Scheflan Michael, Gronovich Yoav, Maisel Lotan Adi, Winder Gilad
From private practice; and the Department of Plastic and Reconstructive Surgery, Shaare Zedek Medical Center.
Plast Reconstr Surg. 2022 Jun 1;149(6):1071e-1079e. doi: 10.1097/PRS.0000000000009090. Epub 2022 Mar 29.
Breast implant illness, although not classified as a disease entity, has recently gained significant attention globally. The purpose of this study was to assess the status of explantation practices, discuss plastic surgeon's attitude toward requests for explantation and capsulectomy, and evaluate surgical management when accepting these challenges.
Twenty closed-ended multiple choice questions were formulated to an opinion poll. The anonymous opinion poll was distributed to members of American Society for Aesthetic Plastic Surgery and presidents of plastic surgery societies on all continents.
A total of 736 plastic surgeons responded to the opinion poll. Although geographic variation was noted, a majority of 69.8 percent stated that explantation surgery had increased in their practice compared to the previous year. Requests for explantation without capsulectomy met with high acceptance rates among surgeons, regardless of whether patients were asymptomatic or not. Patients who also requested capsulectomy received less enthusiastic replies depending on the type of practice, years in practice, implant position, and type of capsulectomy (en bloc, total, or partial). When fat grafting was indicated, 68.7 percent stated that simultaneous lipofilling is limited when capsulectomy is performed, yet 44.5 percent stated that they would remove thin normal capsules in a symptomatic patient even when simultaneous fat grafting is requested by the patient.
The opinion poll supports the hypothesis that demand for explantation and capsulectomy increased globally among symptomatic and asymptomatic patients; that attitudes toward simultaneous capsulectomy are divided; and that management may differ according to geographic location, experience, and type of practice.
乳房植入物相关病症虽未被归类为一种疾病实体，但最近在全球范围内受到了广泛关注。本研究的目的是评估取出植入物手术的开展情况，探讨整形外科医生对取出植入物和包膜切除术请求的态度，并评估应对这些挑战时的手术管理方式。
设计了20个封闭式多项选择题进行民意调查。该匿名民意调查分发给了美国美容整形外科协会的成员以及各大洲整形外科协会的主席。
共有736名整形外科医生回复了民意调查。尽管存在地域差异，但69.8%的大多数医生表示，与上一年相比，他们开展的取出植入物手术有所增加。无论患者有无症状，不进行包膜切除术的取出植入物请求在外科医生中获得了较高的接受率。同时请求包膜切除术的患者，根据执业类型、执业年限、植入物位置和包膜切除术类型（整块切除、全部切除或部分切除），得到的回应热情程度较低。当需要进行脂肪移植时，68.7%的医生表示在进行包膜切除术时同时进行脂肪填充受到限制，然而44.5%的医生表示，即使患者要求同时进行脂肪移植，他们也会在有症状的患者中切除菲薄的正常包膜。
民意调查支持以下假设：在有症状和无症状患者中，全球范围内对取出植入物和包膜切除术的需求有所增加；对同时进行包膜切除术的态度存在分歧；并且管理方式可能因地理位置、经验和执业类型而有所不同。
