Sexual-Esteem and Body-Esteem Perception After Breast Reconstruction According to the Surgical Technique

Breast carcinoma and mastectomy are associated with negative impacts on women's self-esteem and sexuality. There are different surgical techniques to reach breast reconstruction, the most relevant ones being the pedicled latissimus dorsi myocutaneous flap with prosthesis implantation after expander, the deep inferior epigastric perforator flap (DIEP) and only prosthesis implantation after expander. One of the objectives of breast reconstruction is to restore those factors although it is not totally clear which technique has the best outcomes in this regard. The aim of this study was to compare them in terms of self-esteem and sexuality. We selected patients who underwent breast reconstruction after mastectomy concerning the surgical technique. They filled the SESS and BREAST-Q tests, and they were compared among other parameters. Globally, deep inferior epigastric perforator flap (DIEP) scored statistically better results than the other techniques in BREAST-Q, although latissimus dorsi was related to lower complication rate and prosthesis implant associated less length of stay. Deep inferior epigastric perforator flap (DIEP) was the breast reconstruction technique related globally to better outcomes in regard to sexuality and self-esteem.