Background: Over the 27 years following the first report of Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL), significant changes have been made in breast implant surgery trends. This study aimed to determine breast implant selection changes among European plastic surgeons. Methods: The European Association of Plastic Surgeons (EURAPS) promoted a digital survey to 31 national plastic surgery societies across Europe, which spread it to their members. The survey included 37 questions covering demographics, BIA-ALCL perception, current clinical practices, implant selection considerations, and satisfaction with information from health authorities and scientific societies. Anonymous responses were collected from February to April 2024. Results: A total of 904 surgeons from 33 countries participated, 41.5% reported that BIA-ALCL concerns affected patient decisions. Awareness of BIA-ALCL was high (97.2%), with more than 85% approving the quality of information from European scientific societies. The awareness influenced implant texture preferences in both aesthetic and reconstructive breast surgery (p<0.001), in the first with a notable drop in the use of macrotextured implants from 32.6% to 1.8%, while the use of smooth implants (ISO 14607:2018) increased from 11.3% to 44.6%. Similar trends were observed in reconstructive surgery regarding implant texture, but 33.1% of surgeons considered performing autologous reconstruction more often than using implants. Surgeons who encountered BIA-ALCL were more prone to using smooth implants. The recognized causal relationship between implant texture and BIA-ALCL is the main explanation to these changes. Conclusion: Efforts in BIA-ALCL education have heightened surgeons' awareness, improved patient communication, and influenced clinical practices toward safer choices.
The impact of Breast Implant-Associated Anaplastic Large Cell Lymphoma on breast implant surgery: A European survey-based study / Santanellidi Pompeo, Fabio; Firmani, Guido; Tornambene, Roberta; Marrella, Domenico; Mareş, Theodor; Sorotos, Michail. - In: JOURNAL OF PLASTIC, RECONSTRUCTIVE & AESTHETIC SURGERY. - ISSN 1878-0539. - (2025). [10.1016/j.bjps.2024.11.018]
The impact of Breast Implant-Associated Anaplastic Large Cell Lymphoma on breast implant surgery: A European survey-based study
Guido FirmaniSecondo
Writing – Original Draft Preparation
;Michail SorotosUltimo
Writing – Review & Editing
2025
Abstract
Background: Over the 27 years following the first report of Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL), significant changes have been made in breast implant surgery trends. This study aimed to determine breast implant selection changes among European plastic surgeons. Methods: The European Association of Plastic Surgeons (EURAPS) promoted a digital survey to 31 national plastic surgery societies across Europe, which spread it to their members. The survey included 37 questions covering demographics, BIA-ALCL perception, current clinical practices, implant selection considerations, and satisfaction with information from health authorities and scientific societies. Anonymous responses were collected from February to April 2024. Results: A total of 904 surgeons from 33 countries participated, 41.5% reported that BIA-ALCL concerns affected patient decisions. Awareness of BIA-ALCL was high (97.2%), with more than 85% approving the quality of information from European scientific societies. The awareness influenced implant texture preferences in both aesthetic and reconstructive breast surgery (p<0.001), in the first with a notable drop in the use of macrotextured implants from 32.6% to 1.8%, while the use of smooth implants (ISO 14607:2018) increased from 11.3% to 44.6%. Similar trends were observed in reconstructive surgery regarding implant texture, but 33.1% of surgeons considered performing autologous reconstruction more often than using implants. Surgeons who encountered BIA-ALCL were more prone to using smooth implants. The recognized causal relationship between implant texture and BIA-ALCL is the main explanation to these changes. Conclusion: Efforts in BIA-ALCL education have heightened surgeons' awareness, improved patient communication, and influenced clinical practices toward safer choices.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.