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

Background:. 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 thei...

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Main Authors: Laura A. Roider, MD, David C. Nguyen, MD, Shreya Pusapadi Ramkumar, BS, Cody V. Tyson, MD, Herluf G. Lund, MD, Christina M. Plikaitis, MD
Format: Article
Language:English
Published: Wolters Kluwer 2023-07-01
Series:Plastic and Reconstructive Surgery, Global Open
Online Access:http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000005139
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author Laura A. Roider, MD
David C. Nguyen, MD
Shreya Pusapadi Ramkumar, BS
Cody V. Tyson, MD
Herluf G. Lund, MD
Christina M. Plikaitis, MD
author_facet Laura A. Roider, MD
David C. Nguyen, MD
Shreya Pusapadi Ramkumar, BS
Cody V. Tyson, MD
Herluf G. Lund, MD
Christina M. Plikaitis, MD
author_sort Laura A. Roider, MD
collection DOAJ
description Background:. 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.
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spelling doaj.art-8d158f951a7a45cc99bc328ab42779022023-07-28T09:29:00ZengWolters KluwerPlastic and Reconstructive Surgery, Global Open2169-75742023-07-01117e513910.1097/GOX.0000000000005139202307000-00022Practice Trends in the Management of Asymptomatic Breast Reconstruction Patients with Textured Implants: A Survey AnalysisLaura A. Roider, MD0David C. Nguyen, MD1Shreya Pusapadi Ramkumar, BS2Cody V. Tyson, MD3Herluf G. Lund, MD4Christina M. Plikaitis, MD5From the * Division of Plastic & Reconstructive Surgery, Saint Louis University School of Medicine, St. Louis, Mo.From the * Division of Plastic & Reconstructive Surgery, Saint Louis University School of Medicine, St. Louis, Mo.From the * Division of Plastic & Reconstructive Surgery, Saint Louis University School of Medicine, St. Louis, Mo.† Division of Plastic Surgery, University of Alabama School of Medicine, Birmingham, Ala.‡ St. Louis Cosmetic Surgery, Chesterfield, Mo.From the * Division of Plastic & Reconstructive Surgery, Saint Louis University School of Medicine, St. Louis, Mo.Background:. 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.http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000005139
spellingShingle Laura A. Roider, MD
David C. Nguyen, MD
Shreya Pusapadi Ramkumar, BS
Cody V. Tyson, MD
Herluf G. Lund, MD
Christina M. Plikaitis, MD
Practice Trends in the Management of Asymptomatic Breast Reconstruction Patients with Textured Implants: A Survey Analysis
Plastic and Reconstructive Surgery, Global Open
title Practice Trends in the Management of Asymptomatic Breast Reconstruction Patients with Textured Implants: A Survey Analysis
title_full Practice Trends in the Management of Asymptomatic Breast Reconstruction Patients with Textured Implants: A Survey Analysis
title_fullStr Practice Trends in the Management of Asymptomatic Breast Reconstruction Patients with Textured Implants: A Survey Analysis
title_full_unstemmed Practice Trends in the Management of Asymptomatic Breast Reconstruction Patients with Textured Implants: A Survey Analysis
title_short Practice Trends in the Management of Asymptomatic Breast Reconstruction Patients with Textured Implants: A Survey Analysis
title_sort practice trends in the management of asymptomatic breast reconstruction patients with textured implants a survey analysis
url http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000005139
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