Standardized Practice Reduces Complications in Breast Augmentation: Results with the First 290 Consecutive Cases Versus Non-standardized Comparators
Several systematic methods for breast augmentation have been published, providing key principles and technical steps for minimizing complications and optimizing patient satisfaction. The aim of this study was to compare complication rates in patients receiving a breast augmentation performed using a structured, standardized approach versus comparator patients operated on without a standardized approach.
This was a single-center, retrospective review of 290 consecutive breast augmentations performed between October 2016 and September 2017 based on a standardized technique (Randquist’s “five P’s” combined with Adams’ 14-point plan), and 235 comparators who underwent breast augmentations prior to standardization between April 2014 and September 2016. All study subjects were females aged ≥ 18 years, undergoing bilateral breast augmentation, either alone or in the context of augmentation mastopexy or implant replacement. Various implant ranges were used before standardization; most (94.8%) of the standardized procedures used Natrelle® devices. Follow-up lasted for ≥ 12 months.
Significantly fewer patients in the standardized surgery group experienced complications (14.5%, n = 42) compared with the non-standardized group [29.4%, n = 69; Chi square = 6.57; degrees of freedom (df) = 1; p = 0.01041]. Complication rates were also significantly lower in the standardized surgery group for each of the three types of breast augmentation surgery assessed separately. Reoperation rates with standardized and non-standardized surgery were 4.1% (n = 12) and 11.9% (n = 28), respectively (Chi square = 6.4; df = 1; p = 0.01145). Patient satisfaction was increased post-surgery in both groups.
The use of a structured, standardized approach to breast augmentation reduced the risk of postoperative complications.
Level of Evidence IV
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KeywordsBreast augmentation Five P’s 14-Point plan
The authors received financial support for the research, authorship, and publication of this article from Health & Progress s.r.l., Benevento, Italy. We thank Antonio Pezone (Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II) and Imma Fantasia (a freelance data scientist) for assistance with statistical calculations. The authors also thank Dr Timothy Ryder from Biological Communications Limited for medical writing and editorial assistance in developing the manuscript, funded by Allergan.
Compliance with Ethical Standards
Conflict of interest
The authors declared no potential conflicts of interest with respect to the research, authorship, and publication of this article.
Supplementary material 1 (MP4 350392 kb)
- 1.American Society of Plastic Surgeons (2016) Plastic surgery statistics report 2016. www.plasticsurgery.org/documents/News/Statistics/2016/plastic-surgery-statistics-full-report-2016.pdf. Accessed 9 Aug 2018
- 2.Kapoor NS (2017) Common and less-common complications associated with breast implants. Ann Womens Health 1:1002Google Scholar
- 3.Hedén P, Jernbeck J, Hober M (2001) Breast augmentation with anatomical cohesive gel implants: the world’s largest current experience. Clin Plast Surg 28:531–552Google Scholar
- 9.Tebbetts JB, Adams WP (2005) Five critical decisions in breast augmentation using five measurements in 5 minutes: the high five decision support process. Plast Reconstr Surg 116:2005–2016Google Scholar
- 13.Montemurro P, Agko M, Quattrini Li A, Avvedimento S, Heden P (2017) Implementation of an integrated biodimensional method of breast augmentation with anatomic, highly cohesive silicone gel implants: Short-term results with the first 620 consecutive cases. Aesthet Surg J 37:782–792CrossRefGoogle Scholar
- 15.Berretta M, Di Francia R, Tirelli U (2014) Editorial: the new oncologic challenges in the 3RD millennium. World Cancer Res J 1:e133Google Scholar