Sustainability in breast surgery: An eco-audit of the breast implant pathway.

BACKGROUND

Breast implants are the most common type of breast reconstruction performed globally. However, despite the vast number performed annually, the environmental impact of the pathway has yet to be evaluated.

METHODS

A retrospective analysis of 34 immediate breast implant reconstructions at a single reconstructive centre was performed. Process mapping and life-cycle analyses were performed for equipment, staff, patients, and land. A carbon dioxide equivalent was used to estimate the relative contributions of the initial consultation, preoperative, intraoperative, and immediate postoperative periods.

RESULTS

This study estimated the carbon footprint of a patient undergoing immediate reconstructive breast implant surgery to be approximately 48.80 kgCOeq. The majority of emissions came from the intraoperative period (28.58 kgCOeq., 58.57%). Production and transport of surgical and anaesthetic equipment had the highest overall contribution to the carbon footprint (25.46 kgCOeq., 52.17% overall). Patient travel was the second greatest contributor, closely followed by anaesthesia (18.28% and 16.60%, respectively).

CONCLUSIONS

This is the first study to estimate the carbon footprint of the breast implant pathway. Strategies to mitigate the impact of carbon emissions include the reuse of equipment. The impact of revisional procedures and future breast implant exchanges was not included and should be factored into future estimates of carbon footprint calculations.