Jordan Chloe, Sosnowski Krzysztof, Shah Rushabh, Malata Charles
Department of Plastic and Reconstructive Surgery, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Hills Rd, Cambridge, United Kingdom.
School of Clinical Medicine, University of Cambridge, Hills Rd, Cambridge, United Kingdom.
JPRAS Open. 2025 Jun 17;45:212-224. doi: 10.1016/j.jpra.2025.06.004. eCollection 2025 Sep.
Breast augmentation remains one of the most common cosmetic surgical procedures globally yet implant surface preference (textured versus smooth) remains a key area of debate. Whilst textured implants have traditionally been favoured in the UK and Europe, concerns around breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) and the absence of formal guidelines have contributed to wide variations in practice. This study therefore examines current UK practice among plastic surgeons, focusing on surgeon preferences and the factors guiding decision-making.
An anonymised online survey was distributed to UK consultant plastic surgeons performing cosmetic breast augmentation. Data collected included implant surface, brand, incision, pocket, case volume, and ranked decision-making factors. Free-text responses were analysed thematically. Descriptive statistics and chi-square testing were used to explore associations.
Seventy-five consultant plastic surgeons responded (response rate = 31.3 %). Textured implants were most commonly used (82.7 %), although smooth implants were more frequently selected by high-volume surgeons (>50 cases/year, χ²(5) = 11.79, = 0.038, Cramér's = 0.37). Mentor was the preferred brand (53.3 %), while Motiva was more commonly selected by smooth implant users (χ²(5) = 58.3, = 0.011, Cramér's = 0.29). All surgeons preferentially used inframammary incisions; subglandular placement was most common (54.7 %). The top four decision-making factors in implant surface selection were patient preference, cosmetic outcome, risk of capsular contracture and BIA-ALCL possibility. Qualitative themes highlighted the influence of patient expectations, safety concerns, and institutional policy.
UK practice in cosmetic breast augmentation remains varied. Although most surgeons preferred textured implants, a shift towards smooth implants appears to be emerging among high-volume operators.
隆胸手术仍是全球最常见的整形手术之一，然而植入物表面偏好（毛面与光面）仍是一个关键的争议领域。虽然在英国和欧洲，传统上更倾向于使用毛面植入物，但对乳房植入物相关间变性大细胞淋巴瘤（BIA-ALCL）的担忧以及缺乏正式指南导致了实践中的广泛差异。因此，本研究调查了英国整形外科医生的当前实践情况，重点关注医生的偏好以及指导决策的因素。
向英国进行美容隆胸手术的整形外科顾问医生发放了一份匿名在线调查问卷。收集的数据包括植入物表面、品牌、切口、植入腔隙、病例数量以及按重要性排序的决策因素。对自由文本回复进行主题分析。使用描述性统计和卡方检验来探索相关性。
75名整形外科顾问医生回复了问卷（回复率 = 31.3%）。最常使用的是毛面植入物（82.7%），不过手术量大的医生（每年>50例手术）更常选择光面植入物（χ²(5) = 11.79，P = 0.038，克莱默相关系数 = 0.37）。Mentor是首选品牌（53.3%），而Motiva更常被光面植入物使用者选择（χ²(5) = 58.3，P = 0.011，克莱默相关系数 = 0.29）。所有医生都优先采用乳房下皱襞切口；腺体下植入最为常见（54.7%）。植入物表面选择的前四大决策因素是患者偏好、美容效果、包膜挛缩风险和BIA-ALCL可能性。定性主题突出了患者期望、安全担忧和机构政策的影响。
英国美容隆胸手术的实践情况仍然存在差异。尽管大多数医生更喜欢毛面植入物，但手术量大的医生似乎出现了向光面植入物转变的趋势。
