Psychosocial Outcomes of Subpectoral vs. Prepectoral Breast Reconstruction: A Comparative Analysis.

Introduction Breast reconstruction plays a critical role in restoring psychosocial well-being for patients after mastectomy. While both subpectoral and pre-pectoral implant placements are common, their impact on psychosocial outcomes remains understudied. This study investigates the influence of implant placement on patient-reported psychosocial well-being using BREAST-Q (Breast-Related Quality of Life Questionnaire). Methods We reviewed 69 patients who underwent breast reconstruction at Basildon Hospital between 2017 and 2023, utilizing BREAST-Q scales to evaluate psychosocial well-being, physical outcomes, and satisfaction with breasts. Statistical analysis was conducted using independent t-tests to compare psychosocial scores between patients who received subpectoral versus pre-pectoral implants. Results Subpectoral placement was significantly associated with higher psychosocial scores compared to pre-pectoral placement (75.7 vs. 61.9, p=0.046). No significant differences were observed in satisfaction with breasts between the two groups. Linear regression analysis revealed that subpectoral placement was an independent predictor of improved psychosocial outcomes, even after adjusting for other variables. Conclusions Subpectoral implant placement appears to offer superior psychosocial outcomes in breast reconstruction patients compared to pre-pectoral placement. These findings suggest that subpectoral placement should be considered the preferred option for patients prioritizing psychosocial well-being post-reconstruction. Further research is needed to explore the long-term effects of implant placement on quality of life.