{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T21:51:07Z","timestamp":1780437067500,"version":"3.54.1"},"reference-count":26,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2025,11,12]],"date-time":"2025-11-12T00:00:00Z","timestamp":1762905600000},"content-version":"vor","delay-in-days":1,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100002794","name":"Swedish Cancer Society","doi-asserted-by":"publisher","award":["21 0279 SCIA"],"award-info":[{"award-number":["21 0279 SCIA"]}],"id":[{"id":"10.13039\/501100002794","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001034","name":"ALF","doi-asserted-by":"publisher","award":["ALFGBG-1005048"],"award-info":[{"award-number":["ALFGBG-1005048"]}],"id":[{"id":"10.13039\/501100001034","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,3,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Previous studies suggest higher revision rates after primary breast augmentation after massive weight loss (MWL); yet, specific risk factors remain unclear. Robust predictive models are lacking.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>The study aimed to create a nomogram to predict 5-year revision risk after primary breast augmentation in women with massive weight loss, providing a clinical tool to guide surgical decision-making.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A nationwide, population-based study was conducted within the Breast Reconstruction After Bariatric Surgery project (ClinicalTrials.gov NCT07059104). Data from the Scandinavian Obesity Surgery Registry and the Swedish Breast Implant Registry (2008-2022) were linked with national healthcare and prescription databases. Univariable logistic regression and group LASSO with 1000 bootstrap iterations were applied to identify predictors of revision within 5 years. A final multivariable model informed the development of a clinical nomogram.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 810 women undergoing 1604 primary breast augmentations after massive weight loss, 84 (10%) required revision during a median follow-up of 5.5 years. Revisions were associated with smaller implant volumes (P = .032) and shorter intervals between bariatric surgery and augmentation (P = .042). In bootstrap analyses, implant volume (92% selection), surgical timing, and medications impairing wound healing were consistently retained. The final model included these three predictors, forming the basis of the nomogram.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Implant volume, timing of augmentation, and relevant medications were independent predictors for revision. The nomogram provides a tool to support surgical planning and patient counselling in this high-risk population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence: 3 (risk)<\/jats:title>\n                    <jats:p\/>\n                  <\/jats:sec>","DOI":"10.1093\/asj\/sjaf234","type":"journal-article","created":{"date-parts":[[2025,11,8]],"date-time":"2025-11-08T13:00:57Z","timestamp":1762606857000},"page":"284-290","source":"Crossref","is-referenced-by-count":2,"title":["Nomogram Risk Prediction Model for Reoperation\/Revision in the First 5 Years After Primary Breast Augmentation Following Massive Weight Loss: A Clinical Tool"],"prefix":"10.1093","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3218-0881","authenticated-orcid":false,"given":"Emma","family":"Hansson","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7108-6532","authenticated-orcid":false,"given":"Ying","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Grimby-Ekman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Elander","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7043-0063","authenticated-orcid":false,"given":"Anna","family":"Paganini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,11,11]]},"reference":[{"key":"2026030212062849000_sjaf234-B1","doi-asserted-by":"publisher","first-page":"187","DOI":"10.1016\/j.bjps.2024.05.021","article-title":"\u201cNormal\u201d breast dimensions in obese women-reference values and the effect of weight loss","volume":"94","author":"Ockell","year":"2024","journal-title":"J Plast Reconstr Aesthet Surg"},{"key":"2026030212062849000_sjaf234-B2","doi-asserted-by":"publisher","first-page":"1535","DOI":"10.1097\/01.prs.0000182606.92069.13","article-title":"A classification of contour deformities after bariatric weight loss: the Pittsburgh Rating Scale","volume":"116","author":"Song","year":"2005","journal-title":"Plast Reconstr Surg"},{"key":"2026030212062849000_sjaf234-B3","doi-asserted-by":"publisher","first-page":"1090","DOI":"10.1097\/prs.0000000000003294","article-title":"The challenges of augmentation mastopexy in the massive weight loss patient: technical considerations","volume":"139","author":"Coombs","year":"2017","journal-title":"Plast Reconstr Surg"},{"key":"2026030212062849000_sjaf234-B4","doi-asserted-by":"publisher","first-page":"855","DOI":"10.1007\/s11695-024-07066-y","article-title":"Comparison of histological skin changes after massive weight loss in post-bariatric and non-bariatric patients","volume":"34","author":"Hany","year":"2024","journal-title":"Obes Surg"},{"key":"2026030212062849000_sjaf234-B5","doi-asserted-by":"publisher","first-page":"1735","DOI":"10.1007\/s11695-015-1613-y","article-title":"Breast reshaping following bariatric surgery","volume":"25","author":"Vindigni","year":"2015","journal-title":"Obes Surg"},{"key":"2026030212062849000_sjaf234-B6","doi-asserted-by":"publisher","first-page":"1901","DOI":"10.1097\/PRS.0b013e31818d20d6","article-title":"Potential impacts of nutritional deficiency of postbariatric patients on body contouring surgery","volume":"122","author":"Agha-Mohammadi","year":"2008","journal-title":"Plast Reconstr Surg"},{"key":"2026030212062849000_sjaf234-B7","doi-asserted-by":"publisher","first-page":"115","DOI":"10.1016\/j.cps.2018.08.013","article-title":"Common complications and management after massive weight loss patient safety in plastic surgery","volume":"46","author":"Beidas","year":"2019","journal-title":"Clin Plast Surg"},{"key":"2026030212062849000_sjaf234-B8","doi-asserted-by":"publisher","first-page":"1675","DOI":"10.1097\/PRS.0b013e3181b98bb4","article-title":"A comparative analysis and systematic review of the wound-healing milieu: implications for body contouring after massive weight loss","volume":"124","author":"Albino","year":"2009","journal-title":"Plast Reconstr Surg"},{"key":"2026030212062849000_sjaf234-B9","doi-asserted-by":"publisher","first-page":"145","DOI":"10.1016\/j.bjps.2025.10.004","article-title":"Frequency, demographics, and comorbidity of women who have post-bariatric breast implants. 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