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      Contextualizing Breast Implant Removal Patterns with Google Trends: Big Data Applications in Surgical Demand

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          Background:

          The demand for breast implant removal (BIR) has increased substantially in recent years. This study leveraged large datasets available through Google Trends to understand how changes in public perception could be influencing surgical demand, both geographically and temporally.

          Methods:

          Using Google Trends, we extracted relative search volume for BIR-related search terms in the United States from 2006 to 2019. A network of related search terms was established using pairwise correlative analysis. Terms were assessed for correlation with national BIR case volume based on annual reports provided by the American Society of Plastic Surgeons. A surgical demand index for BIR was created on a state-by-state basis.

          Results:

          A network of internally correlated BIR search terms was found. Search volumes for such terms, including “explant” [ρ = 0.912], “breast implant removal” [ρ = 0.596], “breast implant illness” [ρ = 0.820], “BII” [ρ = 0.600], and “ALCL” [ρ = 0.895] ( P < 0.05), were found to be positively correlated with national BIR case volume, whereas “breast augmentation” [ρ = -0.596] ( P < 0.05) was negatively correlated. Our 2019 BIR surgical demand index revealed that Nevada, Arizona, and Louisiana were the states with the highest BIR demand per capita.

          Conclusions:

          Google Trends is a powerful tool for tracking public interest and subsequently, online health information seeking behavior. There are clear networks of related Google search terms that are correlated with actual BIR surgical volume. Understanding the online health queries patients have can help physicians better understand the factors driving patient decision-making.

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          Most cited references18

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          US FDA Breast Implant Postapproval Studies

          To analyze the long-term safety and efficacy outcomes of patients with breast implants.
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            Social networking in online support groups for health: how online social networking benefits patients.

            Jae Chung (2014)
            An increasing number of online support groups (OSGs) have embraced the features of social networking. So far, little is known about how patients use and benefit from these features. By implementing the uses-and-gratifications framework, the author conducted an online survey with current users of OSGs to examine associations among motivation, use of specific features of OSG, and support outcomes. Findings suggest that OSG users make selective use of varied features depending on their needs, and that perceptions of receiving emotional and informational support are associated more with the use of some features than others. For example, those with strong motivation for social interaction use diverse features of OSG and make one-to-one connections with other users by friending. In contrast, those with strong motivation for information seeking limit their use primarily to discussion boards. Results also show that online social networking features, such as friending and sharing of personal stories on blogs, are helpful in satisfying the need for emotional support. The present study sheds light on online social networking features in the context of health-related OSGs and provides practical lessons on how to improve the capacity of OSGs to serve the needs of their users.
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              Understanding Breast Implant Illness, Before and After Explantation

              Background Breast implant illness (BII) after aesthetic breast augmentation remains a poorly defined syndrome encompassing a wide spectrum of symptoms. While previously published series have observed overall symptomatic improvement after breast implant removal, 1–3 there is a lack of studies evaluating changes in specific symptoms over time. The purpose of this study was to gain an understanding of symptoms associated with BII, and to evaluate how these symptoms change after removal of breast implants and total capsulectomy (explantation). We hypothesized that patients presenting with BII would experience both immediate and sustained improvement in constitutional symptoms after explantation. Methods A retrospective study of all patients who underwent explantation by a single surgeon over 2 years was conducted. Repeated-measures analysis of variance accounting for dependency was used to compare symptoms before and after surgery. Multivariate analyses and linear regression models were used to examine the impact of patient- and implant-related factors on changes in symptoms. Results Seven hundred fifty patients met inclusion criteria. Mean preoperative survey score (26.19 ± 11.24) was significantly different from mean postoperative survey score at less than 30 days (9.49 ± 7.56) and greater than 30 days (9.46 ± 7.82, P < 0.001). Patients with a BMI greater than 30 or those with clinically detectable contracture on examination showed greater improvement on their survey scores (P = 0.039, 0.034, respectively). Conclusions Although BII encompasses a large range of symptoms, subjects in this study demonstrated significant and sustained improvement in 11 common symptom domains. This improvement was demonstrable within the first 30 days postoperatively and was maintained beyond 30 days. The study demonstrated a strong association of explantation and specific symptom improvement within the patient population studied. Future investigation will further elucidate possible biologic phenomena to better characterize the pathophysiology and mechanism of BII.
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                Author and article information

                Journal
                Plast Reconstr Surg Glob Open
                Plast Reconstr Surg Glob Open
                GOX
                Plastic and Reconstructive Surgery Global Open
                Lippincott Williams & Wilkins (Hagerstown, MD )
                2169-7574
                05 January 2022
                January 2022
                : 10
                : 1
                : e4005
                Affiliations
                From the [* ]Duke University School of Medicine, Durham, N.C.
                []Department of Surgery, Division of Plastic and Maxillofacial Surgery, Duke University Medical Center, Durham, N.C.
                Author notes
                William M. Tian, BSE, 2616 Erwin Road, Apartment 2426, Durham, NC 27705, E-mail: wmt5@ 123456duke.edu
                Article
                00006
                10.1097/GOX.0000000000004005
                8812673
                35127299
                6a89c88e-1555-4949-895d-af5babc4e9bb
                Copyright © 2022 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of The American Society of Plastic Surgeons.

                This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.

                History
                : 19 September 2021
                : 3 November 2021
                Categories
                Technology
                Original Article
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                UNITED STATES
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