Smooth versus textured implant-based breast reconstruction: a systematic review and meta-analysis of patient satisfaction and complication rates

Abstract

Abstract Background Breast implants are widely used in reconstructive and esthetic breast surgery. Nonetheless, complications such as capsular contracture and Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL) significantly impact patient outcomes. While textured implants are associated with reduced rates of capsular contracture, recent concerns regarding their link to BIA-ALCL necessitate an updated comprehensive analysis comparing smooth and textured breast implants. Methods This protocol has been registered on PROSPERO. We will perform a systematic review and meta-analysis in accordance with PRISMA-P guidelines. MEDLINE (PubMed), Scopus, Web of Science, the Cochrane Library (CENTRAL and Cochrane Reviews) and ClinicalTrials.gov will be searched from inception to present. We will include all comparative studies that report complication or patient reported outcomes. Two reviewers will independently screen studies, extract data and assess risk of bias (using Cochrane ROB 2 for Randomized controlled trials and ROBINS-I for non-randomized studies). Primary outcomes will be implant-related complications, including capsular contracture, seroma, hematoma, infection, asymmetry, implant removal, rippling, rupture and rotation. Secondary outcomes will include patient-reported satisfaction and quality of life measured by BREAST-Q scores. Meta-analysis will be conducted using Review Manager 5.4. Discussion The results of this meta-analysis will provide a clear comparison between smooth and textured breast implants, particularly highlighting differences in complication rates and patient satisfaction.