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The effect of cosmetic surgery on self-esteem and body image: a systematic review and meta-analysis of clinical trial studies

• Original Paper
• Published: 19 July 2022
• Volume 46 , pages 25–33, ( 2023 )

Cite this article

• Mohsen Kazeminia 1 ,
• Nader Salari 2 ,
• Mohammadbagher Heydari 3 ,
• Hakimeh Akbari 4 &
• Masoud Mohammadi   ORCID: orcid.org/0000-0002-5722-8300 4  

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Making changes to one’s appearance as a result of psychological trauma can have an impact on one’s daily life, social activities, and, ultimately, one’s quality of life. Several existing studies have assessed people’s psychology for making a surgery request, demonstrating varying levels of satisfaction with cosmetic surgery, but the results of these studies are contradictory. One of the aims of this meta-analysis is to highlight some of the assumptions made in these studies and clarify the inconsistencies. Moreover, this study aims to determine the effect of cosmetic surgery on self-esteem and body image.

This study included articles published in international databases of Cochrane, Embase, Science Direct, Scopus, PubMed, and Web of Science (WoS) from 2001 to 2019. Heterogeneity between studies was assessed using Cochran’s ( Q ) c and I 2 tests. Due to the found heterogeneity, the random-effects model was used to estimate the standard mean difference of cosmetic surgery tests to measure self-esteem and body image in the intervention group before and after the test.

This systematic meta-analysis and review included 23 articles (13 on self-esteem and 10 on body image). The initial studies included in the meta-analysis had samples of 1232 in the self-esteem intervention group and 1083 in the body image intervention group. In the study of the mean difference between self-esteem and body image before and after cosmetic surgery, the difference between self-esteem scores before and after surgery was 1.1 ± 0.24, which showed an increase in the average score after surgery, and the difference between body image scores was 1.3 ± 0.36. The increase in the mean score indicates postoperative compared to preoperative ( P ˂0.01).

Conclusions

This study’s findings indicate that cosmetic surgery improves self-esteem and body image, which may be of interest to health policymakers and professionals.

Level of evidence : Not ratable.

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Cosmetic Surgery and Self-esteem in South Korea: A Systematic Review and Meta-analysis

Contingencies of self-worth and psychological distress in iranian patients seeking cosmetic surgery: integrative self-knowledge as mediator.

Interest in cosmetic surgery among Iranian women: the role of self-esteem, narcissism, and self-perceived attractiveness

Data availability.

Not applicable.

Abbreviations

Consolidated Standards of Reporting Trials

Preferred Reporting Items for Systematic Reviews and Meta-Analysis

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Acknowledgements

The authors thank the faculty members of the Faculty of Nursing and Midwifery, Kermanshah University of Medical Sciences

This study is the result of research project No. 990410 approved by Student Research Committee of Kermanshah University of Medical Sciences.

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Kermanshah University of Medical Sciences, Kermanshah, Iran

Mohsen Kazeminia

Department of Biostatistics, School of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran

Nader Salari

Department of General Surgery, Faculty of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran

Mohammadbagher Heydari

Cellular and Molecular Research Center, Gerash University of Medical Sciences, Gerash, Iran

Hakimeh Akbari & Masoud Mohammadi

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Contributions

MM and MK contributed to the design; MM contributed to statistical analysis and participated in most of the study steps. MM and NS prepared the manuscript. MK, MM, MBH, and HA assisted in designing the study, and helped in the interpretation of the study. All authors have read and approved the content of the manuscript.

Corresponding author

Correspondence to Masoud Mohammadi .

Ethics declarations

Ethical approval and consent to participate.

Ethics approval was received from the ethics committee of deputy of research and technology, Kermanshah University of Medical Sciences (IR.KUMS.REC.1399.193). In this study, no separation was performed to evaluate gender affirming surgery in nonbinary patients.

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Mohsen Kazeminia, Nader Salari, Mohammadbagher Heydari, Hakimeh Akbari, and Masoud Mohammadi declare no competing interests.

