Exploring Factors Associated with Implant Removal Satisfaction in Breast Implant Illness Patients: A PRO BREAST-Q Study.

Autor:	Bascone CM; From the Division of Plastic Surgery, Department of Surgery, University of Pennsylvania, Philadelphia, Pa., McGraw JR; From the Division of Plastic Surgery, Department of Surgery, University of Pennsylvania, Philadelphia, Pa., Couto JA; From the Division of Plastic Surgery, Department of Surgery, University of Pennsylvania, Philadelphia, Pa., Sulkar RS; From the Division of Plastic Surgery, Department of Surgery, University of Pennsylvania, Philadelphia, Pa., Broach RB; From the Division of Plastic Surgery, Department of Surgery, University of Pennsylvania, Philadelphia, Pa., Butler PD; Division of Plastic and Reconstructive Surgery, Department of Surgery, Yale School of Medicine, New Haven, Conn., Kovach SJ 3rd; From the Division of Plastic Surgery, Department of Surgery, University of Pennsylvania, Philadelphia, Pa.
Jazyk:	angličtina
Zdroj:	Plastic and reconstructive surgery. Global open [Plast Reconstr Surg Glob Open] 2023 Sep 25; Vol. 11 (9), pp. e5273. Date of Electronic Publication: 2023 Sep 25 (Print Publication: 2023).
DOI:	10.1097/GOX.0000000000005273
Abstrakt:	Background: Breast implant illness (BII) is a poorly understood heterogeneous disorder treated with implant removal; however, patient-reported symptoms and outcomes after treatment remain unclear. Methods: A retrospective review of patients undergoing bilateral breast implant removal related to BII by two surgeons at an academic medical center between 2018 and 2022 was conducted. Patients were surveyed using the BREAST-Q Reconstruction model with the American Society for Aesthetic Plastic Surgery BII survey extension. Outcomes were analyzed using multivariable logistic regression, adjusted for patient-associated factors. Results: Forty-seven patients were surveyed with a response rate of 51% (n = 24). Of the 20 patients who completed the survey, the majority were White (85%), with 45% (n = 9) having a documented history of psychiatric illness. Six (30%) patients had capsular contracture and four (20%) had documented implant rupture. Most implant removal procedures (n = 12, 60%) were not covered by insurance. Fourteen (70%) patients reported a net improvement in their symptoms after implant removal, most commonly chest discomfort, muscle pain, fever, and headaches. Capsular contracture was predictive of reduced psychosocial, sexual, and breast satisfaction scores ( P = 0.015). Self-pay was predictive of increased breast satisfaction scores ( P = 0.009), but had no impact on symptomatic improvement. A reduced time to implant removal was predictive of fewer residual symptoms ( P = 0.032). Psychiatric illness had no significant impact on the outcomes. Conclusions: In the setting of suspected or diagnosed BII, a reduced time to implant removal may decrease the risk of residual symptoms and improve overall patient satisfaction. In patients with capsular contracture, preoperative counseling should emphasize that implant removal may only improve physical symptoms. Competing Interests: The authors have no financial interest to declare in relation to the content of this article. (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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