Abstract
Background: Treatment of complications from cosmetic breast augmentation is subsidised by government funding in Australia.
 Aim: We aimed to estimate the total cost to the Australian public health system of the treatment of complications following cosmetic breast augmentation.
 Method: Using the PRISMA 2009 statement, a systematic review was conducted to find articles reporting on complications following cosmetic breast augmentation. A quantitative analysis was performed to calculate overall complication rates.
 An economic cost analysis was performed on data from procedures performed in Australia between 2000-01 and 2014-15. We modelled costs to the public health system for this period and projected costs to the year 2030.
 Results: Thirty-nine articles were identified for inclusion in the quantitative analysis of complication rates following cosmetic breast augmentation. Economic modelling showed an estimated cost of over A$10 million just for surgeons’ and surgical assistants’ fees to treat complications between 2000 and 2015. We forecast over A$50 million for this cost over the subsequent fifteen years. Total health spending on complications is estimated to have been almost A$200 million between 2000 and 2015.
 Conclusion: This study illustrates the significant economic cost to the Australian health system created by complications following cosmetic breast augmentation. We believe this study reinforces the importance of the Australian breast device registry (ABDR) to further guide regulation, economic policy and health policy.
Highlights
With increased pressure on health care budgets, we are seeing more focus on the clinical and cost effectiveness of interventions provided by health systems globally
This study illustrates the significant economic cost to the Australian health system created by complications following cosmetic breast augmentation
We believe this study reinforces the importance of the Australian breast device registry (ABDR) to further guide regulation, economic policy and health policy
Summary
With increased pressure on health care budgets, we are seeing more focus on the clinical and cost effectiveness of interventions provided by health systems globally. The ‘Choosing Wisely’ campaign recently adopted in a number of countries, including Australia, focuses on encouraging patients and clinicians to ‘discuss inappropriate and potentially harmful tests, treatments and procedures.’[1] While the Australian campaign is seeing the development and identification of procedures that may be harmful to patients, there is a paucity of robust clinical studies that clearly define the benefit of cosmetic breast augmentation in non-pathological female breasts. The process of having cosmetic breast augmentation surgery in Australia involves a completely private arrangement (and transactions) between a surgeon, anaesthetist, hospital and patient, with no funding or rebates available through the Medicarebased public health system. Treatment of complications from cosmetic breast augmentation is subsidised by government funding in Australia
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