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Kazeminia, M., Salari, N., Heydari, M. et al. The effect of cosmetic surgery on self-esteem and body image: a systematic review and meta-analysis of clinical trial studies. Eur J Plast Surg 46 , 25–33 (2023). https://doi.org/10.1007/s00238-022-01987-6

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Received : 22 April 2022

Accepted : 08 July 2022

Published : 19 July 2022

Issue Date : February 2023

DOI : https://doi.org/10.1007/s00238-022-01987-6

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85 Plastic Surgery Essay Topic Ideas & Examples

🏆 best plastic surgery topic ideas & essay examples, 📃 simple & easy plastic surgery essay titles, ✅ good essay topics on plastic surgery, ❓ research questions about plastic surgery.

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Psychological and Aesthetic Outcomes in Breast Cancer Patients

Ermoshchenkova, Maria V. MD, PhD *,†,‡ ; Zikiryahodjaev, Aziz D. MD, PhD *,† ; Reshetov, Igor V. MD, PhD * ; Svyatoslavov, Dmitriy S. MD, PhD * ; Sinelnikov, Mikhail Y. MD, PhD *,§

From the * Department of Oncology, Radiotherapy and Plastic Surgery, First Moscow State Medical University, Moscow, Russian Federation

† The P.A. Herzen Moscow Cancer Research Institute – Branch of the Federal State Budgetary Institution “National Medical Research Center of Radiology” at the Ministry of Health Care of the Russian Federation

‡ The First Moscow Clinical Oncology Hospital, Moscow, Russian Federation

§ Research Institute of Human Morphology, Moscow, Russian Federation.

Published online 13 July 2021.

Received for publication December 23, 2020; accepted May 12, 2021.

Disclosure: The authors have no financial interest to declare in relation to the content of this article.

Presented at the Moscow Breast Meeting (Clovermed), February 7, 2019.

Mikhail Y. Sinelnikov, MD, PhD, Institute for Regenerative Medicine, Sechenov University, Udaltzova Ulitza, 4, 370, Moscow, Russian Federation 119415, E-mail: [email protected] .

This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND) , where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.

• RUSSIAN FEDERATION

Background: 

Patients who undergo breast cancer treatment require psychosocial and aesthetic rehabilitation. Advantages of breast reconstruction in-patient rehabilitation are well known. Oncoplastic organ-preserving surgery offers aesthetically better results, yet is often considered less safe than more radical procedures. We compared the aesthetic and psychological outcomes in patients undergoing breast reconstruction and oncoplastic breast cancer treatment.

Methods: 

In total, 1130 patients who received either breast reconstruction or oncoplastic breast cancer surgery were included in the study. Patients were classified into two groups. Group 1 included 510 patients who received breast reconstruction surgery. Group 2 included 620 patients who received oncoplastic surgery. The following aspects were compared between the two groups: demographics, tumor progression, and immunohistochemical aspects, complications, hospitalization stay, and psychological and aesthetic outcomes.

Results: 

Patients in the oncoplastic group showed statistically significant higher psychosocial and aesthetic outcomes, as well as lower incidence of complications, revision rate, disease progression, and recurrence. The majority of oncoplastic patients were treated in early stages of breast cancer.

Conclusion: 

Offering superior treatment results, oncoplastic organ-preserving surgery should be favored in patients with earlier stages of cancer progression.

INTRODUCTION

Malignant neoplasms are one of the leading causes of death and disability. In 2018 in Russia, breast cancer accounted for 20.9% of all malignant neoplasms. The absolute number of new annual cases has significantly increased over the past decade from 52,469 in 2008 to 70,682 in 2018. 1 Breast cancer treatment leaves most patients in need of psychological and somatic rehabilitation. 2 Rehabilitation of cancer patients is a complex system aimed at adapting patients to life after cancer. Modern conservational surgery and advances in breast reconstruction improve the toll of the psychological burden and aesthetic defect, while providing enhanced cancer treatment capabilities. 3–5

Unfortunately, oncoplastic preservation surgery is not available for all patients, and many undergo more radical procedures, including modified radical mastectomy. 6 A modified radical mastectomy has a significant psychological burden, with notable positive effect from breast reconstruction. 7 Therefore, breast cancer treatment today must include breast reconstruction as a component for complex patient rehabilitation. 8

