Evidence map›Paper›PMID 42844385›Full record

ArticleAesthetic plastic surgery2026

Response to: Body Mass Index and Risk Stratification in Breast Augmentation.

Samuel A Knoedler, Jennifer A Watson, Bong-Sung Kim, Martin Kauke-Navarro

Abstract readLetter
PubMed Publisher
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. 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

4 authors.

Samuel A Knoedler *Division of Plastic Surgery, Department of Surgery, Yale School of Medicine, New Haven, CT, USA.ORCID http://orcid.org/0000-0001-5798-8003
Jennifer A Watson *Department of Plastic Surgery and Hand Surgery, University Hospital Zurich, Zurich, Switzerland.
Bong-Sung Kim *Department of Plastic Surgery and Hand Surgery, University Hospital Zurich, Zurich, Switzerland.
Martin Kauke-Navarro *Division of Plastic Surgery, Department of Surgery, Yale School of Medicine, New Haven, CT, USA. kauke-navarro.martin@yale.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundBody mass index (BMI) is an easily available and objective parameter for perioperative risk assessment, but its role in aesthetic breast surgery must be interpreted alongside patient-specific anatomy, implant characteristics, surgical technique, and other procedure-specific factors. We respond to comments regarding our recent analysis of BMI and early outcomes following breast augmentation.

methodsWe contextualize the findings of our ACS-NSQIP-based study with particular attention to the limitations of BMI as a surrogate for breast anatomy, the interpretation of the identified BMI threshold, and the lack of procedure-specific and long-term outcome data within the database.

resultsAlthough BMI does not capture important anatomical and technical determinants of outcome, its association with postoperative morbidity remained consistent across multivariable regression, propensity score matching, and sensitivity analyses. The identified BMI threshold should therefore be interpreted as a risk marker to support patient counseling and perioperative risk assessment rather than as a strict cutoff or contraindication to surgery. Long-term outcomes, including capsular contracture, implant malposition, revision surgery, aesthetic outcomes, and patient-reported satisfaction, remain beyond the scope of ACS-NSQIP and warrant dedicated prospective investigation.

conclusionBMI represents one component of a broader, individualized approach to risk assessment in breast augmentation. Future studies integrating detailed anatomical, implant-related, surgical, and long-term patient-reported variables are needed to further refine risk stratification and shared decision-making. LEVEL OF EVIDENCE V: 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 . (Expert opinions based on non-systematic reviews of results or mechanistic studies).

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.