Risk Factors for Explantation of Breast Implants: A Cross-Sectional Study

Abstract

Background Explantation of breast implant surgery (EBIS) is an emerging surgical field. Precise information about patients undergoing EBIS is important for preoperative planning of breast, augmentation, complications management, and to address any medicolegal issues. Objectives The aim of this study was to further extend current knowledge of EBIS risk factors. Methods An analytic cross-sectional study was conducted involving patients who had previously undergone cosmetic breast augmentation and were seeking EBIS. Results The study recruited 138 patients. The average time from implant placement and decision to explantation was 59.1 months. On average, each 1-year increase in age resulted in a 4% increase in the relative risk (RR) of explantation (confidence interval (CI), 1.07-1.21). Patients who were obese or overweight present a 1.5 times higher risk of EBIS (CI 95%, 1.03-2.29). On average, this RR was 40% lower (CI 95%, 0.33-0.91) in patients who never smoked compared with those with a history of tobacco use. Women with mastalgia had a 72% higher RR for EBIS (CI 95%, 1.11-2.65). The RR of EBIS was 5.6 times higher (CI 95%, 2.42-11.47) in patients presenting major Shoenfeld’s criteria for autoimmune/inflammatory syndrome induced by adjuvants (ASIA). The RR of EBIS was 4.3 times higher (CI 95%, 1.96-8.63) in patients presenting minor Shoenfeld’s criteria for ASIA. Conclusions EBIS poses a higher risk to patients who are overweight/obese, have a history of tobacco use, suffer from mastalgia, or present Shoenfeld’s criteria for ASIA. It is important to assess properly these individuals before performing implant surgery for breast augmentation. Level of Evidence: 4

Breast Implant-Associated Immunological Disorders

“…The systemic symptoms of breast implant illness are a major risk factor for eventual surgery for explantation of the breast implant, with a risk ratio of 5.6 in patients with symptoms including myalgias, arthralgias, fatigue, neuropathy, or cognitive impairment [ 71 ]. Currently, explantation has been shown to be effective in relieving symptoms in most patients with breast implant illness [ 5 , 6 ].…”

Laser-Assisted Liposuction for Autologous Fat Grafting Following Elective Breast Explant Surgery

“…Due to the increasing concern from patients about the risks of adverse events following breast augmentation with implants, such as breast implant-associated anaplastic large cell lymphoma and Autoimmune Syndrome Induced by Adjuvants, or simply changes of aesthetic preference, explantation of breast implant surgery became an emerging surgical field [1][2][3]. Evidence suggests that breast explantation effectively improves silicone-related complaints and that the body's self-satisfaction increases with the placement of breast implants and remains increased after their removal [4][5][6].…”