Breast reconstruction includes symmetry restoration, which often prompts the surgical correction of the contralateral breast gland. When performing breast reconstruction, the possibility for simultaneous plastic surgery of the contralateral breast depends on many treatment aspects, and plays an important role in overall patient rehabilitation. 9 We compared different approaches in breast reconstruction surgery and their effects on patient psychosomatic rehabilitation to support the hypothesis that oncoplastic surgery is as safe and aesthetically sufficient as more radical procedures within similar cohorts.

CONCLUSIONS

Minimally invasive, carefully planned oncoplastic breast cancer treatment yields significantly better results than complex breast reconstruction, and should therefore be favored. Careful patient selection, treatment harmonization, full-body diagnostic procedures, and sentinel lymph node biopsy help expand the range of eligible patients for oncoplastic breast surgery. Breast reconstruction surgery remains an important surgical procedure for patient rehabilitation, and should be considered for patients who undergo more radical surgical procedures.

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Cosmetic Surgery and the Feminist critique: The Dilemma of the 21st Century Woman

Since its inception, modern aesthetic cosmetic surgery has been treated with much scepticism and apprehension by the medical profession, academics, feminists and the general public. The term ‘plastic surgery’ covers a broad range of surgeries that alter appearance. Included in the term is a wide range of reconstructive surgeries, which attempt to replace or repair congenitally malformed, damaged, or amputated areas of the body. Another subset of plastic surgery is cosmetic surgery, which is the topic of the present essay. This essay shall examines various feminist critiques, as advocated by Wolf (1990), Bordo (1993) and Davis (1995) which seek to identify the constraining nature of female relationships with their bodies in modern day society and the recent appeal to the ‘surgical fix’. Finally, by reviewing the content of these various analyses, this essay aims to discuss some key themes which emerge from the literature; namely the motivations and incentives which influence women’s decisions to participate in cosmetic procedures and ultimately, how the embodiment of this identity impacts on their sense of self.

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I've thought about the issue of cosmetic medical interventions, aka, 'getting work done', quite a bit over the years. The idea of using surgery and other invasive procedures to permanently alter a person's body because they and others have decided they don't like and can't accept how they look makes me very uncomfortable, even angry on their behalf in case others have led them to feel that way. I admit right now, I have a longstanding bias against most forms of plastic surgery and cosmetic dermatology, and even the de facto social requirement that women wear heavy makeup, binding clothing, and hobbling footwear to be successful in many fields of work, especially in the performing arts and public media, and to 'make a good catch' as it used to be commonly called. Oh, and these women are often more or less required to 'get work done' at some point, too. While these procedures are performed on men too, over 90% are performed on women, so I'll continue to address cosmetic interventions as if it's primarily a woman's issue, though most of my comments apply to men as well. So why worry about any of it? Is it any of my business what other women freely choose to do with their bodies? Are are my objections just personal, rooted in some sort of insecurity, just 'sour grapes' towards other women who are willing to do what I'm too lazy, cheap, or tomboyish to do?

Psychology and …

Soren Askegaard

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Home — Essay Samples — Nursing & Health — Cosmetic Surgery — Cosmetic Surgery: Exploring Procedures, Motivations, and Implications

Cosmetic Surgery: Exploring Procedures, Motivations, and Implications

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Published: Feb 7, 2024

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Table of contents

Understanding cosmetic surgery, motivations for cosmetic surgery, ethical and psychological implications.

