The Influence of BIA-ALCL on the Use of Textured Breast Implant and Its Placement: A Survey of Dutch Plastic Surgeons

Background: Breast implant-associated anaplastic large-cell lymphoma (BIA-ALCL) and its association with macrotextured breast implants may have induced plastic surgeons to change their breast augmentation and breast reconstruction practice.Objectives: The aim of this study was to survey Dutch plastic surgeons about the effects of BIA-ALCL on their choice of breast implant texture and placement technique.Methods: An online questionnaire was distributed to all members of the Dutch Association of Plastic Surgeons. Descriptive data were presented as frequencies and percentages. Technique alterations were analyzed by the marginal homogeneity test for paired nominal data.Results: A total of 63 plastic surgeons completed the questionnaire. The majority of respondents altered their use of tex-tured implants due to BIA-ALCL concerns for both breast augmentation and reconstruction (75.4% and 69.8%, respectively; both being statistically significant, P <.001). Microtextured and smooth/nanotextured breast implants are now most fre-quently used. BIA-ALCL did not influence the placement technique in breast augmentation and reconstruction (87.7% and 94.3%, respectively). Dual-plane breast implant placement is still the most favored technique for breast augmentation, and submuscular placement is still most favored for breast reconstruction.Conclusions: BIA-ALCL has had a significant impact on the use of macrotextured breast implants by Dutch plastic sur-geons in both aesthetic and reconstructive breast surgery. Breast implant placement technique has not been affected.