Breast Implant Rupture Surveillance Practices among Plastic Surgeons in Publicly Funded Healthcare Systems

Area of Science:

• Plastic Surgery
• Medical Imaging
• Public Health Policy

Background:

• The United States Food and Drug Administration (FDA) recommends silicone breast implant rupture surveillance via MRI or ultrasound.
• Current surveillance guidelines are absent in Canada and the UK, creating a practice gap.
• This study investigates current surveillance practices and barriers among Canadian and UK plastic surgeons.

Purpose of the Study:

• To identify silicone breast implant surveillance practices among plastic surgeons in Canada and the UK.
• To determine perceived barriers to implementing surveillance guidelines.
• To compare surveillance practices between public and private healthcare sectors.

Main Methods:

• A survey was distributed to members of the Canadian Society of Plastic Surgeons (CSPS) and the British Association of Plastic, Reconstructive and Aesthetic Surgeons (BAPRAS).
• Surgeons reported demographics, screening practices, and barriers to surveillance.
• Fisher's exact test was used for statistical analysis of associations.

Main Results:

• Only 2.4% of surveyed surgeons adhered to FDA surveillance guidelines, despite 68% awareness.
• Surgeons in private practice screened significantly more (45%) than those in the public sector (13%).
• The primary barriers cited were a perceived lack of clinical necessity and insufficient evidence supporting the guidelines.

Conclusions:

• Surgeon compliance with silicone breast implant surveillance guidelines is low due to perceived lack of necessity and evidence.
• Public sector surgeons are less likely to screen or recommend surveillance, even when barriers are absent.
• Guidelines should consider current practices, and surgeons need increased awareness of evidence and rupture consequences.