• Rhinoplasty: Nose reshaping to improve aesthetics or function.
• Breast Augmentation: Enlarging or reshaping the breasts through implants or fat transfer.
• Liposuction: Removal of excess fat from specific areas of the body.
• Facelift: Reducing signs of aging through tightening facial muscles and skin.
• Botox and Fillers: Injectable treatments to reduce wrinkles and enhance facial features.
• Enhancing Self-Esteem: Many individuals believe that improving their appearance will boost their self-confidence and overall well-being.
• Correcting Physical Imperfections: Some people opt for cosmetic surgery to correct perceived flaws or deformities that have caused emotional distress.
• Anti-Aging and Youthfulness: The desire to look younger and reduce the signs of aging is a common motivator for cosmetic procedures.
• Social and Professional Advantages: Some individuals believe that an improved appearance can lead to better social interactions and career opportunities.
• Body Image Issues: People with body dysmorphic disorder (BDD) may seek cosmetic surgery excessively due to an obsessive focus on perceived flaws.
• Ethical Considerations: Cosmetic surgery raises ethical questions about body autonomy, societal pressures to conform to beauty standards , and the potential for unnecessary medical risks.
• Psychological Impact: Not all individuals experience improved mental health after cosmetic surgery. Unrealistic expectations and dissatisfaction with results can lead to psychological distress.
• Addictive Behavior: Some individuals become addicted to cosmetic procedures, constantly seeking new alterations and enhancements, which can have negative consequences on their mental and physical health.
• Social and Cultural Influences: Societal and cultural pressures to conform to beauty ideals can contribute to the normalization of cosmetic surgery, potentially influencing individuals to undergo procedures they might not genuinely desire.

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Psychological and Aesthetic Outcomes in Breast Cancer Patients

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Psychological and Aesthetic Outcomes in Breast Cancer Patients

Affiliations.

• 1 Department of Oncology, Radiotherapy and Plastic Surgery, First Moscow State Medical University, Moscow, Russian Federation.
• 2 The P.A. Herzen Moscow Cancer Research Institute - Branch of the Federal State Budgetary Institution "National Medical Research Center of Radiology" at the Ministry of Health Care of the Russian Federation.
• 3 The First Moscow Clinical Oncology Hospital, Moscow, Russian Federation.
• 4 Research Institute of Human Morphology, Moscow, Russian Federation.
• PMID: 34277318
• PMCID: PMC8277256
• DOI: 10.1097/GOX.0000000000003679

Background: Patients who undergo breast cancer treatment require psychosocial and aesthetic rehabilitation. Advantages of breast reconstruction in-patient rehabilitation are well known. Oncoplastic organ-preserving surgery offers aesthetically better results, yet is often considered less safe than more radical procedures. We compared the aesthetic and psychological outcomes in patients undergoing breast reconstruction and oncoplastic breast cancer treatment.

Methods: In total, 1130 patients who received either breast reconstruction or oncoplastic breast cancer surgery were included in the study. Patients were classified into two groups. Group 1 included 510 patients who received breast reconstruction surgery. Group 2 included 620 patients who received oncoplastic surgery. The following aspects were compared between the two groups: demographics, tumor progression, and immunohistochemical aspects, complications, hospitalization stay, and psychological and aesthetic outcomes.

Results: Patients in the oncoplastic group showed statistically significant higher psychosocial and aesthetic outcomes, as well as lower incidence of complications, revision rate, disease progression, and recurrence. The majority of oncoplastic patients were treated in early stages of breast cancer.

Conclusion: Offering superior treatment results, oncoplastic organ-preserving surgery should be favored in patients with earlier stages of cancer progression.

Copyright © 2021 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of The American Society of Plastic Surgeons.

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Conflict of interest statement

Disclosure: The authors have no financial interest to declare in relation to the content of this article.

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Persuasive Essay on Plastic Surgery

How it works

Plastic surgery, you know, is all about changing or fixing up parts of the body. It’s been getting more and more popular over the years. Sure, lots of folks think of it as just making someone look better, but it’s got a whole other side too. It can fix things folks are born with, or stuff that happens from accidents and sickness. I wanna talk about why plastic surgery is actually a good thing, clear up some misunderstandings, and chat about why doing your homework before going under the knife is super important.

First off, plastic surgery can give a big boost to someone’s self-esteem and confidence. Lots of people feel pretty down about how they look, and that messes with their mental health and how they live day-to-day. Imagine having a big scar on your face or being born with something that looks different—people can be really mean. Getting surgery to fix or change that can make a huge difference. You feel better about yourself, and life gets a lot easier. Same goes for stuff like nose jobs or breast implants. It’s not just about looking good; it’s about feeling good in your own skin.

