title: Women's motives to opt for either implant or DIEP-flap breast reconstruction.
abstract: OBJECTIVE
  Understanding women's motives concerning breast reconstructive surgery will contribute to a better counselling and care for the increasing number of women choosing post-mastectomy breast reconstruction (BR).
  
  
  METHODS
  We interviewed 31 women who opted for implant or deep inferior epigastric perforator (DIEP)-flap BR after therapeutic or prophylactic mastectomy. Motives for BR in general and for the selected type of BR were investigated following a phenomenological qualitative research approach.
  
  
  RESULTS
  Women opting for implant BR were concerned with surgery-related issues, such as recovery time, number of scars and impact of surgery. They wanted to return to their daily life and restore their body image as soon as possible. Patients choosing DIEP-flap BR were more focussed on regaining a natural breast and wanted to benefit from the advantages of autologous tissue. Women scheduled for prophylactic mastectomy saw BR as an integral part of their treatment. Patients opting for BR after therapeutic mastectomy wanted to regain a complete body image with BR.
  
  
  CONCLUSIONS
  Patients' motives for implant BR were primarily related to surgical issues, whereas women who chose DIEP-flap BR especially focussed on regaining a breast that resembles their own lost breast as well as possible. Clinical variables (such as therapeutic or prophylactic mastectomy, breast irradiation, and waiting lists) need to be taken into account when considering a certain type of BR, as these can be of great importance in the decision-making process.
authors.affiliation: Center for Human and Clinical Genetics, Leiden University Medical Center, P.O. Box 9600, NL-2300 RC Leiden, The Netherlands. j.p.gopie@lumc.nl
authors.forename: Jessica P
authors.initials: JP
authors.lastname: Gopie
authors.forename: Medard T
authors.initials: MT
authors.lastname: Hilhorst
authors.forename: Annelies
authors.initials: A
authors.lastname: Kleijne
authors.forename: Reinier
authors.initials: R
authors.lastname: Timman
authors.forename: Marian B E
authors.initials: MB
authors.lastname: Menke-Pluymers
authors.forename: Stefan O P
authors.initials: SO
authors.lastname: Hofer
authors.forename: Marc A M
authors.initials: MA
authors.lastname: Mureau
authors.forename: Aad
authors.initials: A
authors.lastname: Tibben
mesh_terms: D000328:Adult; D001828:Body Image; D018427:Breast Implants; D002755:Choice Behavior; D004954:Esthetics; D005260:Female; D057227:Femininity; D006801:Humans; D007407:Interviews as Topic; D016462:Mammaplasty / Q000379:methods*; D008408:Mastectomy; D008875:Middle Aged; D009042:Motivation; D011446:Prospective Studies; D020127:Recovery of Function; D019529:Sexuality; D013524:Surgical Flaps