Wurzer Paul, Rappl Thomas, Friedl Herwig, Kamolz Lars-Peter, Spendel Stephan, Hoflehner Helmut, Parvizi Daryousch
Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, Auenbruggerplatz 29, 8036, Graz, Austria,
Aesthetic Plast Surg. 2014 Dec;38(6):1109-15. doi: 10.1007/s00266-014-0407-2. Epub 2014 Oct 16.
Due to the fact that the number of breast implant surgeries for cosmetic and medical purposes is rising yearly, a discussion about the quality of service for both patients and physicians is more important than ever. To this end, we reviewed the Austrian Breast Implant Register with one specific question in mind: What are the trends?
In the statistical analysis of the Austrian Breast Implant Register, we were able to identify 13,112 registered breast implants between 2004 and 2012. The whole dataset was then divided into medical and cosmetic groups. We focused on device size, surface characteristics, filling material, device placement and incision site. All factors were considered for all examined years.
In summary, the most used device had a textured surface (97 %) and silicone gel as the filling material (93 %). The mean size of implants for the cosmetic group was 240 cc, placement was submuscular (58 %) and the incision site was inframammary (67 %). In the medical group, the mean size was 250 cc. Yearly registrations had their peak in 2008 (1,898 registered devices); from this year on, registrations decreased annually. A slight trend away from subglandular placement in the cosmetic group was noted. Also, the usage of implants with polyurethane surface characteristics has increased since 2008. The smooth surface implants had a peak usage in 2006 and their usage decreased steadily from then on whereas the textured surface was steady over the years.
Keeping the problems related to the quality of breast implants in mind, we could recommend an obligatory national register. Organisations of surgeons and governments should develop and establish these registers. Furthermore, an all-encompassing international register should be established by the European Union and the American FDA (Food and Drug Administration); this might be useful in comparing the individual country registers and also would help in delivering "evidence based" medicine in cosmetic and medical procedures.
This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.
由于用于美容和医疗目的的隆胸手术数量逐年增加，因此对于患者和医生而言，讨论服务质量比以往任何时候都更为重要。为此，我们在回顾奥地利隆胸登记册时心中有一个特定问题：趋势如何？
在对奥地利隆胸登记册进行统计分析时，我们在2004年至2012年期间识别出13112例已登记的隆胸手术。然后将整个数据集分为医疗组和美容组。我们重点关注假体尺寸、表面特征、填充材料、假体植入位置和切口部位。对所有研究年份的所有因素都进行了考量。
总体而言，最常用的假体表面有纹理（97%），填充材料为硅胶（93%）。美容组假体的平均尺寸为240立方厘米，植入位置为胸大肌下（58%），切口部位为乳房下皱襞（67%）。医疗组的平均尺寸为250立方厘米。年度登记数量在2008年达到峰值（1898例已登记假体）；从这一年起，登记数量逐年下降。美容组中，有略微趋势表明逐渐减少胸大肌前植入。此外，自2008年以来，具有聚氨酯表面特征的假体使用量有所增加。表面光滑的假体在2006年使用量达到峰值，此后其使用量稳步下降，而表面有纹理的假体多年来保持稳定。
考虑到与隆胸假体质量相关的问题，我们建议设立强制性的国家登记册。外科医生组织和政府应制定并建立这些登记册。此外，欧盟和美国食品药品监督管理局（FDA）应设立一个全面的国际登记册；这可能有助于比较各个国家的登记册，也有助于在美容和医疗程序中提供“循证”医学。
证据水平V：本刊要求作者为每篇文章指定证据水平。有关这些循证医学评级的完整描述，请参阅目录或作者在线指南www.springer.com/00266。
