title: The Psychosexual Impact of Partial and Total Breast Reconstruction: A Prospective One-Year Longitudinal Study.
abstract: BACKGROUND
  This prospective trial sought to explore patients' satisfaction and expectations for surgery in the areas of sexuality and body image and to evaluate outcomes pertaining to sexual well-being after total and partial breast reconstruction (BR).
  
  
  METHODS
  Patients who underwent mastectomy and immediate total BR (group 1; n = 60) or lumpectomy and reduction mammoplasty (group 2; n = 10) completed a questionnaire preoperatively and 1 year postoperatively to assess their satisfaction with their sex life and body image, perceptions of breasts as a source of sexuality, and expectations of surgery in these areas. Surveys were scored on a 5-point Likert scale, with 5 indicating strongly agree. Change scores were evaluated in the 2 groups (P = 0.05).
  
  
  RESULTS
  In group 1, satisfaction with sex life and body image was unchanged. Pursuit of sexual attractiveness (from 3.78 to 3.31, P = 0.02) and an improved body image (from 3.89 to 3.33, P < 0.01) were cited as expectations for surgery but were achieved less often. When stratified by different types of reconstruction, there were no discernible differences in responses. In group 2, the patients reported an unexpected increase in their partner's perception of them as womanly (from 1.33 to 2.50, P = 0.01) and greater gains in the ability to wear sexually provocative clothing (from 1.78 to 3.11, P < 0.01).Preoperative expectations for improved body image were more often met in group 2 than group 1 (from 3.60 to 4.00 vs from 3.89 to 3.33, P = 0.02). Group 2 experienced greater improvement in body image satisfaction (from 2.80 to 3.80 vs from 3.37 to 3.44, P = 0.03).
  
  
  CONCLUSIONS
  Overall satisfaction with sex life and body image was preserved for both groups; however, the oncoplastic approach achieved significantly larger gains in body image perception.
authors.affiliation: From the Division of Plastic and Reconstructive Surgery, Emory University, Atlanta, GA.
authors.forename: Alexandra M
authors.initials: AM
authors.lastname: Hart
authors.forename: Ximena
authors.initials: X
authors.lastname: Pinell-White
authors.forename: Francesco M
authors.initials: FM
authors.lastname: Egro
authors.forename: Albert
authors.initials: A
authors.lastname: Losken
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001828:Body Image; D001943:Breast Neoplasms / Q000523:psychology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D019538:Health Care Surveys; D006801:Humans; D016462:Mammaplasty / Q000379:methods / Q000523:psychology*; D008408:Mastectomy / Q000523:psychology*; D008875:Middle Aged; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D011446:Prospective Studies; D011788:Quality of Life; D019529:Sexuality / Q000523:psychology*