Tracking Trends in Breast Implant Surgery Techniques From 2005 to 2020

Breast implant placement with inframammary incisions increased from 68% to 80%, while use of peri-areolar incisions decreased from 24% to 14% between 2005 and 2020, according to a study in the December 2023 issue of Plastic and Reconstructive Surgery. 

Submuscular implant placement increased from 22% to 56% during the same time frame.  The use of subglandular breast implant placement decreased from 19% to 7%, the study found,

Use of textured implants increased from 2% in 2011 to 16% in 2016 reflecting a belief that textured implants could reduce problems with contracture around the implants. However, use of textured implants dropped precipitously starting in 2019 and has since stopped completely. Textured implants were used in 0% of cases from 2020 onwards. 

"The findings illustrate evolving trends in breast enhancement over the past 16 years, including factors like the location of the incision and the type and positioning of implants," says lead author Michael J. Stein, MD, a plastic surgeon at Lenox Hill Hospita in New York, N.Y, in a news release.  "The data reflect current best practice among Board-certified plastic surgeons, with attention to safety issues and the latest research evidence." 

To assess practice patterns and surgical techniques over time, Dr. Stein and colleagues analyzed data from the Continuous Certification process of the American Board of Plastic Surgery (ABPS).  

In that process, plastic surgeons submit information on frequently performed "tracer procedures" as evidence of ongoing improvement in clinical practice. The study included data on 31,700 breast augmentation cases submitted by 1,082 surgeons between 2005 and 2020. Cases were divided into early (2005-14) and recent (2015-20) cohorts to assess trends in surgical technique over time. 

Patients in the more recent cohort were less likely to smoke, 12% versus 8%; and less likely to have preoperative mammograms, 29% versus 24%. Women in the recent cohort were more likely to have ptosis (sagging) of the breasts: 23% versus 20%, the study showed

"Our findings lend insights into the continuous evolution of surgical technique in breast augmentation by Board-certified plastic surgeons, with a focus on evidence-based practice to maximize patient safety and patient satisfaction," Dr. Stein says.