Giuseppe Antonio D’amico

Background/Objectives: Investigating how placement of a contralateral breast implant in the context of unilateral implant-based breast reconstruction influences aesthetic and patient-reported outcomes. Methods: A retrospective analysis was performed on a single-center prospectively maintained database (January 2021–March 2025) including patients who underwent unilateral implant-based breast reconstruction in association with a contralateral implant placement or not. Exclusion criteria were bilateral implant-based reconstruction or autologous reconstruction, follow-up of less than 6 months and missing data. Demographics and complications were analyzed. Aesthetic outcomes were evaluated by independent blinded surgeons using the Kroll Scale, patient satisfaction was investigated with the BREAST-Q Reconstruction Module v2.0. Statistical analysis used the Student’s t-test, Multivariate regression analysis and Mann–Whitney U test with significance set at p < 0.05. Results: The study group included 21 patients (40.4%) who received a contralateral implant, while the control group included 31 patients (59.6%) who did not receive a contralateral implant. Patients who received contralateral implants showed a significant improvement in cosmetic outcomes evaluated with the Kroll Scale and a raw increment, without statistical significance, in BREAST-Q scores in all subsections investigated (Psychosocial well-being, Sexual well-being and Satisfaction with breasts). Conclusions: Placing a contralateral breast implant in the context of unilateral implant-based breast reconstruction significantly improves aesthetic outcomes and correlates with higher patient satisfaction scores for the reconstructed breast, compared to placing no contralateral implant, without increasing the overall complication rate.

Background: Hidradenitis suppurativa (HS) is a chronic inflammatory disorder characterized by recurrent nodules, abscesses, and sinus tracts in apocrine gland-bearing areas. Surgery plays a key role in moderate-to-severe disease. As patients increasingly rely on the internet for decision-making, the quality of online information on HS surgery requires critical evaluation. Previous studies have shown poor quality and limited coverage of surgical aspects. This study systematically assesses publicly available websites on the surgical and reconstructive management of HS, quantifies their quality using the modified Ensuring Quality Information for Patients (mEQIP) tool, and identifies areas needing improvement to support informed decisions. Methods: Google, Bing, and Yahoo were searched using five HS surgery-related keywords. The first 50 results per keyword and engine were collected (n = 750), and 214 websites met the inclusion criteria. Sites were categorized by provenance (practitioners, hospitals, healthcare portals, professional societies, encyclopedias) and assessed using the 36-item mEQIP checklist. High quality was defined as ≥23/36 (75th percentile). Comparisons were made by publication era (pre-/post-COVID-19) and source type. Results: The mean mEQIP score was 21.7; only 51 websites (23.8%) met the high-quality threshold. No significant difference emerged between pre- and post-COVID publications. Healthcare portals scored highest (22.8), followed by practitioners (21.5) and hospital sites (21.2); professional societies (19.7) and encyclopedias (17.3) performed worst. Major deficiencies included limited discussion of surgical risks, quality-of-life outcomes, and postoperative care. Conclusions: Online resources on HS surgery are frequently incomplete and omit essential details on risks, recurrence, and reconstructive options. Surgeons should direct patients toward vetted sources, and professional societies should develop accessible, evidence-based patient guidelines.