The Incidence and Outcomes of Breast Implants Among 1696 Women over more than 50 Years

Objective: To investigate the incidence of women with breast implants in 1964–2017 Materials and Methods: All women with breast implants in Olmsted County, MN between January 1, 1992 and December 31, 2017 were identified, and a comprehensive review of individual medical records was performed, adding to a previously identified cohort of women with breast implants in 1964–1991. Incidence rates were calculated and were age- and sex-adjusted to the US white female 2010 population. Results: In 1992–2017, 948 women with breast implants were identified, totaling 1696 Olmsted County, MN women with breast implants in 1964–2017. Overall incidence was 63.3 (95% CI 60.2–66.4) per 100,000 women, but incidence varied significantly over time. Women in 1964–1991 were more likely to have implants for cosmetic reasons and more likely to have silicone implants compared to the 1992–2017 cohort. The overall standardized mortality ratio was 1.17 (95% CI 0.99–1.38) in 1964–1991 and 0.94 (95% CI 0.66–1.29) in 1992–2017. In 1992–2017, breast reconstruction patients had a significantly elevated risk of implant rupture and implant removal versus breast augmentation patients. Conclusion: The incidence of breast implants among women in Olmsted County, MN has varied drastically over the past five decades, with significant changes in the trends for implant type and reason. The findings of this study may provide further insight regarding how risks associated with implants may vary over time. Level of Evidence III: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .