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Background :Cryolipolysis has emerged as a nonsurgical fat reduction alternative to liposuction. Industry payments may impact how physician authors view medical devices in the literature. Under-reporting financial conflicts of interest has raised concerns about full transparency between industry and physicians. Objectives :We aim to determine the impact industry payments to physicians have on the cryolipolysis literature and whether there is under-reporting of financial conflicts of interest in the literature. Methods :We collated all articles that cite the pivotal trial in the Food and Drug Administration approval of a cryolipolysis device. Articles were read independently and coded as favourable or neutral. A separate researcher screened the Centers for Medicare & Medicaid Services Open Payments database for direct or in-kind payments and recorded financial conflicts of interest. Results :A total of 19 articles met the inclusion criteria. This included 37 unique authors across multiple specialties. Eighteen (95%) published articles had at least one author who received industry payment. Payments totalled $1,476,564.16. Twelve (63%) articles were positive, and 7 (37%) neutral. Of the 31 authors who received payments, 11 (35%) did not report a conflict of interest. The majority of industry payments assessed were for consulting fees, which totalled $980,334.86 (66.4%). Conclusions :We found the majority of published opinions on cryolipolysis from the United States were written by physicians who received industry payments. We also found financial conflicts of interest around cryolipolysis devices are under-reported in the literature.

Background:Breast implants were first introduced in the 1960s and have long been used for augmentation and reconstructive breast surgery. More recently, fat grafting for breast augmentation has gained popularity due to the ‘natural’ outcome and lack of implant-related complications. The aim of this study was to conduct a systematic review and meta-analysis comparing patient-related outcome measures between fat grafting and implant-based primary augmentation using the validated BREAST-Q questionnaire. Methods:A systematic review of the literature according to the PRISMA guidelines was conducted in PubMed®, Cochrane Library®, EMBASE®, MEDLINE®, and Scopus® databases. Papers were screened by two independent blinded reviewers. Quality was assessed using MINORS criteria. Results:Fourteen studies were included in the meta-analysis representing a total of 81 fat grafting augmentations and 1535 implant augmentations. The average overall patient satisfaction mean post-operative scores were 13.0 points higher in the implant group based on meta-regression (95% CI: 2.4-23.5; P= .016). There was no statistical difference in reported post-operative sexual well-being, psychosocial well-being, or physical well-being BREAST-Q scores. Conclusion:Although implant-based augmentation resulted in higher post-operative overall satisfaction scores, fat grafting remains a highly desirable alternative for augmentation in the right patient. This meta-analysis strongly highlights that careful patient selection and evaluation of patient goals must be assessed when selecting an augmentation method.