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Erschienen in: Aesthetic Plastic Surgery 5/2021

07.06.2021 | Review

Major Complications After Textured Versus Non-textured Breast Implants in Direct-to-Implant Breast Reconstruction: A Propensity Score Analysis

verfasst von: Christopher P. Bellaire, Farah Sayegh, Pierce Janssen, John W. Rutland, C. Andrew Salzberg

Erschienen in: Aesthetic Plastic Surgery | Ausgabe 5/2021

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Abstract

Background

While the risks and benefits of smooth versus textured implants for breast reconstruction and primary breast augmentation are thoroughly supported in the literature, few studies have examined the relationship between implant shell texture and complications following direct-to-implant (DTI) breast reconstruction.

Objectives

The present study examines the relationship between implant shell texture and complications in patients receiving DTI breast reconstruction.

Methods

Retrospective chart review of patients undergoing DTI breast reconstruction between 2011 and 2018 by a single surgeon was performed. A propensity score matching algorithm was used to eliminate unwanted bias stemming from clinical covariates. Chi-squared and Fisher’s exact tests were used to examine the association between implant shell texture and the following major postoperative complications: capsular contracture, hematoma, seroma, necrosis, infection, and implant loss.

Results

A total of 402 unique patients (751 breasts) were included. The majority received smooth implants compared with textured implants (80.3% vs. 19.7%, respectively); 444 breasts were included for comparative analysis after 2:1 propensity score matching (296 smooth implants, 148 textured implants). The only statistically significant difference in outcomes between the two groups was a higher incidence of hematoma in the textured group (2.0% vs 0.0%), Fisher’s Exact Test p = 0.04. Additionally, the matched cohort revealed a very low overall rate of capsular contracture (1.0%) for smooth implants.

Conclusions

Our data demonstrated non-significant differences for most major complication rates or revision surgery rates for smooth versus textured implants after matching. DTI breast reconstruction with smooth implants remains a safe and effective reconstructive option for select patients.

