Skip to main content
Top

Open Access 02-05-2024 | Original Articles

Medical Specialist Care Utilization Prior to the Explantation of Cosmetic Silicone Breast Implants: A Nationwide Retrospective Data Linkage Study

Authors: Annemiek S. Lieffering, Lotte Ramerman, Robert A. Verheij, Hinne A. Rakhorst, Marc A. M. Mureau, René R. W. J. van der Hulst, Juliëtte E. Hommes

Published in: Aesthetic Plastic Surgery

Login to get access

Abstract

Background

Explantation is the proposed treatment for breast implant illness (BII). Little is known about which medical specialists are visited and what diagnoses are made before explantation is provided as the treatment.

Objectives

This study investigated medical specialist care utilization in women with cosmetic breast implants who underwent explantation compared to women who chose breast implant replacement surgery and to women without breast implants.

Methods

Retrospective cohort study using data linkage with the Dutch Breast Implant Registry and the Dutch health insurance claims database. Visits to medical specialists were examined over the 3 years before explantation. A total of 832 explantation patients were matched and compared to 1463 breast implant replacement patients and 1664 women without breast implants.

Results

Explantation patients were more likely to have visited > 5 different medical specialties compared to both replacement patients (12.3% vs. 5.7%; p < 0.001) and women without breast implants (12.3% vs. 3.7%; p < 0.001). Among explantation patients, women who underwent explantation because of BII were more likely to have visited > 5 different medical specialties compared to women who underwent explantation because of other reasons (25.0% vs. 11.0%; p < 0.001).

Conclusions

Women who underwent explantation of breast implants had higher utilization of medical specialist care in the years before explantation compared to women who underwent breast implant replacement surgery and women without breast implants. Medical specialist care use was especially high among women for whom BII was the registered reason for explantation. These findings suggest further research is needed into the link between BII and the use of medical specialist care.

