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W Grant Stevens

Publications and source records attributed to W Grant Stevens.

4 recordsLinked to original sources
PubMed2006

A comparison of 500 prefilled textured saline breast implants versus 500 standard textured saline breast implants: is there a difference in deflation rates?

BACKGROUND: This study provides the first large-volume (1000 implant) comparison of the deflation rates of Poly Implant Prosthesis prefilled textured saline breast implants versus a control group of Mentor Siltex textured saline implants. METHODS: A consecutive series of 500 Poly Implant Prosthesis prefilled textured saline breast implants was compared with a consecutive series of 500 Mentor Siltex breast implants. Each breast implant was evaluated for a 4-year period, and the annual deflation rate (number of deflations during a given year divided by the total number of implants) and cumulative deflation rate (cumulative total of deflations through a given year divided by the total number of implants) were recorded. Statistical significance was calculated using the Fisher's exact test at year 1 and the chi-square analysis at years 2 through 4. RESULTS: The cumulative deflation rates of the Poly Implant Prosthesis implants was as follows: year 1, 1.2 percent; year 2, 5.6 percent; year 3, 11.4 percent; and year 4, 15.4 percent. The cumulative deflation rates of the Mentor implants was: year 1, 0.2 percent; year 2, 0.6 percent; year 3, 1.6 percent; and year 4, 4.4 percent. At year 1, the difference between deflation rates was not statistically significant (Fisher's exact test, p > 0.05). However, at year 2 (chi-square, 13.29; p < 0.001), year 3 (chi-square, 37.91; p < 0.001), and year 4 (chi-square, 32.69; p < 0.001), the difference was statistically significant. CONCLUSIONS: There was a statistically significant difference between the overall deflation rates of Poly Implant Prosthesis prefilled textured saline breast implants and Mentor Siltex breast implants at year 2, year 3, and year 4. After 4 years, the 15.56 percent cumulative deflation rate of Poly Implant Prosthesis implants was over 3.5 times higher than the 4.31 percent deflation rate of the Mentor Siltex implants. There may be several factors contributing to the higher deflation rate seen in Poly Implant Prosthesis implants, including possible in vitro deflation before implantation and silicone shell curing technique. Nevertheless, this statistically significant deflation difference must be taken into account when balancing the risks and benefits of Poly Implant Prosthesis breast implants.

Breast Implantation↗
PubMed2006

Is it safe to combine abdominoplasty with elective breast surgery? A review of 151 consecutive cases.

BACKGROUND: This study was designed to evaluate and compare the complication rates of patients having abdominoplasty without breast surgery with the rates of those having abdominoplasty with various types of elective breast surgery, including breast augmentation, breast reduction, mastopexy, and mastopexy combined with simultaneous augmentation. METHODS: The data collected represent a retrospective chart review of consecutive abdominoplasty procedures performed at a single outpatient facility by the senior surgeon (W.G.S.) over a 15-year period (1989 to 2004). Two groups were compared: patients who underwent abdominoplasty without breast surgery and those who had abdominoplasty with breast surgery. The second group was subdivided by the various types of breast procedures noted above. The minor complications assessed included seromas, hematomas, infections, and small (<5 cm) wound breakdowns. Major complications evaluated included large (>5 cm) flap necrosis, need for blood transfusion, deep vein thrombosis, pulmonary embolus, myocardial infarction, and death. Additional data compiled included age, sex, tobacco use, body mass index, past medical history, American Society of Anesthesiologists physical status level, and operative times. RESULTS: Of the 415 abdominoplasty procedures, 264 (group 1) did not include simultaneous breast surgery. One hundred fifty-one procedures (group 2) involved simultaneous breast surgery, representing 36 percent of the total. Group 2 was further subdivided into those who had breast augmentation surgery (group 2A, n = 50), those who had breast reduction surgery (group 2B, n = 31), those who had mastopexy surgery (group 2C, n = 28), and those who had simultaneous mastopexy and breast augmentation surgery (group 2D, n = 42). Removal and replacement of implants and capsulectomy/capsulotomy procedures were included in the augmentation group (group 2A). There were no major complications, including flap necrosis (open wound >5 cm), blood transfusions, deep vein thrombosis, pulmonary embolus, myocardial infarction, or death. No patients required hospitalization. No statistically significant associations with complications were noted between groups 1 and 2 (chi-square, 0.0045; p > 0.95, not significant). Furthermore, when subdivided by type of breast surgery, no statistically significant associations were noted among subgroups: group 1 versus 2A (chi-square, 0.96; p > 0.05, not significant), group 1 versus 2B (chi-square, 0.032; p > 0.9, not significant), group 1 versus 2C (chi-square, 0.003; p > 0.975, not significant), and group 1 versus 2D (chi-square, 0.83; p > 0.5, not significant). CONCLUSION: The results of this retrospective review indicate that combining elective breast surgery with abdominoplasty does not appear to significantly increase the number of major or minor complications.

Abdomen↗
PubMed2006

In vitro deflation of prefilled saline breast implants.

BACKGROUND: The purpose of this study was to determine whether or not prefilled breast implants retain their volume in packaging. METHODS: This study examined 32 Poly Implant Prosthesis prefilled textured saline breast implants. All of these implants were within the manufacturer's expiration date at the time of weighing. No holes were visible on any of the implants. All were weighed on an electronic scale. The measured weight was compared with the expected weight (based on the implant size as specified by the manufacturer) and the percentage deflation was calculated. The manufacturer declined to provide specific information about the manufacture dates of the implants; thus, relative age (rather than absolute age) was examined with respect to percentage deflation. RESULTS: Of the 32 implants examined, all showed some degree of deflation (range, 8.84 to 57.14 percent; 95 percent confidence interval of the mean, 22.01 +/- 4.17 percent). There was a moderate correlation (r = 0.41) between relative age of the implant and percentage deflation. CONCLUSIONS: From these results, it is clear that this type of prefilled saline breast implant does not maintain its volume in vitro. If these implants are used, the underfilling could contribute to a higher deflation rate and cosmetic deformity. This risk should be taken into account by plastic surgeons who use this type of implant in breast augmentation procedures.

Breast Implants↗