TY - JOUR
T1 - Autologous Fat Transfer After Augmentation and Reconstruction of the Female Breast
T2 - An International, Cross-Sectional Photo-Comparison Study Among Different Physician and Laymen Study Groups
AU - Groen, Jan-Willem
AU - Piatkowski, Andrzej A.
AU - Sawor, John H.
AU - Wilschut, Janneke A.
AU - Khouri, Roger K.
AU - van der Hulst, Rene R. J. W.
AU - Ritt, Marco J. P. F.
PY - 2018/12
Y1 - 2018/12
N2 - Objective. The aim of this study is to compare the cosmetic evaluation of autologous fat transfer (AFT) for various indications between surgeons and different laymen groups. Background Data. Despite the upsurge in AFT scientific/clinical interest, objectifying satisfaction has only recently progressed beyond simple Likert-type/Visual Analog Scales. Furthermore, differences in satisfaction between laymen and surgeons has not been thoroughly studied. Method. A photo comparison study between European plastic surgeons and different laymen groups was conducted to investigate agreement on cosmetic evaluation of AFT. Three sets of preoperative/postoperative photographs illustrating patients treated with External Vacuum Expansion (EVE) + AFT for various indications in breast surgery were scored according to the Harris Scale, and the interrater agreement was analyzed using Cohen's kappa. Results. The overall agreement between the surgeons and the groups of former augmentation, control group, and deep inferior epigastric artery perforator patients was fair, moderate, and substantial, respectively. Interrater agreements among different laymen groups and surgeons from different countries among themselves was substantial to almost perfect. Finally, we found that laymen are generally more optimistic about postoperative results than surgeons. Conclusion. In our study, former augmentation patients showed the lowest agreement with surgeons, in the cosmetic appreciation of EVE + AFT and this group might benefit from a more thorough preoperative consultation regarding expectations when choosing AFT. However, overall laymen tend to be more optimistic about postoperative results and surgeon education in general does not seem influenced by surgeon nationality. The significant differences between surgeons and laymen in the cosmetic evaluation of EVE + AFT justifies further studies that focus on the qualitative aspects of these differences to further balance patients' and surgeons' expectations.
AB - Objective. The aim of this study is to compare the cosmetic evaluation of autologous fat transfer (AFT) for various indications between surgeons and different laymen groups. Background Data. Despite the upsurge in AFT scientific/clinical interest, objectifying satisfaction has only recently progressed beyond simple Likert-type/Visual Analog Scales. Furthermore, differences in satisfaction between laymen and surgeons has not been thoroughly studied. Method. A photo comparison study between European plastic surgeons and different laymen groups was conducted to investigate agreement on cosmetic evaluation of AFT. Three sets of preoperative/postoperative photographs illustrating patients treated with External Vacuum Expansion (EVE) + AFT for various indications in breast surgery were scored according to the Harris Scale, and the interrater agreement was analyzed using Cohen's kappa. Results. The overall agreement between the surgeons and the groups of former augmentation, control group, and deep inferior epigastric artery perforator patients was fair, moderate, and substantial, respectively. Interrater agreements among different laymen groups and surgeons from different countries among themselves was substantial to almost perfect. Finally, we found that laymen are generally more optimistic about postoperative results than surgeons. Conclusion. In our study, former augmentation patients showed the lowest agreement with surgeons, in the cosmetic appreciation of EVE + AFT and this group might benefit from a more thorough preoperative consultation regarding expectations when choosing AFT. However, overall laymen tend to be more optimistic about postoperative results and surgeon education in general does not seem influenced by surgeon nationality. The significant differences between surgeons and laymen in the cosmetic evaluation of EVE + AFT justifies further studies that focus on the qualitative aspects of these differences to further balance patients' and surgeons' expectations.
KW - autologous fat transfer
KW - EVE
KW - interrater agreement
KW - patients
KW - surgeons
KW - RADIOLOGICAL SAFETY
KW - VOLUME RETENTION
KW - COMPLICATIONS
KW - CANCER
KW - OUTCOMES
KW - IMPLANT
U2 - 10.1177/1553350618798435
DO - 10.1177/1553350618798435
M3 - Article
C2 - 30196770
SN - 1553-3506
VL - 25
SP - 594
EP - 601
JO - Surgical Innovation
JF - Surgical Innovation
IS - 6
ER -