Level of Evidence III

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.​springer.​com/​00266.
Appendix
Available only for authorised users
Literature
1.
go back to reference Magnusson MR, Cooter RD, Rakhorst H et al (2019) Breast implant illness: a way forward. Plast Reconstr Surg 143:74S-81SCrossRefPubMed Magnusson MR, Cooter RD, Rakhorst H et al (2019) Breast implant illness: a way forward. Plast Reconstr Surg 143:74S-81SCrossRefPubMed
2.
go back to reference Maijers MC, de Blok CJM, Niessen FB et al (2013) Women with silicone breast implants and unexplained systemic symptoms: a descriptive cohort study. Neth J Med 71:534–540PubMed Maijers MC, de Blok CJM, Niessen FB et al (2013) Women with silicone breast implants and unexplained systemic symptoms: a descriptive cohort study. Neth J Med 71:534–540PubMed
3.
go back to reference Colaris MJL, de Boer M, van der Hulst RR, Cohen Tervaert JW (2017) Two hundreds cases of ASIA syndrome following silicone implants: a comparative study of 30 years and a review of current literature. Immunol Res 65:120–128CrossRefPubMed Colaris MJL, de Boer M, van der Hulst RR, Cohen Tervaert JW (2017) Two hundreds cases of ASIA syndrome following silicone implants: a comparative study of 30 years and a review of current literature. Immunol Res 65:120–128CrossRefPubMed
4.
go back to reference Wee CE, Younis J, Isbester K et al (2020) Understanding breast implant illness, before and after explantation: a patient-reported outcomes study. Ann Plast Surg 85:S82–S86CrossRefPubMedPubMedCentral Wee CE, Younis J, Isbester K et al (2020) Understanding breast implant illness, before and after explantation: a patient-reported outcomes study. Ann Plast Surg 85:S82–S86CrossRefPubMedPubMedCentral
6.
go back to reference Glicksman C, McGuire P, Kadin M et al (2022) Impact of capsulectomy type on post-explantation systemic symptom improvement: findings from the ASERF systemic symptoms in women-biospecimen analysis study: part 1. Aesthet Surg J 42:809–819CrossRefPubMed Glicksman C, McGuire P, Kadin M et al (2022) Impact of capsulectomy type on post-explantation systemic symptom improvement: findings from the ASERF systemic symptoms in women-biospecimen analysis study: part 1. Aesthet Surg J 42:809–819CrossRefPubMed
7.
go back to reference Metzinger SE, Homsy C, Chun MJ, Metzinger RC (2022) Breast implant illness: treatment using total capsulectomy and implant removal. Eplasty 16:e5 Metzinger SE, Homsy C, Chun MJ, Metzinger RC (2022) Breast implant illness: treatment using total capsulectomy and implant removal. Eplasty 16:e5
8.
go back to reference Bird GR, Niessen FB (2022) The effect of explantation on systemic disease symptoms and quality of life in patients with breast implant illness: a prospective cohort study. Sci Rep 12:21073CrossRefPubMedPubMedCentral Bird GR, Niessen FB (2022) The effect of explantation on systemic disease symptoms and quality of life in patients with breast implant illness: a prospective cohort study. Sci Rep 12:21073CrossRefPubMedPubMedCentral
9.
go back to reference Rohrich RJ, Kenkel JM, Adams WP et al (2000) A prospective analysis of patients undergoing silicone breast implant explantation. Plast Reconstr Surg 105:2529–2537CrossRefPubMed Rohrich RJ, Kenkel JM, Adams WP et al (2000) A prospective analysis of patients undergoing silicone breast implant explantation. Plast Reconstr Surg 105:2529–2537CrossRefPubMed
10.
go back to reference Glicksman C, McGuire P, Kadin M et al (2023) Longevity of post-explantation systemic symptom improvement and potential etiologies: findings from the ASERF systemic symptoms in women - biospecimen analysis study: part 4. Aesthet Surg J 43:1194–1204CrossRefPubMedPubMedCentral Glicksman C, McGuire P, Kadin M et al (2023) Longevity of post-explantation systemic symptom improvement and potential etiologies: findings from the ASERF systemic symptoms in women - biospecimen analysis study: part 4. Aesthet Surg J 43:1194–1204CrossRefPubMedPubMedCentral
11.
go back to reference Spit KA, Scharff MJ, de Blok CJ et al (2022) Patient-reported systemic symptoms in women with silicone breast implants: a descriptive cohort study. BMJ Open 12:e057159CrossRefPubMedPubMedCentral Spit KA, Scharff MJ, de Blok CJ et al (2022) Patient-reported systemic symptoms in women with silicone breast implants: a descriptive cohort study. BMJ Open 12:e057159CrossRefPubMedPubMedCentral
13.
go back to reference Miseré RML, van der Hulst RRWJ (2022) Self-reported health complaints in women undergoing explantation of breast implants. Aesthet Surg J 42:171–180CrossRefPubMed Miseré RML, van der Hulst RRWJ (2022) Self-reported health complaints in women undergoing explantation of breast implants. Aesthet Surg J 42:171–180CrossRefPubMed
14.
go back to reference Lieffering AS, Hommes JE, Ramerman L et al (2022) Prevalence of local postoperative complications and breast implant illness in women with breast implants. JAMA Netw Open 5:e2236519CrossRefPubMedPubMedCentral Lieffering AS, Hommes JE, Ramerman L et al (2022) Prevalence of local postoperative complications and breast implant illness in women with breast implants. JAMA Netw Open 5:e2236519CrossRefPubMedPubMedCentral
15.