Then, there’s the health side. Plastic surgery isn’t just about looks; it can actually help with medical problems too. Take breast reduction, for example. It can help with back pain and bad posture if your breasts are too big. Or a nose job that helps you breathe better if you’ve got a crooked septum. And after accidents or cancer, surgery can help folks get back to their normal lives by fixing up damaged body parts. So, it’s not just vanity—it’s about feeling better physically too.

But even with all these good things, plastic surgery gets a bad rap. People say it pushes unrealistic beauty standards and makes folks shallow. But honestly, deciding to get surgery is a personal choice. Lots of people just wanna feel good about themselves. And with all the new tech and better methods, plastic surgery is safer and easier to get than before. If you talk with a good doctor and know what to expect, you can get results that look natural and still keep what makes you unique.

That said, it’s super important to really think it through before getting any surgery done. Do your research and talk to qualified doctors to get a clear picture of what could happen. Know the risks and what the results might be. Also, remember surgery isn’t a magic fix for deep emotional problems. Sometimes, talking to a therapist can help you make better decisions and handle any changes after surgery.

So, to wrap it up, plastic surgery can do a lot more than just make you look good. It can help you feel better about yourself, fix health problems, and give people a second chance after accidents or illness. Even though some people still have negative views about it, getting surgery is a personal choice and should be respected. With the right info, advice, and expectations, it can lead to really positive changes. In the end, plastic surgery is a valuable medical field that can truly change lives for the better.

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Psychological and Aesthetic Outcomes in Breast Cancer Patients

Maria v. ermoshchenkova.

From the * Department of Oncology, Radiotherapy and Plastic Surgery, First Moscow State Medical University, Moscow, Russian Federation

† The P.A. Herzen Moscow Cancer Research Institute – Branch of the Federal State Budgetary Institution “National Medical Research Center of Radiology” at the Ministry of Health Care of the Russian Federation

‡ The First Moscow Clinical Oncology Hospital, Moscow, Russian Federation

Aziz D. Zikiryahodjaev

Igor v. reshetov, dmitriy s. svyatoslavov, mikhail y. sinelnikov.

§ Research Institute of Human Morphology, Moscow, Russian Federation.

Background:

Patients who undergo breast cancer treatment require psychosocial and aesthetic rehabilitation. Advantages of breast reconstruction in-patient rehabilitation are well known. Oncoplastic organ-preserving surgery offers aesthetically better results, yet is often considered less safe than more radical procedures. We compared the aesthetic and psychological outcomes in patients undergoing breast reconstruction and oncoplastic breast cancer treatment.

In total, 1130 patients who received either breast reconstruction or oncoplastic breast cancer surgery were included in the study. Patients were classified into two groups. Group 1 included 510 patients who received breast reconstruction surgery. Group 2 included 620 patients who received oncoplastic surgery. The following aspects were compared between the two groups: demographics, tumor progression, and immunohistochemical aspects, complications, hospitalization stay, and psychological and aesthetic outcomes.

Patients in the oncoplastic group showed statistically significant higher psychosocial and aesthetic outcomes, as well as lower incidence of complications, revision rate, disease progression, and recurrence. The majority of oncoplastic patients were treated in early stages of breast cancer.

Conclusion:

Offering superior treatment results, oncoplastic organ-preserving surgery should be favored in patients with earlier stages of cancer progression.

INTRODUCTION

Malignant neoplasms are one of the leading causes of death and disability. In 2018 in Russia, breast cancer accounted for 20.9% of all malignant neoplasms. The absolute number of new annual cases has significantly increased over the past decade from 52,469 in 2008 to 70,682 in 2018. 1 Breast cancer treatment leaves most patients in need of psychological and somatic rehabilitation. 2 Rehabilitation of cancer patients is a complex system aimed at adapting patients to life after cancer. Modern conservational surgery and advances in breast reconstruction improve the toll of the psychological burden and aesthetic defect, while providing enhanced cancer treatment capabilities. 3 – 5

