5.4%) and implant retention of 94.6%.
An integrated onco-aesthetic approach was associated with substantial improvements in patient-reported outcomes, favorable aesthetic results, and high implant retention. Patient satisfaction was more closely related to achieved aesthetic quality than to contralateral symmetrization itself, supporting individualized bilateral reconstructive planning.

PMID:
42762670
Bibliographic data and abstract were imported from PubMed on 20 Sep 2026.

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