Level of Evidence III

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine Ratings, please refer to Table of Contents or online Instructions to Authors www.​springer.​com/​00266.
Literatur
1.
Zurück zum Zitat Albornoz CR, Bach PB, Mehrara BJ et al (2013) A paradigm shift in U.S. Breast reconstruction: increasing implant rates. Plast Reconstr Surg 131(1):15–23CrossRef Albornoz CR, Bach PB, Mehrara BJ et al (2013) A paradigm shift in U.S. Breast reconstruction: increasing implant rates. Plast Reconstr Surg 131(1):15–23CrossRef
2.
Zurück zum Zitat Malata CM, Feldberg L, Coleman DJ, Foo IT, Sharpe DT (1997) Textured or smooth implants for breast augmentation? Three year follow-up of a prospective randomised controlled trial. Br J Plast Surg 50(2):99–105CrossRef Malata CM, Feldberg L, Coleman DJ, Foo IT, Sharpe DT (1997) Textured or smooth implants for breast augmentation? Three year follow-up of a prospective randomised controlled trial. Br J Plast Surg 50(2):99–105CrossRef
3.
Zurück zum Zitat Buonomo OC, Morando L, Materazzo M et al (2020) Comparison of round smooth and shaped micro-textured implants in terms of quality of life and aesthetic outcomes in women undergoing breast reconstruction: a single-centre prospective study. Updates Surg 72(2):537–546CrossRef Buonomo OC, Morando L, Materazzo M et al (2020) Comparison of round smooth and shaped micro-textured implants in terms of quality of life and aesthetic outcomes in women undergoing breast reconstruction: a single-centre prospective study. Updates Surg 72(2):537–546CrossRef
4.
Zurück zum Zitat Swanson E (2019) Plastic surgeons defend textured breast implants at 2019 U.S. food and drug administration hearing: why it is time to reconsider. Plast Reconstr Surg Glob Open 7(8):e2410CrossRef Swanson E (2019) Plastic surgeons defend textured breast implants at 2019 U.S. food and drug administration hearing: why it is time to reconsider. Plast Reconstr Surg Glob Open 7(8):e2410CrossRef
5.
Zurück zum Zitat Collis N, Coleman D, Foo IT, Sharpe DT (2000) Ten-year review of a prospective randomized controlled trial of textured versus smooth subglandular silicone gel breast implants. Plast Reconstr Surg 106(4):786–791CrossRef Collis N, Coleman D, Foo IT, Sharpe DT (2000) Ten-year review of a prospective randomized controlled trial of textured versus smooth subglandular silicone gel breast implants. Plast Reconstr Surg 106(4):786–791CrossRef
6.
Zurück zum Zitat Asplund O, Gylbert L, Jurell G, Ward C (1996) Textured or smooth implants for submuscular breast augmentation: a controlled study. Plast Reconstr Surg 97(6):1200–1206CrossRef Asplund O, Gylbert L, Jurell G, Ward C (1996) Textured or smooth implants for submuscular breast augmentation: a controlled study. Plast Reconstr Surg 97(6):1200–1206CrossRef
7.
Zurück zum Zitat Munhoz AM, Clemens MW, Nahabedian MY (2019) Breast implant surfaces and their impact on current practices: where we are now and where are we going? Plast Reconstr Surg Glob Open 7(10):e2466CrossRef Munhoz AM, Clemens MW, Nahabedian MY (2019) Breast implant surfaces and their impact on current practices: where we are now and where are we going? Plast Reconstr Surg Glob Open 7(10):e2466CrossRef
8.
Zurück zum Zitat Swanson E (2019) The textured breast implant crisis: a call for action. Ann Plast Surg 82(6):593–594CrossRef Swanson E (2019) The textured breast implant crisis: a call for action. Ann Plast Surg 82(6):593–594CrossRef
9.
Zurück zum Zitat Poeppl N, Schreml S, Lichtenegger F, Lenich A, Eisenmann-Klein M, Prantl L (2007) Does the surface structure of implants have an impact on the formation of a capsular contracture? Aesthetic Plast Surg 31(2):133–139CrossRef Poeppl N, Schreml S, Lichtenegger F, Lenich A, Eisenmann-Klein M, Prantl L (2007) Does the surface structure of implants have an impact on the formation of a capsular contracture? Aesthetic Plast Surg 31(2):133–139CrossRef
10.
Zurück zum Zitat Cepeda MS, Boston R, Farrar JT, Strom BL (2003) Comparison of logistic regression versus propensity score when the number of events is low and there are multiple confounders. Am J Epidemiol 158(3):280–287CrossRef Cepeda MS, Boston R, Farrar JT, Strom BL (2003) Comparison of logistic regression versus propensity score when the number of events is low and there are multiple confounders. Am J Epidemiol 158(3):280–287CrossRef
11.
Zurück zum Zitat Ho D, Imai K, King G, Stuart EA (2011) MatchIt: nonparametric preprocessing for parametric causal inference. J Stat Softw 42(8):28CrossRef Ho D, Imai K, King G, Stuart EA (2011) MatchIt: nonparametric preprocessing for parametric causal inference. J Stat Softw 42(8):28CrossRef
12.
Zurück zum Zitat Staffa SJ, Zurakowski D (2018) Five steps to successfully implement and evaluate propensity score matching in clinical research studies. Anesth Analg 127(4):1066–1073CrossRef Staffa SJ, Zurakowski D (2018) Five steps to successfully implement and evaluate propensity score matching in clinical research studies. Anesth Analg 127(4):1066–1073CrossRef
13.
Zurück zum Zitat Salzberg CA (2012) Direct-to-implant breast reconstruction. Clin Plast Surg 39(2):119–126CrossRef Salzberg CA (2012) Direct-to-implant breast reconstruction. Clin Plast Surg 39(2):119–126CrossRef
14.
Zurück zum Zitat Veiga DF, Filho JV, Schnaider CS, Archangelo I (2005) Late hematoma after aesthetic breast augmentation with textured silicone prosthesis: a case report. Aesthetic Plast Surg 29(5):431–433CrossRef Veiga DF, Filho JV, Schnaider CS, Archangelo I (2005) Late hematoma after aesthetic breast augmentation with textured silicone prosthesis: a case report. Aesthetic Plast Surg 29(5):431–433CrossRef
