Evidence map›Paper›PMID 41136701›Full record

SynthesisAesthetic plastic surgery2026

Breast Capsule Thickness and Clinical Capsular Contracture: A Systematic Review and Meta-Analysis.

Morvarid Mehdizadeh, Tristan Furnary, Jian H Li, Reinhard M Knerr, Ashley Brunson, Jose Foppiani, Daniela Lee, Maria J Escobar-Domingo, Angelica Hernandez Alvarez, Samuel J Lin

Abstract readSystematic ReviewMeta-AnalysisReview
PubMed Publisher
In one paragraph

Synthesis in Aesthetic plastic surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Morvarid Mehdizadeh *Division of Plastic and Reconstructive Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, 110 Francis St, Suite 5 A Boston, Boston, MA, 02215, USA.
Tristan Furnary *Division of Plastic and Reconstructive Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, 110 Francis St, Suite 5 A Boston, Boston, MA, 02215, USA.
Jian H LiSUNY Upstate Medical University Norton College of Medicine, Syracuse, NY, USA.
Reinhard M KnerrDivision of Plastic and Reconstructive Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, 110 Francis St, Suite 5 A Boston, Boston, MA, 02215, USA.
Ashley BrunsonDivision of Plastic and Reconstructive Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, 110 Francis St, Suite 5 A Boston, Boston, MA, 02215, USA.
Jose FoppianiDivision of Plastic and Reconstructive Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, 110 Francis St, Suite 5 A Boston, Boston, MA, 02215, USA.
Daniela LeeDivision of Plastic and Reconstructive Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, 110 Francis St, Suite 5 A Boston, Boston, MA, 02215, USA.
Maria J Escobar-DomingoDivision of Plastic and Reconstructive Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, 110 Francis St, Suite 5 A Boston, Boston, MA, 02215, USA.
Angelica Hernandez AlvarezDivision of Plastic and Reconstructive Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, 110 Francis St, Suite 5 A Boston, Boston, MA, 02215, USA.
Samuel J LinDivision of Plastic and Reconstructive Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, 110 Francis St, Suite 5 A Boston, Boston, MA, 02215, USA. sjlin@bidmc.harvard.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundCapsular contracture is a leading cause of morbidity after breast augmentation and often necessitates reoperation. This study analyzes the association between breast capsule thickness and severity of capsular contracture, distinguishing benign from pathological cases.

methodsLiterature review was conducted across PubMed, Medline, and Web of Science according to PRISMA guidelines, for articles published between 2014 and 2024. Data extracted included author, year, sample size, age, implant type, capsule thickness, capsular contracture presence, and Baker score. A permutation test determined a minimum thickness cutoff associated with capsular contracture. Statistical meta-analysis, permutation analysis, and univariate Poisson regression were conducted using R 4.4.1 (Boston, MA).

resultsOf 649 publications, 12 met inclusion criteria, examining 590 breast samples from 403 patients. The mean capsular thickness was 708 µm. The capsular contracture rate was 47.6% of breasts and in 69.7% of patients. Meta-regression of 534 samples across nine studies including 25 unique patient groupings showed a pooled capsular contracture rate in breasts of 58.2% (95% CI: 28.2-83.1). Capsular thicknesses in the highest (OR 23.99, 95% CI: 13.31-45.10, p < 0.001) and middle (OR 16.22, 95% CI: 9.95-27.16, p < 0.001) tertiles had higher odds of contracture compared to the lowest tertile. Univariate Poisson regression showed a 0.069% (95% CI: 0.050-0.087, p < 0.001) increase in contracture per micrometer of capsule thickness. The minimum significant cutoff was 601.5 µm (p < 0.05), below which studies had significantly lower capsular contracture rates.

conclusionsCapsule thickness correlates with capsular contracture, suggesting a measurable predictor for pathological contracture. LEVEL OF EVIDENCE III: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors   www.springer.com/00266 .

Indexed as

BreastBreast ImplantationBreast ImplantsImplant Capsular ContractureAdultFemaleHumansRisk AssessmentSeverity of Illness IndexBreast augmentationBreast implantBreast surgeryCapsular contractureCapsule thicknessOutcome surveillance

Identifiers

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.