Unfortunately, oncoplastic preservation surgery is not available for all patients, and many undergo more radical procedures, including modified radical mastectomy. 6 A modified radical mastectomy has a significant psychological burden, with notable positive effect from breast reconstruction. 7 Therefore, breast cancer treatment today must include breast reconstruction as a component for complex patient rehabilitation. 8

Breast reconstruction includes symmetry restoration, which often prompts the surgical correction of the contralateral breast gland. When performing breast reconstruction, the possibility for simultaneous plastic surgery of the contralateral breast depends on many treatment aspects, and plays an important role in overall patient rehabilitation. 9 We compared different approaches in breast reconstruction surgery and their effects on patient psychosomatic rehabilitation to support the hypothesis that oncoplastic surgery is as safe and aesthetically sufficient as more radical procedures within similar cohorts.

MATERIALS AND METHODS

A retrospective analysis of 1130 cases of breast cancer treatment results was conducted at P.A. Hertsen Moscow Oncology Research Center from 2013–2019. The study design and protocol were reviewed and approved by the institutional review board of our institution, which waived informed consent due to the retrospective nature of the study.

Right breast cancer was seen in 553 cases (48.94%); left breast cancer, in 577 cases (51.06%). An estimated 538 (47.6%) patients were premenopausal, and 592 patients were menopausal (52.4%). Patients classified according to immunohistochemical tumor characteristics are presented in Table ​ Table1 1 .

Immunohistochemical Characteristics of Patient Pathology

The patients were separated into two groups according to treatment tactic (Table ​ (Table2). 2 ). Group 1 included 510 who received breast reconstruction surgery (45.13%); Group 2 included 620 patients who received oncoplastic breast surgery (54.87%). Patient treatment tactic was decided by an institutional multidisciplinary oncological council. Oncoplastic surgery included patients who received lumpectomies with breast tissue preservation via volume displacement. 10 Nipple preservation oncoplastic surgery was carried out in 583 patients. All Group 2 patients underwent radiation therapy with a dose of 41.5 ± 5.6 Gy. Retrospective data regarding patient age, menopausal statue, cancer stage, progression, therapy, surgery type, contralateral breast surgery, and complications were evaluated. Patients with genetic predisposition were not included in the current study.

Overall Study Characteristics and Results

Immunohistochemistry analysis was performed to evaluate cancer subtype. HEr-2/neu assay was confirmed by fluorescent in situ hybridization analysis in all cases. All patients included in the study underwent a survey for evaluation of aesthetic results and psychological criteria. The survey “Evaluation of Cosmetic Results after Organ-preserving Operations, Oncoplastic Resections, Reconstructive Plastic Surgery in Patients with Breast Cancer” was developed at P.A. Hertsen Moscow Oncology Research Center, and the results were graded on an overall scale: excellent (5.0–4.0), good (4.0–3.0), satisfactory (3.0–2.0), and unsatisfactory (2.0–0.0).

The significances of differences between Group 1 and Group 2 were determined using the independent t -test or the nonparametric Mann-Whitney U-test when variables were nonnormally distributed. Complications and revision rates were compared using Pearson’s chi-squared test or Fisher’s exact test. The analysis was conducted using IBM SPSS Statistics for Windows, version 19.0 (IBM Corp., Armonk, N.Y.). Results are presented as means ± SD or as numbers and percentages, and statistical significance was set at a P value less than 0.05.

Study results are presented in Table ​ Table2. 2 . Patient demographic characteristics and mean follow-up time did not have any negative impact on study outcomes, as there were no significant differences between the two groups. Group 1 had significantly more patients in premenopausal state ( P < 0.001). Patients in Group 2 had more postmenopausal patients with hormone-dependent cancers.

In regard to immunohistochemical characteristics of cancer type, Group 1 had less Luminal A, Luminal B HER-2/neu negative ( P < 0.001), and Luminal B HER-2/neu positive subtypes. Patients in Group 1 had generally later-stage cancers. Group 2 patients predominantly had early stage cancer ( P < 0.001), which accounted for treatment tactic. Cancer progression was significantly higher in Group 1 patients ( P < 0.001).

