Current Practices and Evolving Trends in Implant-based Breast Reconstruction in China: A Nationwide Cross-sectional Survey.

BACKGROUND

Implant-based breast reconstruction (IBBR) is widely used globally and in China, but regional disparities and concerns about complications persist. This nationwide survey evaluates current IBBR practices and trends.

METHODS

A cross-sectional survey was conducted in 215 hospitals in 2022, collecting data on surgical volume, reconstruction types, mesh usage, and complications. A total of 198 hospitals provided complete responses, with 122 offering IBBR.

RESULTS

IBBR hospitals had higher surgical volumes, greater bed capacity, more breast specialists, and higher reconstruction rates. In these hospitals, IBBR accounted for a median of 93.5% of reconstructions, with a median annual volume of 24.5 (interquartile range [IQR]: 9-59.3). High-volume hospitals (≥100 IBBR/y) performed 69.4% of cases. TiLOOP Bra was available in 76.2% of hospitals, with 45.9% using it in more than 50% of cases. Prepectoral reconstruction comprised a median of 30% of IBBR cases. Most IBBR procedures used a single mesh (median 95%, IQR: 60%-100%), whereas 2-mesh usage was rare. Direct-to-implant reconstruction with mesh was the most common immediate approach (54.1%), increasing from 23.2% in 2017. Radiation therapy (62.3%), capsular contracture (62.3%), and infection (61.5%) were the leading concerns. Estimated median complication rates were 5% (IQR: 0%-10%) for contracture, 3% (IQR: 1%-10%) for infection, and 2% (IQR: 0%-5%) for implant loss.

CONCLUSIONS

IBBR adoption is increasing in China, particularly with mesh-assisted techniques such as TiLOOP Bra. However, disparities in access and concerns over complications highlight the need for standardized care and further research.