Evidence map›Paper›PMID 41974903›Full record

ArticleAesthetic plastic surgery2026

Machine Learning to Predict Implant-Based Breast Reconstruction Failure: A Bootstrap-Validated Elastic Net Model.

Yanis Berkane, Anna Scarabosio, Glenda G Caputo, Paul Girard, Roberta Albanese, Damiano Tambasco, Nicolas Bertheuil, Frédéric Bodin, Nicolas Jacquinot, Pier Camilo Parodi

Abstract read
In one paragraph

Article in Aesthetic plastic surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing 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

1 citing paper in PubMed.

  1. Review
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.

Yanis Berkane *Department of Plastic, Reconstructive and Aesthetic Surgery, CHU de Rennes, University of Rennes, 35000, Rennes, France. yanis.berkane@chu-rennes.fr.ORCID http://orcid.org/0000-0003-4190-5132
Anna Scarabosio *Plastic and Reconstructive Surgery, Department of Medical Area, University Hospital Santa Maria della Misericordia of Udine, 33100, Udine, Italy.
Glenda G CaputoPlastic and Reconstructive Surgery, Department of Medical Area, University Hospital Santa Maria della Misericordia of Udine, 33100, Udine, Italy.
Paul GirardDepartment of Plastic, Reconstructive and Aesthetic Surgery, CHU de Rennes, University of Rennes, 35000, Rennes, France.
Roberta AlbanesePlastic and Reconstructive Surgery, Department of Medical Area, University Hospital Santa Maria della Misericordia of Udine, 33100, Udine, Italy.
Damiano TambascoPlastic Surgery Unit, San Carlo di Nancy Hospital, 00165, Rome, Italy.
Nicolas BertheuilDepartment of Plastic, Reconstructive and Aesthetic Surgery, CHU de Rennes, University of Rennes, 35000, Rennes, France. nicolas.bertheuil@chu-rennes.fr.
Frédéric BodinDepartment of Plastic, Aesthetic and Maxillofacial Surgery, CHRU de Strasbourg, 67091, Strasbourg, France.
Nicolas JacquinotDepartment of Gastroenterology, Nancy University Hospital, University of Lorraine, Vandoeuvre-lès-Nancy, F-54052, Nancy, France.
Pier Camilo ParodiPlastic Surgery Unit, San Carlo di Nancy Hospital, 00165, Rome, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundImplant-based reconstruction failure remains a significant complication following breast reconstruction, with substantial implications for patient outcomes. Reliable preoperative risk prediction tools are lacking.

methodsA retrospective single-center cohort study was conducted, including 381 IBR procedures performed from 2006 to 2023. Reconstruction failure was defined as explantation without immediate replacement within one year. Elastic net regression was used to develop a multivariable model based on age, BMI, smoking status, radiation therapy, chemotherapy, use of expander, and implant plane. Internal bootstrap validation was performed following the 2024 TRIPOD + AI guidelines. Model performance was assessed using AUC, calibration curves, and decision curve analysis. A real-time online calculator was deployed for clinical use.

resultsThe mean follow-up was 38.2 ± 27.2 months. The observed IBR failure rate was 5.5% (n = 21). The final model included key predictors such as postoperative radiotherapy, expander use, and an interaction term between age and BMI. Discrimination was strong with an optimism-corrected AUC of 0.856 (95% CI 0.76-0.935). Calibration analysis demonstrated optimal agreement between predicted and observed outcomes, and decision curve analysis confirmed the model's net clinical benefit over default strategies. The model is accessible via an online tool ( https://urls.fr/BIWCeO ).

conclusionsThis study presents a robust, internally validated predictive model for implant loss following IBR. The online calculator suggests real-time, individualized risk estimation, supporting preoperative counseling and surgical decision-making in the future. External validation and clinical implementation studies are warranted to confirm its broader applicability. LEVEL OF EVIDENCE IV: 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

Breast ImplantationBreast ImplantsBreast NeoplasmsMachine LearningMammaplastyAdultCohort StudiesFemaleHumansMastectomyMiddle AgedPrediction AlgorithmsPredictive Learning ModelsRetrospective StudiesRisk AssessmentTreatment FailureBreast implantBreast reconstructionImmediate reconstructionMultivariate analysisPredictive scoreRadiationReconstruction failure

Identifiers

PMID41974903
PMCPMC13315410

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Registered trials

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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.