Breast implants: a flourishing market open to innovation

It is often mistakenly thought that cosmetic breast surgery is a concern for only a small portion of the population. But the figures show the opposite: this market will not be less than 1.4 billion dollars worldwide in 2024, with an annual growth of 4.1%. But this segment of the economy is far from being spared by global health scandals (we remember the PIP implants in France). In this context, how can we envisage the future of the breast implants market that is both flourishing and under pressure? Alcimed proposes here some elements of answer.

The global breast implants market, a growing but little diversified market

Silicone breast prostheses dominate the market by far

In 2018, 1,862,506 breast augmentation procedures were performed worldwide, 6.1% more than in 2017. While breast augmentation is a surgical procedure that can be performed by different means: implant placement, lipomodeling, or a combination of the two techniques, implant placement is the most common practice worldwide. Thus, 90.4% of revenues in this market come more specifically from silicone implants. The so-called “saline” prostheses, composed of a physiological serum, are much less frequently used. The use of silicone prostheses is more for aesthetic purposes, but it should not be forgotten that their use is for reconstructive purposes in about 10% of cases.

The most prosthesis-consuming countries

In Europe, the most promising markets are Germany (65,876 procedures per year) and Italy (64,976 procedures per year). It is estimated that in France there are about 22,500 procedures per year.

The United States and Brazil are the two most important markets in the world. The United States leads the way with about 320,000* procedures per year, performed at a wide range of fees, up to $25,000 for some surgeons.

Brazil accounts for 14.8% of breast augmentation worldwide. Women there perform cosmetic surgery procedures from a very young age. A total of 37.6% of breast augmentation patients under the age of 17 worldwide are Brazilian. This is partly due to the importance of the influence of social networks. In this country where the cult of the body is omnipresent, performing a breast augmentation is a symbol of social success and the influencers set the trend and encourage this dynamic.

In Europe, the most promising markets are Germany (65,876* procedures per year) and Italy (64,976* procedures per year). It is estimated that in France there are about 22,500 procedures per year.

A recently destabilized breast implants offer

Scandals related to current breast prostheses

A scientific study initiated in 2011 recently delivered its results. It shows that macro-textured silicone prostheses, which are widely marketed and will be in use until 2019, are a factor in the development of cancer, large cell anaplastic lymphoma, in a significant number of women.

Despite the fact that this market is growing, it has been affected by various scandals for several years. A scientific study initiated in 2011 recently delivered its results. It shows that macro-textured silicone prostheses, which are widely marketed and will be in use until 2019, are a factor in the development of cancer, large cell anaplastic lymphoma, in a significant number of women.

Faced with this alarming observation, the French regulatory authorities have withdrawn the CE mark from all macro-textured prostheses. Global manufacturers such as Allergan have been banned from their flagship product, both in Europe and in the United States, where the FDA has also decided to withdraw these prostheses from the market. Other scandals have tarnished the sector’s reputation: PIP prostheses in France in the 2000s, contaminated breast milk in South Korea more recently…

Tightening of breast implants supply

The withdrawal of macrotextured prostheses leads to a reduction in the supply of implants available on the market. Indeed, this texturing is essential for so-called anatomical prostheses. Unlike round prostheses, these must remain fixed in the breast and not rotate. They are drop-shaped and the result would be unsightly if they did not remain in place. The alternative to macro-texturing is then micro-texturing or even nano-texturing, but more innovative options have not yet been developed. There are therefore only two types of silicone prostheses on the market today: smooth and micro-textured. For the latter, only one manufacturer is still authorized to market them in Europe – the German company Polytech, which offers a range of anatomical implants. Customers therefore have access to a reduced choice of prostheses and brands have very little room to differentiate themselves.

New demands and expectations of patients and healthcare professionals

Some patients wish to move towards more natural solutions

In recent years, particularly in France, there has been a greater demand for surgical procedures that do not involve the placement of silicone implants. These patients are looking for a more natural technique. The answer brought to this demand by the surgeon is the lipomodeling technique. It consists of injecting into the breast fat extracted from another part of the patient’s body. This practice, which does not involve the implantation of foreign bodies, remains limited in terms of results and longevity. Indeed, it is not possible to perform this operation on a woman who does not have a sufficient fat reserve. Secondly, it is not possible to obtain the forward projection of the breast with lipomodeling. Moreover, to obtain a large volume, the surgeon must sometimes perform several operations, because he can hardly anticipate the amount of fat that he will have to inject to gain volume: the fat reabsorption rate is indeed very random depending on the patient.

Surgeons are attentive to market innovations

In France, surgeons are attentive and consider innovations with great optimism in order to be able to respond to women who wish to benefit from more natural and sustainable techniques throughout their lives, without posing a threat to their health, when the silicone prosthesis is a device that is recommended to be changed throughout life, and that can implies complications.

Manufacturers themselves talk about the need to develop and accelerate R&D processes to respond to this trend and the desire to innovate in a promising market. So what will the breast prosthesis of the future look like? Alcimed is in solidarity with the Pink October movement, and in this sense is committed to exploring the possibilities of tomorrow’s breast prosthesis for application in the field of breast reconstruction, in order to guarantee access to the benefits of this innovation for all women.

About the authors

Agnès, Project Manager, Cassandre, Consultant, Célia, Project Manager and Mélina, Consultant, in Alcimed’s Public Health Policy team in France

*ISAPS Global Survey – 2018