Study of Global Variations in Breast Augmentation Procedures and Outcomes

Goals/Purpose: Although breast augmentations are one of the most prevalent cosmetic procedures performed globally, there are a myriad of variations between countries in procedural techniques, implant characteristics, and post-operative outcomes. there are documented variations in preference in implant size, material, and texture used by surgeons and preferred among patients between countries. In this study we ascertain these procedural variations and their effect on patient outcomes by stratifying studies by countries in order to determine differences in procedural technique, patient preferences, outcomes, and complications by country. Countries studied include Argentina, Bangladesh, Brazil, China, Colombia, France, India, Italy, Japan, Pakistan, South Korea, Switzerland, United Kingdom and United States.

Methods/Technique: A review of literature was conducted to identify publications detailing procedural techniques, cosmetic outcomes, and complications for breast augmentation procedures. 27 studies were analyzed for the following outcomes of interest: type of implant, mean implant volume, implant material, implant placement, implant location, patient satisfaction, and surgical complication rate. The following demographic data was also extracted: mean follow-up time, number of patients, mean patient age, and BMI. Articles were subsequently stratified by country of institution from which the study originated.

Results/Complications: Across all countries, mean age of patients was 36.3 (7.2); however, mean age was significantly higher in Argentina (52.0) and Japan (53.4) (P= 0.029). While patient BMI’s were consistently normal and non-obese across countries (21.5), mean implant volume varied significantly between countries (307.6 cc) with the United States having the largest mean implant volume (400 cc) and China having the smallest (239 cc). Additionally, although not significant, the prevalence of implant material and texture varied between countries. While most countries used silicone implants, Argentina (100%) and Pakistan (69.8%) heavily relied on saline implants. Ultimately, patient satisfaction rates were similar across all countries with mean satisfaction being 90.1%; however, rates of complication varied across countries.

Conclusion: There were profound variations in surgical techniques, implant material and implant volume across countries. This may explain significance in variation of complication rates across countries. Nevertheless, patient satisfaction remains high and relatively similar across countries.