Practice Trends in the Management of Asymptomatic Breast Reconstruction Patients with Textured Implants: A Survey Analysis.

Autor:	Roider LA; From the Division of Plastic & Reconstructive Surgery, Saint Louis University School of Medicine, St. Louis, Mo., Nguyen DC; From the Division of Plastic & Reconstructive Surgery, Saint Louis University School of Medicine, St. Louis, Mo., Pusapadi Ramkumar S; From the Division of Plastic & Reconstructive Surgery, Saint Louis University School of Medicine, St. Louis, Mo., Tyson CV; Division of Plastic Surgery, University of Alabama School of Medicine, Birmingham, Ala., Lund HG; St. Louis Cosmetic Surgery, Chesterfield, Mo., Plikaitis CM; From the Division of Plastic & Reconstructive Surgery, Saint Louis University School of Medicine, St. Louis, Mo.
Jazyk:	angličtina
Zdroj:	Plastic and reconstructive surgery. Global open [Plast Reconstr Surg Glob Open] 2023 Jul 17; Vol. 11 (7), pp. e5139. Date of Electronic Publication: 2023 Jul 17 (Print Publication: 2023).
DOI:	10.1097/GOX.0000000000005139
Abstrakt:	Despite the increasing prevalence of breast implant associated anaplastic large cell lymphoma, there remains a paucity of literature guiding management of asymptomatic patients with textured breast implants. This risk can be anxiety provoking in breast reconstruction patients given their history of cancer or increased future risk. The purpose of this study is to evaluate current practice trends when managing the concerned asymptomatic patient following textured implant-based breast reconstruction. Methods: An electronic survey was distributed to members of the American Society of Plastic Surgeons, regarding management of asymptomatic breast reconstruction patients with textured devices. Anonymous responses were collected, and statistical analysis was performed. Results: A total of 304 responses were received. Of respondents, 237 (92%) have managed asymptomatic patients with textured devices. Historically, the overwhelming majority (89%) used textured devices; however, only 25% report current use. Regarding management of asymptomatic breast reconstruction patients, 87% recommend conservative management, while 13% recommend surgical management. When surgery is performed, 16.3% of respondents elected for implant exchange, 33.8% recommended implant exchange with partial capsulectomy, and 49.8% elected for implant exchange with total capsulectomy. Evaluation of practice patterns based on demographics demonstrated statistically significant differences in current use of textured devices and management of acellular dermal matrix. Conclusions: Despite decreased current use, there is a significant population of asymptomatic breast reconstruction patients with a history of textured devices concerned for risk of breast implant associated anaplastic large cell lymphoma. This survey demonstrates ongoing variability in surgeon recommendations regarding conservative and surgical management of these patients and the need for continued development of evidence-based guidelines. Competing Interests: Dr. Lund is a shareholder of Revance, Engage technology, and Brijett. All the other authors have no financial interest to declare in relation to the content of this article. Disclosure statements are at the end of this article, following the correspondence information. (Copyright © 2023 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of The American Society of Plastic Surgeons.)
Databáze:	MEDLINE
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