Unexpected returns to the operating room after microsurgical breast reconstruction: A qualitative study of patients' experiences.

PURPOSE: Unplanned takebacks after microsurgical breast reconstruction are rare but potentially distressing events. We aimed to describe women's experiences of unplanned takebacks after microsurgical breast reconstruction, with particular focus on how the event was experienced during the acute phase and how it was perceived over time.

METHODS: A qualitative study was conducted at a Swedish university hospital. Women who underwent an unplanned takeback within the first postoperative week after microsurgical breast reconstruction between 2018 and 2025 were invited to participate. Seven women were interviewed 1.8-6.6 years after their primary reconstruction. Data were collected through semi-structured interviews and analysed using inductive qualitative content analysis.

RESULTS: The analysis resulted in a main category, navigating threatened security during the unplanned takeback, and four generic categories including experiences of safety, experiences of vulnerability, experiences in the emergency phase and moving forward after the takeback. The women described the takeback as an acute and largely uncontrollable event that threatened their sense of bodily security and control. Feelings of vulnerability, fear, memory gaps and powerlessness were prominent. Simultaneously, safety was supported by clear information, trust in surgical competence, professional care and staff presence. Over time, the women integrated the takeback into their recovery, often without regretting reconstruction, but with a changed understanding of surgical risk, bodily consequences and future treatment decisions.

CONCLUSION: Unplanned takebacks after microsurgical breast reconstruction may continue to be significant after several years. Patient safety and security can be strengthened through repeated information, competent and reassuring care and attention to patients' own perceptions of symptoms.