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Page 8 of 14 Chin et al. Plast Aesthet Res 2023;10:52 https://dx.doi.org/10.20517/2347-9264.2023.44

Figure 3. Domain analysis of included articles in embodiment and breast reconstruction literature review.

undergoing unilateral mastectomy, postural control and balance can be altered [43-46] . In evaluations of
mastectomy-induced spinal deformities, several studies have reported on the correlation between
immediate breast reconstruction and the prevention of spinal postural changes [47-49] , though delayed breast
[50]
reconstruction has not demonstrated significant improvement in this regard . In our review, some women
reported postural imbalance following mastectomy, thus highlighting the integral role of immediate
reconstruction in attempting to restore postural symmetry . Quixadá et al. objectively measured posture
[41]
through vertical spine and vertical head angles in a 3D motion capture system and examined the correlation
between posture and affect in breast cancer survivors who underwent a therapeutic course of Qigong mind-
body training . Notably, patients who improved in fatigue and anxiety scales had better vertical head
[51]
[51]
values, suggesting a connection between posture and affect within an embodied paradigm . Overall, the
postural domain was the least captured within this embodiment literature review, which suggests future
work is needed to assess the influence of measurements of posture on embodiment.

Psychosocial
The psychosocial dimensions of embodiment were the predominant focus of the identified literature on
breast embodiment. In addition to the impacts on sexual well-being and social relationships discussed
previously, much of the literature raised the effect of breast reconstruction on self-image, which included
traditional conceptions of body image, as well as a broader sense of self-identity . Multiple articles
[52]
discussed how patients undergoing breast cancer surgery are often left in a state of altered
embodiment [18,25,41,42,53,54] . Beyond the visual anatomical alterations, patients’ language around self-
conceptualization following mastectomy described insecurities related to sexuality, gender identity, beauty,
and femininity [55-57] .

These broader questions around self-identity highlight how psychosocial dimensions of breast embodiment
include the patient’s experience within a given societal context . While breast reconstruction is a lived
[58]
experience from within, the impact of its visual representation on others influences body image and, in turn,
embodiment. The breast embodiment literature brings attention to how reconstructive breast surgery is