Work

Implant surface selection in primary cosmetic breast augmentation: A national cross-sectional study of UK plastic surgeons

Year: 2025

Type: article

Abstract: Introduction Breast augmentation remains one of the most common cosmetic surgical procedures globally yet implant surface preference (textured versus smooth) remains a key area of debate. Whilst textured implants have traditionally been favoured in the UK and Europe, concerns around breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) and the absence of formal guidelines have contributed to wide variations in practice. This study therefore examines current UK practice among plastic surgeons, focusing on surgeon preferences and the factors guiding decision-making. Methods An anonymised online survey was distributed to UK consultant plastic surgeons performing cosmetic breast augmentation. Data collected included implant surface, brand, incision, pocket, case volume, and ranked decision-making factors. Free-text responses were analysed thematically. Descriptive statistics and chi-square testing were used to explore associations. Results Seventy-five consultant plastic surgeons responded (response rate=31.3%). Textured implants were most commonly used (82.7%), although smooth implants were more frequently selected by high-volume surgeons (>50 cases/year, χ²(5) = 11.79, p = 0.038, Cramér's V = 0.37). Mentor was the preferred brand (53.3%), while Motiva was more commonly selected by smooth implant users (χ²(5) = 58.3, p = 0.011, Cramér's V = 0.29). All surgeons preferentially used inframammary incisions; subglandular placement was most common (54.7%). The top four decision-making factors in implant surface selection were patient preference, cosmetic outcome, risk of capsular contracture and BIA-ALCL possibility. Qualitative themes highlighted the influence of patient expectations, safety concerns, and institutional policy. Conclusion UK practice in cosmetic breast augmentation remains varied. Although most surgeons preferred textured implants, a shift towards smooth implants appears to be emerging among high-volume operators.

Source: JPRAS Open

DOI: 10.1016/j.jpra.2025.06.004

Authors: Chloe Jordan, Krzysztof Sosnowski, Rushabh Shah, Charles Malata

Institutions: Cambridge University Hospitals NHS Foundation Trust, Addenbrooke's Hospital, University of Cambridge, Anglia Ruskin University

Language: English

Topic: Breast Implant and Reconstruction

Subfield: Surgery

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $1,920