Evaluations of the aesthetic results and patient satisfaction with the late pedicled TRAM flap breast reconstruction.

With the goal of evaluating the aesthetic results, testing the reliability of the rating systems used, and determining the patients' level of satisfaction with their breast reconstruction, pedicled transverse rectus abdominis musculocutaneous flap reconstruction was performed in 20 patients who had undergone mastectomy. The results were evaluated and compared 3, 6, and 12 months after reconstruction using the patients' own assessments (a rating of 0-10 points) and scoring by two senior plastic surgeons (using 0-10-point global rating scales as well as the five subscales of the modified Garbay system). The interrater and intrarater agreement was poor to fair for the majority of the subscales. When evaluating by grades, there was significant difference (p < 0.001) between the patients and the raters at postoperative months 3 and 6. At month 12, one of the raters attributed significantly lower grades (p < 0.001) than the patients and the other rater. The authors observed a higher level of satisfaction by the patients than by the raters.