Quality of life after prophylactic mastectomy with simultaneous reconstruction

Objective. To analyze the incidence of complications and factors affecting the quality of life after prophylactic mastectomy with simultaneous breast reconstruction. Material and methods. The study was based on analysis of 87 prophylactic mastectomies with simultaneous breast reconstruction. In the 1st group, patients underwent subcutaneous/skin-sparing mastectomy with simultaneous breast reconstruction with silicone implant and thoracodorsal artery perforator flap/deepithelialized flap. In the 2nd group, surgery was supplemented by simultaneous breast reconstruction with silicone implant and mesh implant/ acellular dermal matrix. In the 3rd group, surgical intervention was supplemented by simultaneous prepectoral breast reconstruction with silicone endoprosthesis without cover. Results. In case of individual analysis of the need for additional implant covering (pinch test >2.5 cm, skin state, no ptosis), it is possible to use prepectoral placement of endoprosthesis with subsequent good aesthetic results. Complications (seroma, necrosis, infection, capsular contracture, animation and diastasis) significantly worsened assessment of treatment outcomes in all categories. Conclusion. The authors developed an algorithm for simultaneous breast reconstruction taking into account ptosis and pinch test. This algorithm may be valuable to preserve the quality of life after surgery. © 2025 Elsevier B.V., All rights reserved.