Dear editor, we would like to discuss on the publication on "patient satisfaction in bilateral and unilateral breast reconstruction" (Sinno, Salvino, & Vandevender, 2014). Sinno et al. (2014) concluded that "patients were more satisfied with bilateral reconstruction because of improved symmetry, superior aesthetic appearance without clothing, and overall satisfaction with the reconstructive process" (p. 141). In fact, the beauty is the big concern on any females. Loss of breast can be a big stigma, and the good reconstruction should answer the concern on beauty. The concern on symmetry is a big issue, and it is strongly related to beauty. As previously reported by Craft et al. (2011), the symmetry is the important factor determining the satisfaction on the patient in bilateral breast reconstruction (either autologous or implant-based type). Aesthetic is a big issue for the patient, and it is also not dependent on additional radiotherapy or not (Krueger et al., 2001). Nevertheless, it should be noted that receiving radiotherapy is the factor that prevents the aesthetic result of reconstruction (Tallet et al., 2003). Hence, special plan for supporting nursing care to the patients who get breast reconstruction and have previous radiotherapy is recommended.

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