According to a research review that appeared recently in Plastic and Reconstructive Surgery, breast implant size selection systems based on breast tissue measurements may provide better outcomes than approaches relying more on the patient’s or surgeon’s preference.
In their study, Drs William P. Adams, Jr, of University of Texas Southwestern Medical Center, Dallas, and Daniel McKee of McMaster University, Hamilton, Ont, Canada, performed a “data-driven review” of methods used by plastic surgeons to select the appropriate implant size for breast augmentation surgery, according to a media release from Wolters Kluwer Health: Lippincott Williams and Wilkins.
They divided the implant size selection systems into three groups:
- No breast measurements. Implants are chosen based solely on the patient’s or surgeon’s preference.
- Dimensional analysis systems. Implants are chosen in order to establish a desired result, with measurements performed to determine the implant needed to achieve that result.
- Tissue-based planning (TBP). Breast tissue measurements are used to set “clear and narrow boundaries” for implant selection based on clinical guidelines, with limited to no flexibility.
“The top 10 studies based on methodological quality all used patients’ breast dimensions before selecting final implant dimensions, and this should now be considered standard of practice based on our analysis,” the researchers write. The TBP studies reported low rates of repeat surgery, compared to industry standards and accepted research values, per the release.
Just four out of 33 studies reported clinical outcomes that could be compared to any standard, while none of the studies compared two or more sizing systems, the researchers note. Overall, 60% of studies scored zero on the quality rating scale used—including some popular sizing systems that were “not grounded on any published data or evidence,” according to the release.
Based on their data, Adams and McKee are evaluating a new “implant-specific” TBP system designed to guide the surgeon to a selection of manufactured implant styles and models. “Going forward,” they write, “new published systems should [use] rigorous quantitative methods so that comparisons can be made in terms of patient outcomes,” the release concludes.
[Source(s): Wolters Kluwer Health: Lippincott Williams and Wilkins, Science Daily]