title: Impact of delayed implant and DIEP flap breast reconstruction on body image and sexual satisfaction: a prospective follow-up study.
abstract: OBJECTIVE
  Prospective studies regarding the psychosexual impact after different types of breast reconstruction (BR) are scarce. The impact of either implant or deep inferior epigastric artery perforator (DIEP) flap BR on body image and sexual relationship satisfaction was investigated in time.
  
  
  METHODS
  At baseline, 98 women opting for delayed implant or DIEP flap BR after mastectomy for breast cancer completed a survey. The majority was followed up at 6 months (96%) and 20 months (86%) postoperatively. Questionnaires included the body image scale, Dutch Relationship Questionnaire, Short Form - 36 Health Survey and the Impact of Event Scale.
  
  
  RESULTS
  Mixed modeling analyses indicated that preoperative body image improved significantly after 20 months (p < 0.001), and there was no statistically significant difference between the two types of BR. A better body image was related to a better general mental health (p = 0.02), less cancer distress (p < 0.001) and a higher partner relationship satisfaction (p < 0.001). Sexual relationship satisfaction also increased after 20 months (p = 0.01), and it was positively related to higher partner relationship satisfaction but negatively affected by hormonal therapy.
  
  
  CONCLUSIONS
  Body image and sexual relationship satisfaction significantly improved after BR, and this was not related to the BR type. Psychosexual consequences from previous cancer treatment may interfere. Lower general mental health, higher cancer distress, less partner relationship satisfaction or receiving hormonal therapy can negatively affect body image or sexual relationship satisfaction.
authors: Center for Human and Clinical Genetics, Leiden University Medical Center, Leiden, the Netherlands.
authors: Jessica P
authors: JP
authors: Gopie
authors: Moniek M
authors: MM
authors: ter Kuile
authors: Reinier
authors: R
authors: Timman
authors: Marc A M
authors: MA
authors: Mureau
authors: Aad
authors: A
authors: Tibben
mesh_terms: D001828:Body Image / Q000523:psychology*; D018427:Breast Implants / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016462:Mammaplasty / Q000523:psychology*; D008408:Mastectomy / Q000523:psychology*; D008875:Middle Aged; D010549:Personal Satisfaction; D011446:Prospective Studies; D012725:Sexual Behavior / Q000523:psychology*; D011795:Surveys and Questionnaires; D013997:Time Factors
keywords: body image; breast reconstruction; cancer; oncology; partner relationship; sexual satisfaction