The aesthetic implication of scar position in breast reconstruction

In these enlightened times of patient involvement in operative planning, th e patient has a much greater input into procedure selection, especially whe re several options are available. Breast reconstruction is a prime example of combined decision making. although options are still limited by pre-exis ting scars and previous treatment. In this study we eliminated all variable s of reconstruction except the resulting scar pattern in an attempt to disc over what was most acceptable to the patient. Various postoperative results , such as single scars and flaps, were mimicked unilaterally and bilaterall y by drawing them on the same live subject. These photographic images were then formulated into a questionnaire and distributed to various female grou ps for scoring. Results show a preference for single-line horizontal scars in unilateral and bilateral reconstructions; scars that encroached the uppe r medial quadrant scored less well. The preferred flap reconstruction is al so positioned horizontally, but in the lower pole. Overall, the preferred r econstruction in all groups was a single unilateral horizontal scar. (C) 20 01 The British Association of Plastic Surgeons.