Current Trends in Breast Augmentation: Analysis of 2011-2015 Maintenance of Certification (MOC) Tracer Data

Abstract

Background

Breast augmentation is the most common aesthetic surgery performed in the United States. Despite its popularity, there is no clear consensus on many aspects of the procedure.

Objectives

We assessed current trends and changes in breast augmentation from January 1, 2011 to December 31, 2015.

Methods

A retrospective cross-sectional study of 11,756 women undergoing breast augmentation based on the American Board of Plastic Surgery Maintenance of Certification (ABPS MOC) Tracer Database was performed.

Results

There were clearly dominant trends in how ABPS certified plastic surgeons performed breast augmentations. The majority of surgeries were performed in freestanding outpatient (47.3%) or office operating room (33.7%). The inframammary fold incision was most popular (75.1%), followed by periareolar (17.8%) and transaxillary approaches (4.1%). Implants were more commonly placed in a submuscular pocket (30.6%), compared to dual plane (26.7%) or subglandular (6.7%). Silicone implants (66.8%) were favored over saline (25.1%), with a statistically significant increase in silicone prostheses from 2011 to 2015. Data was "not applicable" or "other" in the remainder of cases. There was a dramatic increase in administration of both preoperative antibiotics (3.8% in 2011, 98.7% in 2015, p<0.05) and deep venous thromboembolism (DVT) prophylaxis (3.8% in 2011, 90.6% in 2015, p<0.05) during the study period. Both overall adverse events (7.4%) and reoperation rates (2.2%) were low.

Conclusions

Changes in standard-of-care for breast augmentation are reflected by the evolving practice patterns of plastic surgeons. This is best evidenced by the dramatic increase in use of antibiotic and DVT prophylaxis from 2011 to 2015.