Psychosocial and surgical aspects of breast reconstruction.

Why are only less than 1% of the mastectomized women in The Netherlands reconstructed? We report the results of four studies, among reconstructed patients and their partners, among women who had an amputation only and among general and plastic surgeons in The Netherlands. In contrast to what is thought by (plastic) surgeons, women do not opt in the first place for breast reconstruction because of emotional or cosmetic reasons, but to be freed from the prosthesis. Surgeons hardly ever take the initiative to inform patients about breast reconstruction. Knowledge about breast reconstruction is gained mainly from the mass media. Nearly all reconstructed patients are satisfied with the results. This is independent of the objective cosmetic results. In our opinion amputated women should be informed about breast reconstruction in the same way as about the external prostheses. We also reviewed the surgical aspects concerning indications, timing and available techniques of breast reconstruction. We concluded that the improved surgical procedures make breast reconstruction less burdensome for the patients than the older surgical techniques.