The Efficacy and Associated Learning Curve of Office-Based High-Resolution Ultrasound to Detect Shell Failure in Breast Implants


 
 
 HRUS is widely used in plastic surgery practices to detect implant rupture prior to revision surgery. Published research has found a good overall accuracy to detect shell failure. The literature often references a learning curve associated with incorporating this imaging technique into a medical practice, but it is yet to be visualized or defined.
 
 
 
 This study calculated current test statistics for the use of HRUS to detect shell failure, as well as define the associated learning curve with respect to the predicted improvement for statistics of test and surgeon proficiency.
 
 
 
 A retrospective review of sequential in-office HRUS on patients with breast implants was conducted across two plastic surgery practices. Pre-operative ultrasound reports and intra-operative findings were compared. Test statistics were calculated for each group of ten subsequent patient and a regression analysis was performed to define the learning curve.
 
 
 
 480 implants were examined and averages for all test statistics were calculated. All were higher than most of the previously reported literature standards. The regression analysis showed a linear improvement for both sensitivity and specificity over time, with significant improvement in sensitivity.
 
 
 
 The study shows a high efficacy of HRUS to detect shell failure in breast implants. There is also a calculable linear improvement for all test values of the HRUS over time. Surgeons were able to remain above literature standard for sensitivity after their 60th HRUS reading. This improvement shows that continued use and practice with the imaging technique allow for more accurate findings.
