The Influence of BIA-ALCL on the Use of Textured Breast Implant and its Placement: A Survey of Dutch Plastic Surgeons.

BACKGROUND: Breast implant-associated anaplastic large-cell lymphoma (BIA-ALCL) and its association with macrotextured breast implants may have induced plastic surgeons to change their breast augmentation and breast reconstruction practice.

OBJECTIVES: We surveyed Dutch plastic surgeons about the effects of BIA-ALCL on their choice of breast implant texture and placement technique.

METHODS: An online questionnaire was distributed among all members of the Dutch Association of Plastic Surgeons (NVPC). Descriptive data were presented as frequencies and percentages. Technique alterations were analyzed using marginal homogeneity test for paired nominal data.

RESULTS: A total of 63 plastic surgeons completed the questionnaire. The majority of respondents altered implant texture use due to BIA-ALCL for both breast augmentation and reconstruction (75.4% and 69.8%, respectively; both being statistically significant, p<0.001). Microtextured and smooth/nanotextured breast implants are now most frequently used. BIA-ALCL did not influence the placement technique in breast augmentation and reconstruction (87.7% and 94.3%, respectively). Dual-plane breast implant placement is still the most favored technique in breast augmentation and submuscular placement is still most favored in breast reconstruction.

CONCLUSIONS: BIA-ALCL has had a significant impact on the use of macrotextured breast implants by Dutch plastic surgeons in both aesthetic and reconstructive breast surgery. The breast implant placement technique has not been affected.