Breast and Cosmetic Implant Registry - January to December 2021, Management Information

The provider organisation is the clinic or hospital responsible for the patient’s operation. An operating site is the place where the operation was undertaken. A provider may use more than 1 operating site. The submitting organisation is the provider which submitted data to the registry. Submitting organisations may input data about operations taking place at other provider sites.

Operations are undertaken by either NHS or independent providers, at either NHS or independent sites. The NHS sometimes arranges for an operation to be undertaken at an independent provider's operating site, and vice-versa. Between January and December 2021, the approximate breakdown between NHS and independent operating sites was 45% and 55%, respectively (Chart 01).

The BCIR records 5 main operation types:

1. Primary cosmetic augmentation;
2. Reconstruction;
3. Replacement;
4. Reposition; and
5. Explant.

The majority of breast implant operations recorded in the registry occur in the independent sector. Chart 02a shows the breakdown of primary cosmetic augmentation operations by provider type. The majority of these operations are undertaken by independent providers. This pattern, however, varies between the type of operation undertaken. Chart 02b shows the breakdown of reconstruction, replacement, reposition, and explant operations by provider type. Most reconstructions are carried out by the NHS, while the independent sector accounts for most replacements.

Chart 03 shows the number of patients treated by NHS and independent providers in 2021. The majority of patients (84%) were treated in the independent sector.

Chart 04 shows the changes over time by category of operation between 2017 and 2021, in England, Scotland and Northern Ireland (Northern Ireland included in 2021 data for the first time). 

From the start of the registry in October 2016 to December 2021, a general upward trend in volumes of all operation types is observed (Chart 05). The impact of COVID-19 can be seen between February and December 2020. However, there was an apparent recovery in 2021, with operation volumes reaching their pre-2020 levels by around May 2021. The drop in volumes observed in December 2021 may be seasonal (displaying a similar pattern to previous years). Data for 2022 (when available) should be able to provide more evidence of any post-COVID-19 recovery in the volume of BCIR operations.

The registry collects information related to the device that has been implanted during the operation. Not all operations involve implanting a device. A device is only recorded in the registry where the operation involves primary cosmetic augmentation, reconstruction or replacement. Chart 06 shows the distribution of device implants by NHS and independent providers. Most device implants are provided in the independent sector (approximately 90%).

The registry collects information on complications related to the patient’s implant operation. The complication may or may not be the reason that the operation took place and, in a bilateral operation, complications may be found on 1 or both sides. Between January and December 2021, 10 people had breast implant operations during which anaplastic large cell lymphoma (ALCL) was found. The registry cannot identify whether these cases of ALCL are instances of breast implant associated anaplastic large cell lymphoma (BIA-ALCL). More information on complications is available in the BCIR interactive data visualisation (below).

Patient and operation values between 1 and 7 are rounded to 5 - all other values are rounded to the nearest 5. The number of provider organisations has not been rounded.