IQUAM was established as EQUAM in 1992 for the purpose of addressing the issue of safety when using silicone gel and other filling materials during plastic surgery. In the past years, within the framework of advanced technological devices, additional issues have been discussed during the biennial meetings. The organization was founded by a group of plastic surgeons from various European, Central and South American, African, Southeast Asian and Middle-Eastern countries. Representatives participating at meetings are plastic surgeons, scientists, manufacturers and delegates from governmental bodies involved in the development and surveillance of advanced technologies, devices and techniques in the field of plastic surgery. Consensus Conferences are held biennially in an informal setting.

The IVth Consensus Conference, held in June 2000, focused on the recommendation by the British Medical Devices Agency (MDA) for the recall of the TrilucentTM breast implant. It also discussed the European Parliament's assessment of the continuing use of the silicone gel-filled breast implant and their demand to ban its use. Other key topics discussed were the growing experience with the use of Botulinum toxin in aesthetic surgery, the implementation of an international breast implant registry (IBIR), and the latest updates regarding safety issues of ultrasound-assisted lipoplasty (UAL).

Breast implants are still considered to be an issue of safety in the field of plastic surgery, and the main concern is primarily the need for repeat surgical procedures. Therefore, the field of fillers is obviously going to be one of the most important topics in the forseeable future, especially in view of the upsurge of procedures forecast to take place within the coming years.

Another topic that will require evaluation will be the use of vacuum treatment for closure of chronic wounds and wounds that have typically undergone a difficult healing period.

A major step towards the implementation of the IBIR was taken at the Vth Consensus Conference held in July 2002. The IBIR should be regarded in the context of post marketing surveillance and the safe use of breast implants. A universal form to be used by national registries has been laid out. Recent data demonstrating extreme oxidation of soybean oil in the TrilucentTM breast implants substantiated the call for the immediate explantation of soybean oil-filled breast implants. The safe use of silicone gel-filled breast was re-emphasized. Various UAL technologies used in plastic surgery apply the same basic physical properties of ultrasound whose long-term effects are still being questioned. Botulinum toxin has been widely applied in aesthetic plastic surgery in the last decade, and its application in the appropriate indications seems safe. Botulinum toxin A may be applied as a substitute or in conjunction with aesthetic plastic surgery. Various resorbable and non-resorbable injectable materials for soft tissue augmentation are available at present. Substantial biochemical and biophysical differences exist. Not all of the non-resorbable materials have withstood the test of time, and some should still be considered experimental.

The IBIR continued to be the focus of the VIth Consensus Conference, held in Regensburg in June 2004, as were the issues of UAL and injectable filling material.

At the close of meetings, a Consensus Declaration is drawn up summarizing the conclusions of the meeting, and is presented to the health ministry and plastic surgery society of each member country. In this last decade of high tech and the advent of more sophisticated equipment, our responsibility as surgeons to evaluate the safety of these new technologies becomes increasingly important. The interaction between clinicians, scientists and manufacturers prior to and during the implementation of new technologies is essential in order to ensure the safe application of these technologies in clinical use. It is imperative that IQUAM continue its vigilance and scientific evaluation of both old and new technologies, devices and surgical procedures, for the assurance of safety and enhancement of patient education. IQUAM thus serves to reassure patients, physicians, medical bodies and the general public of the commitment to safety and high standards on the part of the plastic surgery community.