go back to reference van der Maaden T, Moltó-Pulgmartí C, de Jong WH, et al (2017) Gezondheidsklachten bij vrouwen met een siliconen borstimplantaat. Een inventarisatie. RIVM Rapport 2017-0151. RIVM, Bilthoven van der Maaden T, Moltó-Pulgmartí C, de Jong WH, et al (2017) Gezondheidsklachten bij vrouwen met een siliconen borstimplantaat. Een inventarisatie. RIVM Rapport 2017-0151. RIVM, Bilthoven
16.
go back to reference Tang S, Anderson NE, Faasse K et al (2022) A qualitative study on the experiences of women with breast implant illness. Aesthet Surg J 42:381–393CrossRefPubMed Tang S, Anderson NE, Faasse K et al (2022) A qualitative study on the experiences of women with breast implant illness. Aesthet Surg J 42:381–393CrossRefPubMed
17.
go back to reference Rakhorst HA, Mureau MAM, Cooter RD et al (2017) The new opt-out Dutch National Breast Implant Registry—lessons learnt from the road to implementation. J Plast Reconstr Aesthet Surg 70:1354–1360CrossRefPubMed Rakhorst HA, Mureau MAM, Cooter RD et al (2017) The new opt-out Dutch National Breast Implant Registry—lessons learnt from the road to implementation. J Plast Reconstr Aesthet Surg 70:1354–1360CrossRefPubMed
18.
go back to reference Spronk PER, Becherer BE, Hommes J et al (2019) How to improve patient safety and quality of care in breast implant surgery? First outcomes from the Dutch Breast Implant Registry (2015–2017). J Plast Reconstr Aesthet Surg 72:1607–1615CrossRefPubMed Spronk PER, Becherer BE, Hommes J et al (2019) How to improve patient safety and quality of care in breast implant surgery? First outcomes from the Dutch Breast Implant Registry (2015–2017). J Plast Reconstr Aesthet Surg 72:1607–1615CrossRefPubMed
22.
go back to reference UNESCO Institute for Statistics (2012) The international standard classification of education ISCED 2011. UNESCO Institute for Statistics, MontrealCrossRef UNESCO Institute for Statistics (2012) The international standard classification of education ISCED 2011. UNESCO Institute for Statistics, MontrealCrossRef
24.
go back to reference WHO (2000) Obesity: preventing and managing the global epidemic. Report of a WHO consultation. World Health Organ Tech Rep Ser 894:i–xii, 1–253 WHO (2000) Obesity: preventing and managing the global epidemic. Report of a WHO consultation. World Health Organ Tech Rep Ser 894:i–xii, 1–253
25.
go back to reference Adidharma W, Latack KR, Colohan SM et al (2020) Breast implant illness: Are social media and the internet worrying patients sick? Plast Reconstr Surg 145:225e–227eCrossRefPubMed Adidharma W, Latack KR, Colohan SM et al (2020) Breast implant illness: Are social media and the internet worrying patients sick? Plast Reconstr Surg 145:225e–227eCrossRefPubMed
26.
go back to reference Azzi AJ, Almadani Y, Davison P (2021) A national survey to assess the population’s perception of breast implant-associated anaplastic large cell lymphoma and breast implant illness. Plast Reconstr Surg 147:795–803CrossRefPubMed Azzi AJ, Almadani Y, Davison P (2021) A national survey to assess the population’s perception of breast implant-associated anaplastic large cell lymphoma and breast implant illness. Plast Reconstr Surg 147:795–803CrossRefPubMed
27.
go back to reference Giltay EJ, Moens HJB, Riley AH, Tan RG (1994) Silicone breast protheses and rheumatic symptoms: a retrospective follow up study. Ann Rheum Dis 53:194–196CrossRefPubMedPubMedCentral Giltay EJ, Moens HJB, Riley AH, Tan RG (1994) Silicone breast protheses and rheumatic symptoms: a retrospective follow up study. Ann Rheum Dis 53:194–196CrossRefPubMedPubMedCentral
28.
go back to reference Miseré RML, Colaris MJL, Tervaert JWC, Van Der Hulst RRWJ (2021) The prevalence of self-reported health complaints and health-related quality of life in women with breast implants. Aesthet Surg J 41:661–668CrossRefPubMed Miseré RML, Colaris MJL, Tervaert JWC, Van Der Hulst RRWJ (2021) The prevalence of self-reported health complaints and health-related quality of life in women with breast implants. Aesthet Surg J 41:661–668CrossRefPubMed
31.
go back to reference The GBD 2015 Obesity Collaborators (2015) Health effects of overweight and obesity in 195 countries over 25 years. N Engl J Med 377:13–27CrossRef The GBD 2015 Obesity Collaborators (2015) Health effects of overweight and obesity in 195 countries over 25 years. N Engl J Med 377:13–27CrossRef
33.
go back to reference Brown N, White J, Milligan A et al (2012) The relationship between breast size and anthropometric characteristics. Am J Hum Biol 24:158–164CrossRefPubMed Brown N, White J, Milligan A et al (2012) The relationship between breast size and anthropometric characteristics. Am J Hum Biol 24:158–164CrossRefPubMed
Metadata
Title
Medical Specialist Care Utilization Prior to the Explantation of Cosmetic Silicone Breast Implants: A Nationwide Retrospective Data Linkage Study
Authors
Annemiek S. Lieffering
Lotte Ramerman
Robert A. Verheij
Hinne A. Rakhorst
Marc A. M. Mureau
René R. W. J. van der Hulst
Juliëtte E. Hommes
Publication date
02-05-2024
Publisher
Springer US
Published in
Aesthetic Plastic Surgery
Print ISSN: 0364-216X
Electronic ISSN: 1432-5241
DOI
https://doi.org/10.1007/s00266-024-04047-5