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Different types of implants for reconstructive breast surgery.

Nicola Rocco1, Corrado Rispoli, Lorenzo Moja

  • 1Department of Clinical Medicine and Surgery, University of Naples "Federico II", Via S. Pansini, 5, Naples, Italy.

The Cochrane Database of Systematic Reviews
|May 17, 2016
PubMed
Summary

Limited research exists on breast implant types for reconstruction after mastectomy. Current evidence quality is poor, hindering informed patient choices regarding risks and complications of different implant options.

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Area of Science:

  • Oncology
  • Plastic Surgery
  • Medical Device Research

Background:

  • Breast cancer is a leading cause of cancer death in women globally.
  • Mastectomy for breast cancer often necessitates breast reconstruction.
  • Breast implants are utilized to restore breast aesthetics post-mastectomy.

Purpose of the Study:

  • To evaluate breast implant effects on capsular contracture.
  • To assess surgical complications and patient satisfaction after reconstructive surgery.
  • To determine the impact of different implants on quality of life.

Main Methods:

  • Systematic review of randomized controlled trials (RCTs) and quasi-RCTs.
  • Searched multiple databases including Cochrane, MEDLINE, EMBASE, CENTRAL, WHO ICTRP, and ClinicalTrials.gov.
  • Included comparisons of implant surface, filler, shape, volume, and generation.

Main Results:

  • Five RCTs with 202 participants were included; studies were heterogeneous and at high risk of bias.
  • Saline implants showed better outcomes for capsular contracture and patient satisfaction than silicone implants, but with higher reintervention rates.
  • Textured vs. smooth, PVP-hydrogel vs. saline, anatomical vs. round, and variable vs. fixed volume implants showed mixed or non-significant results with very low-quality evidence.

Conclusions:

  • High-quality RCTs are scarce for evaluating breast implants in reconstructive surgery.
  • The current evidence base is largely unsatisfactory, preventing informed patient counseling on risks.
  • Further high-quality RCTs with larger participant numbers are needed to guide clinical decisions.