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Breast augmentation is a commonly performed cosmetic procedure. We set out to determine whether there was any effect on breastfeeding in females after breast implants. The aim of this study was to perform a systematic review and meta-analysis of the current evidence on breastfeeding outcome and complications in females with breast augmentation. A systematic review was performed utilizing MEDLINE, EMBASE, and all evidence-based medicine reviews from their respective inception dates to November 7, 2022, to assess outcomes of breastfeeding in females with breast implants (PROSPERO ID: CRD42022357909). This review was in accordance with both the Cochrane Handbook for Systematic Review of Interventions and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Eleven studies (4 prospective and 7 retrospective) in total were included in the review. A total of 8197 out of 9965 (82.25%) patients were successfully able to breastfeed after breast implants. Of 5 studies that included a control group, 343,793 of 388,695 (88.45%) women without breast implants successfully breastfed. A meta-analysis of 5 comparative studies showed a significant reduction of breastfeeding in females with breast implants, n = 393,686, pooled odds ratio = 0.45 (95% CI, 0.38 to 0.53). Complications described included pain, mastitis, insufficient or excessive lactation, and nipple inversion. There may be impairment in ability to breastfeed for females who receive breast implants when compared with those without. Additional studies on the topic are needed to further clarify the relationship. Level of Evidence: 4

Background “Spin” is a form of reporting bias where there is a misappropriated presentation of study results, often overstating efficacy, or understating harms. Abstracts of systematic reviews (SRs) in other clinical domains have been demonstrated to employ spin, which may lead to clinical recommendations not justified by the literature. Objectives The authors sought to determine the prevalence of spin strategies in abstracts of plastic surgery SRs. Methods A literature search was conducted in MEDLINE, Embase, and CENTRAL to identify all SRs published in the top 5 plastic surgery journals from 2015 to 2021. Screening, data extraction, and spin analysis were performed by 2 independent reviewers. Data checking of the spin analysis was performed by a plastic surgery resident with graduate-level training in clinical epidemiology. Results From an initial search of 826 SRs, 60 SRs and meta-analyses were included in this study. Various types of spin were identified in 73% of SR abstracts (n = 44). “Conclusion claims the beneficial effect of the experimental treatment despite high risk of bias in primary studies” was the most prevalent type of spin and was identified in 63% of SRs (n = 38). There were no significant associations between the presence of spin and study characteristics. Conclusions This study found that 73% of abstracts in plastic surgery SRs contain spin. Although systemic reviews represent the highest level of evidence, readers should be aware of types of “spin” when interpreting results and incorporating recommendations into patient care.