Study designs of evaluations included in the review
Randomised controlled trials (RCTs) and controlled clinical trials were eligible for the review. Case series and case reports on AFT were also eligible, as were case series from multicentre trials on saline and cohesive silicone gel implants. Conference material, letters, comments and discussions were included as background papers.
Specific interventions included in the review
Surgery involving AFT for breast augmentation compared with saline or cohesive silicone gel implants were the interventions of interest. Hydrogel implants, tissue expanders, inflatable implants and silicone gel implants were not considered.
Participants included in the review
Studies performed in humans and animals were eligible for the review. The participants had to be undergoing breast augmentation for aesthetic reasons.
Outcomes assessed in the review
The review considered mortality and morbidity rates, mammographic issues, and psychosocial effects including patient satisfaction. The effectiveness of the enhancement was also studied using measures of fat reabsorption, scarring and durability of enhancement. Further outcomes considered were the cost-effectiveness and the failure of operations.
The review presented data on the mortality and morbidity rates, all reported complications after treatment, capsule formation, deflation in implants, reoperation rate and radiological measures. The efficacy demonstrated in the included studies was reported in terms of breast enhancement measures and patient satisfaction measures.
How were decisions on the relevance of primary studies made?
According to the authors, reasons had to be given for excluding studies. Other than that, the authors did not state how the papers were selected for the review, or how many reviewers performed the selection.