A new study highlights how age plays a pivotal role in shaping surgical outcomes and patient satisfaction for those undergoing breast reconstruction after mastectomy. The findings, published in the January issue of Plastic and Reconstructive Surgery, reveal nuanced effects of age on complications and quality of life, offering valuable insights for both surgeons and patients.

Conducted by Minji Kim and colleagues at Memorial Sloan Kettering Cancer Center, the study analyzed outcomes for 4,730 patients who underwent either autologous breast reconstruction (ABR) or implant-based breast reconstruction (IBR). Of these, 32.5% opted for ABR, while 67.5% chose IBR. Researchers assessed complications and patient-reported outcomes (PROs) at various intervals, from preoperative evaluations to as long as five years post-surgery.

The data revealed that older age was significantly linked to an elevated risk of complications such as mastectomy skin flap or nipple necrosis, infection, and seroma. When it came to patient satisfaction, older individuals reported lower scores in the Satisfaction with Breasts domain of the BREAST-Q survey, a widely used tool for assessing breast surgery outcomes. However, the same group exhibited higher scores in the Psychosocial Well-Being domain, suggesting a greater sense of emotional resilience and social adjustment following surgery.

Interestingly, the study found no significant correlation between age and other domains such as Physical Well-Being of the Chest or Sexual Well-Being. Further subgroup analyses revealed distinct patterns of complications and satisfaction profiles depending on whether patients underwent ABR or IBR, underscoring the importance of personalized care approaches.

The findings have practical implications for preoperative counseling and surgical planning, particularly for older patients. “Older patients should be informed about the potential associated risks and anticipated PROs,” the authors emphasized. They added that this information could help surgeons and patients collaboratively develop strategies to maximize satisfaction and minimize complications.

By shedding light on age-related differences in breast reconstruction outcomes, the study equips healthcare providers with the knowledge needed to optimize care for a diverse patient population, fostering better-informed decision-making and tailored postoperative support.