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Patients and Providers Experiences with Breast Implants: A Rapid Qualitative Review

Last updated: August 21, 2018
Project Number: RC1007-000
Product Line: Rapid Response
Research Type: Devices and Systems
Report Type: Summary with Critical Appraisal
Result type: Report

Question

  1. What are the experiences’ and perspectives’ of patients who receive breast implants, a nd their providers who offer them?

Key Message

Women who had breast reconstruction due to asymmetrical breasts described how their condition made them feel not normal and unfeminine. Post-surgery, women described increased feelings of self-confidence and that they were more comfortable wearing fitted clothes, going out and revealing their unclothed body to partners. Women tended to be secretive about the reason for their breast reconstruction surgery. Reasons for secrecy that were offered by the participants included not wanting to be viewed as weird and that the condition and its treatment are not well-known.Many themes emerged when researchers explored how women with breast cancer, and then a mastectomy, make decisions about breast reconstruction. Women spoke about the meaning of their breasts to themselves and to their sense of identity. Notions of femininity, normalcy and the natural body varied amongst women and influenced their views on breast reconstruction. For instance, women who had an ethos of the natural body chose not to have reconstructive surgery or chose autologous breast reconstruction, as the latter did not involve foreign materials in the body. Women sometimes chose breast implants because it restored a normal appearance and did not involve pain in multiple sites (compared to autologous reconstruction). These perceptions and views were shaped by the cultural and social context of the women’s lives. Women’s choices about breast reconstruction were also influenced by their views on the alternative (e.g. breast prostheses), their views on the surgical procedure and on the views of their community, family and medical team. Medical teams raised the issue of breast reconstruction, often early in the course of treatment. Sometimes these options were framed by notions of personalized care. However, data from interviews with women and health care professionals in the UK and in France suggest that sometimes these options were framed based on the expertise and availability of treatment options at the clinic and the perspective of the surgeon, rather than on the needs and perspective of the woman.Women who were satisfied with the outcome of surgery felt that it satisfied or exceeded expectations. Whereas those who were disappointed reported that the outcome was not as good as they had anticipated, or they felt that that they had not been fully informed about all the options available to them, No literature was found that distinguished the experience of women who received different types of implants (e.g. saline vs silicone). There was no research that was found that described the perspectives of health care professionals about their preferences or decision-making among different type of breast implants. The only literature describing health care professional perspectives concerns their views on the inadequacy of information offered to women about treatment options.