Scott L. Spear

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The Baker classification of capsular contracture remains the most popular and practical method of assessing clinical firmness of the breast after augmentation mammaplasty. This classification system was never intended to describe prosthetic breast reconstruction. A modification of the Baker classification to include classes IA, IB, II, III, and IV has been(More)
BACKGROUND Augmentation/mastopexy is of considerable interest to plastic surgeons who perform breast surgery because of its complexity as well as its high rate of legal claims. METHODS This single-surgeon, 3-year study evaluated complications, outcomes, and reoperation rates among 166 patients who underwent 171 procedures for primary and secondary(More)
In 2004, the authors reported their findings with placement of tissue expanders for breast reconstruction in the partial submuscular position, the equivalent of the “dual-plane” technique for breast augmentation. Limitations with subpectoral expander placement include difficulty controlling the lower pole of the pocket during expansion, unprotected device(More)
Among the potential complications associated with the use of breast implants are the risks of periprosthetic infection and device extrusion. There is little published information about the effective management of these situations. Conservative recommendations include antibiotic therapy and removal of the implant until resolution of the infection or until(More)
A 7-year experience with 171 consecutive immediate breast reconstructions by one surgeon using a textured integrated-valve tissue expander was reviewed. All patients were reconstructed in multiple stages using a temporary biodimensional tissue expander followed months later by a long term implant. There was one (0.6 percent) spontaneous expander deflation(More)
BACKGROUND The purpose of this study was to evaluate both clinical outcomes and satisfaction in patients who have undergone prophylactic mastectomy and breast reconstruction. METHODS A 5-year retrospective analysis of the senior author's (S.L.S.) experience with breast reconstruction following prophylactic mastectomy was performed. Timing, type of(More)
BACKGROUND Silicone gel-filled breast implants were developed in 1962 but did not fall under the auspices of the U.S. Food and Drug Administration until 1976 and were not classified as class III devices until 1988. This set the stage for a series of Food and Drug Administration advisory panel meetings and a moratorium on the sale of these implants from 1992(More)
Little has been published regarding the treatment of patients with long-established capsular contracture after previous submuscular or subglandular breast augmentation. This study reviews 7 years of experience in treating established capsular contracture after augmentation mammaplasty by relocating implants to the "dual-plane" or partly subpectoral(More)
BACKGROUND The goal of this consensus is to establish an algorithm for the management of patients who develop a late or delayed periprosthetic fluid collection. A work group of practicing plastic surgeons and device industry physicians met periodically by teleconference and discussed issues pertinent to the diagnosis and management of late periprosthetic(More)
In this study, the authors investigated the physiologic effects of the altered body composition that results from surgical removal of large amounts of subcutaneous adipose tissue. Fourteen women with body mass indexes of greater than > 27 kg/m2 underwent measurements of fasting plasma insulin, triglycerides, cholesterol, body composition by dual-energy(More)