title: Differences between patients and medical professionals in the evaluation of aesthetic outcome following breast reconstruction with implants.
abstract: OBJECTIVE
  Most studies on breast reconstruction evaluate different surgical techniques, types of implant or time of reconstruction. Moreover, evaluations are usually performed either by surgeons or by patients, but are rarely compared. We conducted a study on aesthetic outcome following breast reconstruction with implants comparing the evaluation by patients versus medical professionals.
  
  
  METHODS
  Forty-seven patients, who had a breast reconstruction with implants between 2001 and 2010 (median follow-up 71 months), underwent a clinical examination, standardized photo documentation and filled out a questionnaire to evaluate their aesthetic result (rate 1 very good to 5 very poor). Photo documentation was independently evaluated by 18 medical professionals using the same evaluation instrument and the results were compared. Gender and patient aspects were taken into account.
  
  
  RESULTS
  We found statistically significant differences between patients and medical professional ratings. The patient evaluation was better through all categories as compared to the evaluation by medical personnel. The degree of medical education or gender aspects did not significantly affect the professional ratings. Age at reconstruction, length of follow-up or primary versus secondary reconstruction did not seem to make a difference in the evaluations of the patients versus the medical professionals..
  
  
  CONCLUSIONS
  The differences between patient and expert opinion in rating of aesthetic results indicate that patient satisfaction is influenced by multiple factors and not only by good aesthetic outcome. Patient evaluation should therefore be carefully considered in treatment and outcome studies of breast reconstruction..
authors.affiliation: Department of Plastic, Reconstructive and Aesthetic Surgery, Innsbruck Medical University, Anichstrasse 35, 6020 Innsbruck, Austria.
authors.forename: T
authors.initials: T
authors.lastname: Wachter
authors.affiliation: Department of Medical Statistics, Informatics and Health Economics, Innsbruck Medical University, Schoepfstrasse 41/1, 6020 Innsbruck, Austria.
authors.forename: M
authors.initials: M
authors.lastname: Edlinger
authors.affiliation: Department of Plastic, Reconstructive and Aesthetic Surgery, Innsbruck Medical University, Anichstrasse 35, 6020 Innsbruck, Austria.
authors.forename: C
authors.initials: C
authors.lastname: Foerg
authors.affiliation: Department of Plastic, Reconstructive and Aesthetic Surgery, Innsbruck Medical University, Anichstrasse 35, 6020 Innsbruck, Austria.
authors.forename: G
authors.initials: G
authors.lastname: Djedovic
authors.affiliation: Division of Biological Chemistry, Biocenter, Innsbruck Medical University, Innrain 80-82, 6020 Innsbruck, Austria.
authors.forename: C
authors.initials: C
authors.lastname: Mayerl
authors.affiliation: Department of Psychiatry and Psychotherapy, University Hospital for Psychosomatic Medicine, Innsbruck Medical University, Anichstrasse 35, 6020 Innsbruck, Austria.
authors.forename: J
authors.initials: J
authors.lastname: Kinzl
authors.affiliation: Department of Plastic, Reconstructive and Aesthetic Surgery, Innsbruck Medical University, Anichstrasse 35, 6020 Innsbruck, Austria.
authors.forename: T
authors.initials: T
authors.lastname: Bauer
authors.affiliation: Department of Plastic, Reconstructive and Aesthetic Surgery, Innsbruck Medical University, Anichstrasse 35, 6020 Innsbruck, Austria. Electronic address: dolores.wolfram@i-med.ac.at.
authors.forename: D
authors.initials: D
authors.lastname: Wolfram
mesh_terms: D000368:Aged; D001291:Attitude of Health Personnel; D018427:Breast Implants; D004954:Esthetics; D005180:Faculty, Medical; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007396:Internship and Residency; D008297:Male; D016462:Mammaplasty; D008875:Middle Aged; D063868:Patient Outcome Assessment; D017060:Patient Satisfaction; D010781:Photography; D012189:Retrospective Studies; D013337:Students, Medical; D011795:Surveys and Questionnaires
keywords: Aesthetic outcome evaluation; Breast reconstruction; Implants; Questionnaire