Matros Evan, Shamsunder Meghana G, Rubenstein Robyn N, Polanco Thais O, McCarthy Colleen M, Nelson Jonas A, Gutowski Karol, Tops Steering Committee The
Plastic and Reconstructive Surgery Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, N.Y.
University of Chicago and University of Illinois, Chicago, Ill.
Plast Reconstr Surg Glob Open. 2021 Mar 18;9(3):e3499. doi: 10.1097/GOX.0000000000003499. eCollection 2021 Mar.
Breast-implant-associated anaplastic large cell lymphoma (BIA-ALCL) is associated with prolonged exposure to textured implants. Current studies describing textured implant use are limited to single center/surgeon experiences. Using the Tracking Operations and Outcomes for Plastic Surgeons database, the study aims to characterize national trends in rates of smooth versus textured implant utilization. The hypothesis is that rates of textured implant use have decreased in the most recent time period.
Tracking Operations and Outcomes for Plastic Surgeons was queried from 2007 to 2019 for CPT codes involving breast implant use in augmentation and reconstruction. The rate of smooth and textured implant utilization was calculated for each year per procedure type. Generalized additive models with a smoothing function and Pearson chi-square tests were used to assess the trends.
Textured implant use peaked in 2016, being utilized in 17.83% of cosmetic and 40.88% of reconstructive procedures. Textured implants were more commonly used for reconstructive compared with cosmetic cases for 2007-2009, 2011, and 2013-2019 ( < 0.02). Both cosmetic and reconstructive cases had nonlinear trends in textured implant use over the study period, with textured rates decreasing from 2017 to 2019 ( < 0.001). In 2019, textured implants were used in 2.15% of cosmetic and 7.58% of reconstructive cases.
This is the first national study describing trends in textured versus smooth breast implant use in the United States. Textured implant utilization peaked in 2016. Based on a median time horizon of 10 years before development of BIA-ALCL, the peak number of cases can be anticipated in 2026 or thereafter.
乳房植入物相关间变性大细胞淋巴瘤（BIA-ALCL）与长期接触表面有纹理的植入物有关。目前描述表面有纹理植入物使用情况的研究仅限于单中心/外科医生的经验。本研究利用整形外科医生手术追踪与结果数据库，旨在描述全国范围内光滑型与表面有纹理型植入物使用率的趋势。假设是在最近一段时间内，表面有纹理型植入物的使用率有所下降。
查询2007年至2019年整形外科医生手术追踪与结果数据库中涉及隆胸和乳房重建中使用乳房植入物的CPT编码。计算每种手术类型每年光滑型和表面有纹理型植入物的使用率。使用具有平滑函数的广义相加模型和Pearson卡方检验来评估趋势。
表面有纹理型植入物的使用在2016年达到峰值，在美容手术中占17.83%，在重建手术中占40.88%。在2007 - 2009年、2011年以及2013 - 2019年期间，与美容手术相比，表面有纹理型植入物在重建手术中使用更为普遍（<0.02）。在研究期间，美容手术和重建手术中表面有纹理型植入物的使用均呈现非线性趋势，从2017年到2019年使用率下降（<0.001）。2019年，表面有纹理型植入物在美容手术中占2.15%，在重建手术中占7.58%。
这是美国第一项描述表面有纹理型与光滑型乳房植入物使用趋势的全国性研究。表面有纹理型植入物的使用率在2016年达到峰值。基于BIA-ALCL发病前10年的中位时间跨度，预计2026年或之后会出现病例数峰值。
