Background and objective.

Over the last several years there has been great controversy about different aspects related to breast implants. In fact, the potential relationship between implant texture and anaplastic large cell lymphoma led to the voluntary recall of Biocell® coated implants (Allergan®) in July 2019.

The main purpose of this study was to evaluate the preferences and daily practice of members of Spanish Association of Aesthetic Plastic Surgery (AECEP) regarding to breast implant surgery. Additionally, we assessed possible changes experienced in clinical practice since our survey published in 2017.

Methods.

A 15 questions survey, regarding to the selection and different clinical aspects related to breast augmentation, was carried out between January and March 2019 among AECEP members. In addition, a comparative study between current data and those reported in 2017 survey was conducted.

Results.

The 146 members of the AECEP received an invitation to participate in the survey, of whom 74 (50.7%) responded to it. Of the responses obtained, 67.6% (n=50) corresponded to men, 89.2% (n=66) had more than 10 years of professional experience and 70.2% (n=52) had an age between 46 and 65 years. Regarding the type of implant, 52.7% (n=39) showed a preference for round microtextured implants and 47.3% (n=35) preferred anatomical microtextured implants.

Compared to the 2017 survey, a significantly greater proportion of participants preferred round microtextured and anatomical microtextured implants (p = 0.0025 and p = 0.0015, respectively). In contrast, a significantly lower proportion preferred the use of round macrotextured implants (p = 0.0018) and anatomical macrotextured ones (p <0.0001). The submuscular plane was of choice for 44.6% (n=33). Grade III / IV capsular contracture was the main indication for total capsulectomy for 94.5% (n=70). Most of participants ( 93.1%, n=68) were in favor of a vigilant attitude in patients with Biocell®-coated implants. 85.1% (n=63) recommended surveillance with imaging techniques and only 25.7% (n=19) thought that the use of macro-textured implants must be prohibited.

Conclusions.

The results of this survey showed a significant change in the current clinical practices among the participants. Comparing with 2017 survey, there has been a significant increase in the use of smooth / nano-textured and microtextured breast implants, while the use of macro-textured breast implants has been significantly reduced.

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