The internet has become a valuable research tool for most of us. When we have a question about something many of us turn to the internet to research our answer. Here we can find information and opinion from others. And as we all know not all information is accurate.
I have noticed other the past decade many patients come in very well informed about their condition and the surgery they wish to have. Some of the information comes from the referring doctor, some from family and friends and some from internet sources. Many of the cancer support groups have very informative sites as does our plastic surgery society. There are also forums were women can receive information and support from other women with similar conditions.
I personally like my patients to be as informed as possible. I find it often is helpful when they have learned about their medical condition and possible surgical options. During the initial consultation I generally discuss the different options available and the benefits and risks associated with each for the specific patient. Prior research done by the patient helps them better understand. Occasionally some “facts” need to be disproven as not all internet information is accurate. This communication between doctor and patient is important to make sure each understand the goals and expectations of each other.
Recently a group from Harvard Medical School published a study evaluating internet use and the decision fro breast reconstruction. They are a referral center for microsurgery (DIEP, free TRAM, SIEA, GAP) but also perform nonmicrosurgical procedures (implants, TRAM, latissimus flaps). The group looked at the many different sociodemographics of their patients comparing those that chose microsurgery to those that did not. It seems the patients that did not choose microsurgery were the younger and older group. The microsurgery group age was between 40-49 years. This microsurgery group also relied on the internet more for their own decision making compared to the other groups that also based their decisions on doctor received information. It appears this microsurgery group are more independent decision makers.
I can certainly agree with this information. In my own practice I have noticed younger women opting for implant reconstruction. I think this age group is very open and favorable to implants and wants the look implants can provide. Certainly many of them would benefit from a DIEP free flap and they would avoid potential implant issues as they get older. Many older patients just don’t want a long surgery and so some of them opt for an implant. And just as the group in Massachusetts most patients I see who want a DIEP have done extensive research on their options and come in already knowing that is what they want. They understand the complexity of the surgery and the reconstructive process and that’s why they want a long term solution. Once healed from their reconstruction they know it is unlikely they will need additional surgery in years to come.