15.
Zurück zum Zitat Hsiao H-T, Tung K-Y, Lin C-S (2002) Late hematoma after aesthetic breast augmentation with saline-filled, textured silicone prosthesis. Aesthetic Plast Surg 26(5):368–371CrossRef Hsiao H-T, Tung K-Y, Lin C-S (2002) Late hematoma after aesthetic breast augmentation with saline-filled, textured silicone prosthesis. Aesthetic Plast Surg 26(5):368–371CrossRef
16.
Zurück zum Zitat Salzberg CA, Ashikari AY, Berry C, Hunsicker LM (2016) Acellular dermal matrix-assisted direct-to-implant breast reconstruction and capsular contracture: a 13-year experience. Plast Reconstr Surg 138(2):329–337CrossRef Salzberg CA, Ashikari AY, Berry C, Hunsicker LM (2016) Acellular dermal matrix-assisted direct-to-implant breast reconstruction and capsular contracture: a 13-year experience. Plast Reconstr Surg 138(2):329–337CrossRef
17.
Zurück zum Zitat The aesthetic society's cosmetic surgery national data bank: statistics 2019 (2020) Aesthet Surg J 40(Suppl 1):1–26 The aesthetic society's cosmetic surgery national data bank: statistics 2019 (2020) Aesthet Surg J 40(Suppl 1):1–26
18.
Zurück zum Zitat Negenborn VL, Dikmans REG, Bouman MB, Wilschut JA, Mullender MG, Salzberg CA (2018) Patient-reported outcomes after ADM-assisted implant-based breast reconstruction: a cross-sectional study. Plast Reconstr Surg Glob Open 6(2):e1654CrossRef Negenborn VL, Dikmans REG, Bouman MB, Wilschut JA, Mullender MG, Salzberg CA (2018) Patient-reported outcomes after ADM-assisted implant-based breast reconstruction: a cross-sectional study. Plast Reconstr Surg Glob Open 6(2):e1654CrossRef
19.
Zurück zum Zitat Calobrace MB, Schwartz MR, Zeidler KR, Pittman TA, Cohen R, Stevens WG (2017) Long-term safety of textured and smooth breast implants. Aesthet Surg J 38(1):38–48CrossRef Calobrace MB, Schwartz MR, Zeidler KR, Pittman TA, Cohen R, Stevens WG (2017) Long-term safety of textured and smooth breast implants. Aesthet Surg J 38(1):38–48CrossRef
20.
Zurück zum Zitat Vardanian AJ, Clayton JL, Roostaeian J et al (2011) Comparison of implant-based immediate breast reconstruction with and without acellular dermal matrix. Plast Reconstr Surg 128(5):403e–410eCrossRef Vardanian AJ, Clayton JL, Roostaeian J et al (2011) Comparison of implant-based immediate breast reconstruction with and without acellular dermal matrix. Plast Reconstr Surg 128(5):403e–410eCrossRef
21.
Zurück zum Zitat Ho G, Nguyen TJ, Shahabi A, Hwang BH, Chan LS, Wong AK (2012) A systematic review and meta-analysis of complications associated with acellular dermal matrix-assisted breast reconstruction. Ann Plast Surg 68(4):346–356CrossRef Ho G, Nguyen TJ, Shahabi A, Hwang BH, Chan LS, Wong AK (2012) A systematic review and meta-analysis of complications associated with acellular dermal matrix-assisted breast reconstruction. Ann Plast Surg 68(4):346–356CrossRef
22.
Zurück zum Zitat Thuesen B, Siim E, Christensen L, Schrøder M (1995) Capsular contracture after breast reconstruction with the tissue expansion technique. A comparison of smooth and textured silicone breast prostheses. Scand J Plast Reconstr Surg Hand Surg 29(1):9–13CrossRef Thuesen B, Siim E, Christensen L, Schrøder M (1995) Capsular contracture after breast reconstruction with the tissue expansion technique. A comparison of smooth and textured silicone breast prostheses. Scand J Plast Reconstr Surg Hand Surg 29(1):9–13CrossRef
23.
Zurück zum Zitat Derby BM, Codner MA (2015) Textured silicone breast implant use in primary augmentation: core data update and review. Plast Reconstr Surg 135(1):113–124CrossRef Derby BM, Codner MA (2015) Textured silicone breast implant use in primary augmentation: core data update and review. Plast Reconstr Surg 135(1):113–124CrossRef
24.
Zurück zum Zitat Collett DJ, Rakhorst H, Lennox P, Magnusson M, Cooter R, Deva AK (2019) Current risk estimate of breast implant-associated anaplastic large cell lymphoma in textured breast implants. Plast Reconstr Surg 143(3S A Review of Breast Implant-Associated Anaplastic Large Cell Lymphoma):30s–40s Collett DJ, Rakhorst H, Lennox P, Magnusson M, Cooter R, Deva AK (2019) Current risk estimate of breast implant-associated anaplastic large cell lymphoma in textured breast implants. Plast Reconstr Surg 143(3S A Review of Breast Implant-Associated Anaplastic Large Cell Lymphoma):30s–40s
25.
Zurück zum Zitat Cordeiro PG, Ghione P, Ni A et al (2020) Risk of breast implant associated anaplastic large cell lymphoma (BIA-ALCL) in a cohort of 3546 women prospectively followed long term after reconstruction with textured breast implants. J Plast Reconstr Aesthet Surg 73(5):841–846CrossRef Cordeiro PG, Ghione P, Ni A et al (2020) Risk of breast implant associated anaplastic large cell lymphoma (BIA-ALCL) in a cohort of 3546 women prospectively followed long term after reconstruction with textured breast implants. J Plast Reconstr Aesthet Surg 73(5):841–846CrossRef
Metadaten
Titel
Major Complications After Textured Versus Non-textured Breast Implants in Direct-to-Implant Breast Reconstruction: A Propensity Score Analysis
verfasst von
Christopher P. Bellaire
Farah Sayegh
Pierce Janssen
John W. Rutland
C. Andrew Salzberg
Publikationsdatum
07.06.2021
Verlag
Springer US
Erschienen in
Aesthetic Plastic Surgery / Ausgabe 5/2021
Print ISSN: 0364-216X
Elektronische ISSN: 1432-5241
DOI
https://doi.org/10.1007/s00266-021-02377-2

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