Thirteen-Year Trends in Primary Aesthetic Breast Augmentation, Implant Replacement, and Explantation: A Prospective Observational Cohort Study

An institutional prospective observational registry was established at IQ Interquirofanos to collect standardized clinical and surgical information and evaluate temporal trends in aesthetic breast surgery. Data included in this analysis were prospectively recorded at the time of surgery between January 1, 2012, and December 31, 2024.

The analytical cohort consisted of 22,642 unique adult participants. No participant contributed more than one surgical event. Each participant was assigned to one of three mutually exclusive procedural groups: primary aesthetic breast implant placement, breast implant replacement, or definitive breast implant removal without replacement.

Data collected included age, sex, calendar year of surgery, procedure category, right- and left-sided breast implant volumes, duration of prior implant use, and the primary recorded indication for implant replacement or removal. For replacement procedures, both prior and newly placed implant volumes were evaluated. For removal procedures, prior implant volumes were recorded.

When implant duration coexisted with another clinical or aesthetic indication for secondary surgery, the specific clinical or aesthetic indication was prioritized. "Time with implants" was recorded as the primary indication only when another specific indication was not present.

The primary outcome was the annual number and proportion of primary implant placements, implant replacements, and implant removals. Secondary outcomes included implant volumes by calendar year and procedural group, duration of prior implant use, indications for replacement and removal, and associations between age, implant volume, and implant duration.