Abstract
BACKGROUND: The Australian Breast Device Registry (ABDR) records breast implant surgeries Australia-wide. In addition to clinical data, the ABDR has collected patient-reported outcome measures (PROMs) to better understand patient outcomes following implant surgery. OBJECTIVES: Our objective was to assess the association between postoperative PROMs and revisional surgery due to complications for reconstructive and cosmetic breast implant patients. METHODS: A cohort study design was performed. All primary breast augmentation and breast reconstruction implant insertion procedures with 2 years of follow-up after PROM response, and with at least 1 PROM completed between October 30, 2017, and May 16, 2021, registered with the ABDR were identified. The primary outcome investigated was complications requiring revision at 2 years post PROM completion. Binary logistic regression models were applied to assess the predictive ability of PROMs. RESULTS: A total of 5321 reconstructive procedures and 25,777 cosmetic breast procedures were followed. Multivariate regression for the reconstructive cohort showed that 3 PROM variables, feel, rippling, and tightness, predicted revision due to complications within 2 years of PROM response (OR 0.71, 95% CI 0.56-0.90, P = .004; OR 0.70, 95% CI 0.57-0.87, P < .001; and OR 0.80, 95% CI 0.69-0.93, P = .003, respectively). Multivariate regression for the cosmetic cohort showed that 3 PROM variables, look, rippling, and tightness, predicted revision due to complications within 2 years of PROM response (OR 0.51, CI 0.42-0.63, P < .001; OR 0.78, CI 0.63-0.95, P = .014; and OR 0.79, CI 0.67-0.94, P = .006, respectively). CONCLUSIONS: Postoperative PROMs were significantly associated with revisional surgery due to complications. PROMs may be employed to predict the likelihood of complications and revision following breast implant surgery.