The short-term psychological impact of complications after breast reconstruction

Objectives: Few studies have focused on the psychological impact of postoperative complications after breast reconstruction (BR). As postoperative complications after BR usually lead to a prolonged recovery time and sometimes require additional surgery, the short-term impact on distress was investigated. Methods: Pre- and postoperatively, psychological questionnaires were sent to 152 women who underwent either implant BR or deep inferior epigastric artery perforator flap BR (DIEPBR). In addition, patients and physicians' reports of postoperative complications during the first 4-6 weeks after BR were scored. The course of anxiety, depression and cancer-specific distress, and the effect of complications on distress were investigated. Results: Implant BR patients reported decreased anxiety after surgery, and both groups reported reduced cancer-specific distress after surgery. However, depressive symptoms tended to increase after DIEPBR. If complications occurred, both reconstruction groups reported increased depressive and anxiety symptoms, and DIEPBR patients even had depressive symptoms of clinical concern. A significant number of patients with complications reported alarming levels of distress. Timing and laterality were not significantly correlated with distress. Conclusions: Complications after BR have a significant impact on emotional well-being shortly after surgery. As distress affects quality of life and health outcomes, it is of great importance to offer psychological support to these patients. Distress can be evaluated by monitoring the emotional impact of BR during post-surgery consults, or with the standard use of short psychological questionnaires that patients can complete at home.

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