September brought us another riveting #PRSJournalClub featuring an article that assesses the cost-utility analysis of direct to implant breast reconstruction compared to two-stage expander-implant based breast reconstruction. The discussion featured responses from Dr. Mo Nahabedian (@DrMoSLS) and Dr. Naveen Krishnan (@prince_naveenk) who have both co-authored a number of cost-utility analysis studies.

Two-stage expander-implant based breast reconstruction is the most common form of reconstruction in the United States. In comparison, direct-to-implant breast reconstruction would obviate the need for a second surgery and potentially save costs but in the literature, it has shown to be associated with a higher incidence of re-operations secondary to skin flap necrosis and device failure. Whether or not this modality is cost-effective has not been proven and this study’s aim was to analyze the cost and quality of life in patients undergoing single-stage or expander-implant based breast reconstruction.