Impact of personality traits on choice and perceptions of autologous breast reconstruction.

Abstract

There is little data examining the psychosocial characteristics of women who choose a type of autologous postmastectomy reconstruction. This study sought to investigate the role of personality on decision making and postoperative satisfaction in autologous breast reconstruction. A retrospective survey of 120 consecutive patients who had undergone transverse rectus abdominis myocutaneous (TRAM) or perforator flap (PF) reconstruction over a 4-year period by a single surgeon at a single academic institution. All patients underwent similar preoperative consultations and were categorized into one of four groups based on surgical procedure they chose and their PF candidacy as determined by body mass index, age, and laterality. The survey packet included three validated measures of personality indices and a quality-of-life questionnaire. Intergroup analysis was performed using the Wilcoxon rank sum test. The overall survey response rate was 52.5%. PF patients were younger (p = 0.007) and more likely to undergo bilateral reconstruction (p = 0.0009) relative to TRAM patients. Comparisons between the two most clinically extreme groups showed significant results with regard to personality testing. Patients who were deemed not ideal PF candidates but nevertheless chose PF reconstruction were shown to be more narcissistic (p = 0.033), extroverted (p = 0.024), and having a higher postoperative quality of life (p = 0.021) than those who were deemed ideal PF candidates but ended up choosing pedicled TRAM reconstruction. Specific personality traits play a role in the patients' choice of a reconstructive option and their overall postoperative satisfaction. Clinicians should be aware of the possible influence of personality type on surgery selection.