Antiaging Group Barcelona, Rda General Mitre 84 entlo, 08021, Barcelona, Spain.
Clínica Estética Córdoba, Córdoba, Spain.
Aesthetic Plast Surg. 2020 Dec;44(6):1957-1964. doi: 10.1007/s00266-020-01846-4. Epub 2020 Jul 6.
The purpose of this study was to evaluate the current perceptions, preferences, and practice of plastic surgeons in Europe regarding breast implant surgery after the controversy on macrotextured implants and BIA-ALCL and the voluntary recall of all biocell implants.
A survey comprising 15 questions about implant selection and postoperative routines associated with breast augmentation was sent to all society members of the EASAPS.
Out of 1473 correspondents, 416 completed the survey with response rate being 28.2%. Countries with less than ten respondents were not included in the analysis. A total of 359 respondents (24.4%) were included in the analysis. Twenty-one respondents (5.8%) had a clinical experience < 5 years, 43 (12%) had 5-10 years' experience, and 295 (82.2%) had > 10 years' experience. Regarding the type of implant, only 6.1% would use a macrotextured implant. Fourteen per cent of surgeons would recommend to change a biocell implant in any case, even without symptoms or problems (rupture, seroma, and capsular contracture), 99.7% would send the capsule for histopathological study (99.7%), 98.9% would perform bilateral implant replacement in case of a unilateral problem of rupture, contracture, or seroma, and 80.8% of respondents considered capsulectomy as a technique for managing capsular contracture degree III/IV.
The main conclusion is the heterogenicity of answers and practice, due to the lack of guidelines and scientific evidence on breast implants. Although 22 (6.1%) respondents would use a macrotextured implant (either round or anatomic), 71.6% of respondents considered that there is not enough information for removing macrotextured implants from the market and that they should be allowed to be used unrestrictedly or under close surveillance of the regulatory agencies.
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 .
本研究旨在评估欧洲整形医生在涉及乳房植入物手术方面的当前认知、偏好和实践，该手术在关于宏观纹理植入物和 BIA-ALCL 的争议以及所有生物细胞植入物的自愿召回后进行。
向 EASAPS 的所有学会成员发送了一项包含 15 个关于乳房增大相关植入物选择和术后常规问题的调查。
在 1473 名回复者中，有 416 人完成了调查，回复率为 28.2%。回复人数少于 10 人的国家未纳入分析。共有 359 名回复者（24.4%）纳入分析。21 名回复者（5.8%）的临床经验不足 5 年，43 名（12%）有 5-10 年的经验，295 名（82.2%）有 10 年以上的经验。关于植入物类型，只有 6.1%的医生会使用宏观纹理植入物。14%的医生会建议在任何情况下更换生物细胞植入物，即使没有症状或问题（破裂、血清肿和包膜挛缩），99.7%的医生会进行包膜组织病理学研究（99.7%），98.9%的医生会在出现单侧破裂、挛缩或血清肿问题时进行双侧植入物更换，80.8%的医生认为包膜切除术是治疗包膜挛缩 III/IV 级的技术。
主要结论是由于缺乏关于乳房植入物的指南和科学证据，导致回答和实践存在异质性。尽管有 22 名（6.1%）医生会使用宏观纹理植入物（圆形或解剖型），但 71.6%的医生认为没有足够的信息将宏观纹理植入物从市场上移除，并且应该允许它们不受限制地使用或在监管机构的密切监测下使用。
证据等级 III：本刊要求作者为每篇文章分配一个证据等级。有关这些循证医学评级的完整描述，请参考目录或在线作者指南 www.springer.com/00266 。
