Holidays With Perks: A Registry-based Study Investigating Revision Procedures Among Patients With Breast Implants Inserted Overseas.

BACKGROUND

Cosmetic tourism for breast augmentation has increased globally, yet the downstream burden of complications and revision surgery in returning patients remains poorly quantified. This study compares the characteristics and complication profiles of breast implant revision procedures among Australian residents whose devices were inserted overseas with those inserted domestically.

METHODS

A retrospective registry-based study was conducted using Australian Breast Device Registry data (2012-2023). Australian residents who underwent breast implant explantation or replacement between 2016 and 2023, with documented implant insertion location, were included. Primary outcomes were the incidence of breast implant revision and types of complications, stratified by overseas versus domestic insertion. Secondary outcomes included public versus private hospital management, explant-only versus replacement procedures, concurrent mastopexy or reduction, and geographic and temporal trends.

RESULTS

Among 30,579 breast implant revision procedures, 3577 (11.7%) involved overseas-inserted devices, with both the number and proportion increasing over time. Patients with overseas-inserted implants were younger at revision (median 41 versus 44 y, P < 0.001). A greater proportion of overseas-related complications were treated in public hospitals (2.7% versus 1.5%, P < 0.001). Revisions due to complications were more common in the overseas group (73.0% versus 69.8%, P < 0.001). Device rupture (27.0% versus 24.5%), malposition (24.9% versus 20.5%), and skin scarring concerns (4.4% versus 2.2%) were more frequent among overseas-inserted implants (all P < 0.001).

CONCLUSIONS

Revision of overseas-inserted breast implants is increasing in Australia and is associated with a higher burden of specific complications and greater public hospital utilization, highlighting the need for improved counseling, surveillance, and health policy responses.