Plastic surgeons can reduce breast implant re-operations in augmentation patients to 3 percent by following a new system of decision and management algorithms, according to a study published in Plastic and Reconstructive Surgery® (PRS), the official medical journal of the American Society of Plastic Surgeons (ASPS). At the same time, these algorithms can raise patients' safety and overall satisfaction, the study also found.
During the U.S. Food and Drug Administration (FDA) advisory panel hearings on silicone breast implants in October 2003, panelists expressed concern about the manufacturer's reported 20 percent re-operation rate for silicone breast implants.
"Although plastic surgeons began to use saline implants after silicone implants were banned by the FDA, the re-operation rates for primary breast augmentation have remained largely unchanged for more than a decade," said John Tebbetts, MD, ASPS member and study author. "We originally created these algorithms to help manage potential problems and educate patients about the benefits and risks of breast augmentation. What we also found was that the algorithms significantly reduced the rate of re-operation, increased patient safety and made patients happier about the results of their procedure."
Directly responding to the FDA's concerns, a group of board-certified plastic surgeons formed the Breast Augmentation Surgeons for Patients Initiative (BAPSI). They adopted the algorithms from Dr. Tebbetts' practice and expanded them to address a number of clinical situations, including re-operations to change the size of implant, capsular contracture, infection, implant displacement and silent rupture of silicone implants.