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

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 BI...

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Main Authors: Corey M. Bascone, MD, MBA, J. Reed McGraw, BS, Javier A. Couto, MD, Reena S. Sulkar, BS, MBA, Robyn B. Broach, PhD, Paris D. Butler, MD, MPH, Stephen J. Kovach, III, MD, FACS
Format: Article
Language:English
Published: Wolters Kluwer 2023-09-01
Series:Plastic and Reconstructive Surgery, Global Open
Online Access:http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000005273
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author Corey M. Bascone, MD, MBA
J. Reed McGraw, BS
Javier A. Couto, MD
Reena S. Sulkar, BS, MBA
Robyn B. Broach, PhD
Paris D. Butler, MD, MPH
Stephen J. Kovach, III, MD, FACS
author_facet Corey M. Bascone, MD, MBA
J. Reed McGraw, BS
Javier A. Couto, MD
Reena S. Sulkar, BS, MBA
Robyn B. Broach, PhD
Paris D. Butler, MD, MPH
Stephen J. Kovach, III, MD, FACS
author_sort Corey M. Bascone, MD, MBA
collection DOAJ
description 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.
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spelling doaj.art-204cdb8e410247f1b146eed68bf80e452023-09-28T07:09:03ZengWolters KluwerPlastic and Reconstructive Surgery, Global Open2169-75742023-09-01119e527310.1097/GOX.0000000000005273202309000-00064Exploring Factors Associated with Implant Removal Satisfaction in Breast Implant Illness Patients: A PRO BREAST-Q StudyCorey M. Bascone, MD, MBA0J. Reed McGraw, BS1Javier A. Couto, MD2Reena S. Sulkar, BS, MBA3Robyn B. Broach, PhD4Paris D. Butler, MD, MPH5Stephen J. Kovach, III, MD, FACS6From the * Division of Plastic Surgery, Department of Surgery, University of Pennsylvania, Philadelphia, Pa.From the * Division of Plastic Surgery, Department of Surgery, University of Pennsylvania, Philadelphia, Pa.From the * Division of Plastic Surgery, Department of Surgery, University of Pennsylvania, Philadelphia, Pa.From the * Division of Plastic Surgery, Department of Surgery, University of Pennsylvania, Philadelphia, Pa.From the * Division of Plastic Surgery, Department of Surgery, University of Pennsylvania, Philadelphia, Pa.† Division of Plastic and Reconstructive Surgery, Department of Surgery, Yale School of Medicine, New Haven, Conn.From the * Division of Plastic Surgery, Department of Surgery, University of Pennsylvania, Philadelphia, Pa.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.http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000005273
spellingShingle Corey M. Bascone, MD, MBA
J. Reed McGraw, BS
Javier A. Couto, MD
Reena S. Sulkar, BS, MBA
Robyn B. Broach, PhD
Paris D. Butler, MD, MPH
Stephen J. Kovach, III, MD, FACS
Exploring Factors Associated with Implant Removal Satisfaction in Breast Implant Illness Patients: A PRO BREAST-Q Study
Plastic and Reconstructive Surgery, Global Open
title Exploring Factors Associated with Implant Removal Satisfaction in Breast Implant Illness Patients: A PRO BREAST-Q Study
title_full Exploring Factors Associated with Implant Removal Satisfaction in Breast Implant Illness Patients: A PRO BREAST-Q Study
title_fullStr Exploring Factors Associated with Implant Removal Satisfaction in Breast Implant Illness Patients: A PRO BREAST-Q Study
title_full_unstemmed Exploring Factors Associated with Implant Removal Satisfaction in Breast Implant Illness Patients: A PRO BREAST-Q Study
title_short Exploring Factors Associated with Implant Removal Satisfaction in Breast Implant Illness Patients: A PRO BREAST-Q Study
title_sort exploring factors associated with implant removal satisfaction in breast implant illness patients a pro breast q study
url http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000005273
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