Anatomic Implants in Breast Reconstruction: A Comparison of Outcomes and Aesthetic Results Compared to Smooth Round Silicone Implants

Abstract

Background Direct comparison studies of outcomes and aesthetic satisfaction of anatomic implants compared to other implants are scarce in the literature. Objectives The objective of this study was to compare outcomes and aesthetic satisfaction of patients who underwent breast reconstruction with anatomic implants vs other implants (smooth round silicone). Methods A retrospective chart review was performed of patients who underwent implant-based breast reconstruction over 3 years. Outcomes including complications, number of surgeries, need for revisions, and aesthetic satisfaction of patients were tracked and compared. Results A total of 156 patients met inclusion criteria for this study. A total of 123 underwent reconstruction with a round implant, and 33 underwent reconstruction with an anatomic implant. Of the 156 patients, 38 underwent a 1-stage direct-to-implant reconstruction and the remainder underwent a 2-stage implant reconstruction. The round and anatomic implant groups did not differ with regards to number of surgeries, revisions, utilization of contralateral symmetry procedures, implant-related reoperations, complications, implant loss, infection, capsular contracture, and seroma. The Breast Q survey had a response rate of 27%. On all parameters, the round and anatomic implant groups did not significantly differ. Conclusions There were no significant differences among round and shaped implants in regards to complications, revision surgeries, and overall outcomes. Furthermore, patients showed no differences regarding satisfaction and well-being when surveyed on the Breast Q survey. The decision of implant choice in breast reconstruction should be based on surgeon comfort and the patient’s needs/body type. Level of Evidence: 4

Safe and Efficient Implant-based Breast Reconstruction

“…There is currently no evidence that a difference in aesthetic outcome exists between textured anatomic implants and smooth round implants in breast reconstruction. 33 , 34 In this regard, and since a variety of cohesivity levels are widely available with smooth devices, it may be prudent for plastic surgeons to utilize implants with smooth shells, which can produce excellent aesthetic results while eliminating the potential risk for BIA-ALCL.…”

Evaluation of Different Breast Implant Shapes in the Same Patient: Is There Really a Difference between Round and Anatomical Implants?

“…Comparing pros and cons of both shapes, the risk of malrotation is one of the main drawbacks of anatomical implants, which is around 5%, especially after subglandular placement. [1][2][3][4][5] The development of BIA-ALCL…”

Moving towards patient-reported outcomes in routine clinical practice: implementation lessons from the BREAST-Q

“…There are few longitudinal BREAST-Q studies in the surgery research literature; a 2016 systematic review noted that only 29% of PRO studies using BREAST-Q were prospective, while 71% were cross-sectional [ 21 ]. BREAST-Q completion rates have been reported as low as 27% [ 22 , 23 ], demonstrating the need for increased investment and investigation into strategies for improving patient participation in this important health metric for both clinical care and research. One strategy evaluated in areas outside of breast reconstruction is the use of electronic PROM administration; however, studies have shown low sustainability with decreasing patient compliance when electronic PROM capture methods were not coupled with additional reminders or manual administration by research or clinical staff.…”