The overall complication rate was higher in Group 1 ( P < 0.001), significantly burdened by implant-related complications, which account for over 50% of all complications in that group. Surgical revision rate was significantly greater in Group 1.

Aesthetic result, evaluated via surveying, was significantly better in Group 2, as well as the psychosocial impact ( P < 0.001). The psychological setbacks in patients in Group 1 were significantly greater, with average grade being just above satisfactory.

The psychological impact of breast reconstruction on patient quality of life has been previously assessed; many such studies have shown significant advantages of breast reconstruction. 11 – 13 Oncoplastic breast conserving surgery has also shown significant advantages in aesthetic and psychosocial patient well-being after cancer treatment. 14 , 15 We have offered a comparison of aesthetic outcome and psychosocial well-being in patients undergoing mastectomy with reconstruction and patients who receive oncoplastic surgery. The results show significant advantages of oncoplastic surgery, with lower recurrence and progression rates, as well as improved aesthetic and psychosocial recovery, lower complication rate, reduced overall risk of perioperative complications, and shorter hospitalization stay.

Important considerations can be made from the results of our study. Because minimally invasive procedures offer better aesthetic outcomes, high-risk patients with early or undetected cancer, genetic predisposition, and complicated family history may benefit from early treatment. Patients with genetic predisposition and Stage 0 cancer may be offered a prophylactic mastectomy in cases of high risk of breast cancer, as this offers for a more tissue sparing approach, with retention of axillary regional anatomy and of the cutaneous pocket. Due to the nature of our evaluation, such patients were not included in the study, yet present an important cohort with special considerations in terms of treatment efficacy and aesthetic results.

Our results show specific similarities with large cohort evaluations performed in North American centers. 16 – 23 Our study is the first such study performed in the Russian Federation, and is unique due to the region of origin. Specific differences between results seen in previous publications concerning aesthetic and psychological outcomes in oncoplastic patients can be attributed to healthcare and social peculiarities. The use of standardized PROM tools, such as BREAST-Q, is currently limited in Russia due to local guidelines restricting researchers to develop locally adapted patient surveys.

The drawbacks of this retrospective evaluation include significant differences between groups in regard to tumor progression. Despite this, we believe that this fact actually underlines the importance of consideration for oncoplastic surgery of patients in early stages of breast cancer. Therefore, oncoplastic preservation surgery should be favored over complex breast reconstruction for patients in earlier stages of tumor progression. Another limitation of our study is the use of unvalidated questionnaires. We relied on our own institutional questionnaires to better reflect specific points requiring evaluation for this study. Nonetheless, this imposes certain limitations in direct comparison between previous studies, similar to ours.

Reconstructive plastic surgery plays an important role in the surgical rehabilitation of patients with breast cancer, and it provides good aesthetic and psychological rehabilitation after breast cancer treatment. Organ-preserving oncoplastic surgery contributes to significantly better aesthetic and psychological results. Both methods provide restoration of the natural form of the breast, contribute to improving and accelerating the rehabilitation of patients with breast cancer due to the timely return of patients to active social activities, preventing psychological stress, reducing the incidence of disability. Careful consideration should be taken to selection of patients for these procedures. In treatment of earlier stages of breast cancer, preference should be given to oncoplastic organ-preserving surgery. Breast reconstruction surgery has a wider range of patient eligibility and is favorable at later stages and in delayed treatment.

CONCLUSIONS

Minimally invasive, carefully planned oncoplastic breast cancer treatment yields significantly better results than complex breast reconstruction, and should therefore be favored. Careful patient selection, treatment harmonization, full-body diagnostic procedures, and sentinel lymph node biopsy help expand the range of eligible patients for oncoplastic breast surgery. Breast reconstruction surgery remains an important surgical procedure for patient rehabilitation, and should be considered for patients who undergo more radical surgical procedures.

Published online 13 July 2021.

Disclosure: The authors have no financial interest to declare in relation to the content of this article.

Presented at the Moscow Breast Meeting (Clovermed), February 7, 2019.