Implant Removal / Replacement

Breast Implant Removal

9th March 2011

Implant Removal / Replacement

Breast Implant Removal - Mr Richards, Leading Plastic Surgeon of Aurora clinics removes a ruptured hydrogel breast implant. He explains the reasons why breast implants can rupture and explains why the newer generation of breast implants are less likely to rupture. For more information or to book a free consultation please contact Aurora on 01844 214362.

Transcript

Breast Implant Removal

Hello. My name is Adrian Richards. I’m a plastic and cosmetic surgeon and the Surgical Director of Aurora Clinics based here in the United Kingdom. In this video, I’ll be taking you through an operation which I performed earlier today on a lady who had hydrofilled breast implants inserted 12 years ago. She was genuinely quite well until three weeks ago when the left breast suddenly expanded to approximately twice the size of normal, with fullness in the upper pole. And this video is going to show you the operation. I hope you find it useful and informative.

So here we can see her pictures before the operation showing the left implant is much larger than the right, particularly in the upper portion of the breast, as we can see there.

This is actually in the operation, and she actually had a very long scar from her previous breast surgery as you can see here, which measured 13 centimetres. I’m only going to use the central 5.5 centimetres of that in this case, because I don’t need to open the entire incision.

Here I am just dissecting down on the implant. And remember, this implant is supposed to be possibly ruptured. I’m just going down there onto the implant now through the capsule, which is the lining of the implant.

I don’t know if you can see there’s fluid coming up, so that shows immediately that the breast implant has ruptured. So I’ve just cut through the capsule, and you can see lots of greeny yellowy fluid there that I’m just removing. And you can see here I’m doing this with suction, just trying to keep everything as clean as possible, just removing everything with suction. So again, minimum wound contamination. And I just continue removing. I don’t know if you can see the fluid going up my sucker there.

Again here I’ve removed most of it. I’m just removing the last little remnants from the corners of the pockets.

And the next stage is to remove the implant. Here you can see it was actually upside down there, and it’s a very poor condition ruptured implant.

Next stage is to clean everything out and insert a temporary inflatable implant, which I can blow up with a syringe as I’m doing now. This gives me good control over the final size of the breast, and here I’ve increased the size significantly and that’s a good fit.

Here’s my antibiotics going in, which lie around the implant. And here’s the brand new, latest generation cohesive implant just about to be inserted. And you can see, I’m just inserting that there, and I just slip it into the pocket just here.

And then I would just sew the area up with absorbable stitches in a nice, neat closure, three-layer closure. This is the final layer with what we call a subcuticular, which is a running PDS stitch under the skin which will absorb and won’t need to be formally removed.

Here on the left, similar procedure. In fact the scar was longer on this side. But again, I’m only going to use the middle bit. I’m going to draw a line down from the nipple, the inner aspect of the nipple, and that’s going to be in a marking of where I’m going to incise, as you can see here. That’s the least visible area for an incision.

Here I am just going down onto the implant again, as you can see. Again, lots of fluid. On this side, it was much more watery, interestingly. So maybe this was possibly a more acute rupture, a sudden rupture, which had caused the area to expand rapidly.

And here you can see there’s quite a lot of inflammation, and some of the fluid is quite bloody at the bottom of the pocket.

Here I am just removing the implant. You can see it has got some fluid in it, but it’s mostly all water. And here you can see me just sort of squeezing the water out. So I suspect this lady has had really quite a quick rupture which caused the inflation.

Here I am just blowing up the implant as I did on the other side, and the fill was very similar to the other side.

Now because she’s had sudden inflammation in that side, I’m going to insert a drain in the left.

Here are my antibiotics going in, as on the other side, and here I am just inserting the same size implant on the left as on the right. And a very similar closure and the completed closure is with this tissue glue. You can see me just holding the stitches there.

So here we are at the end of the procedure, very symmetrical breasts.

And here you can see the implants. This is the one from the left with me showing the rupture here with the forceps going inside.

This is from the right with, as you can see, quite a lot of gelatinous fluid coming from within the implant. So it was really a very good thing I did remove the implant at this stage, because the left was acutely ruptured, and they were going to cause significant problems.

Well, thank you very much for watching the videos. I hope you found them useful and informative. If you’d like any more information about this type of surgery or indeed any other type of cosmetic or plastic surgery, please feel free to contact us either via our website, Aurora-Clinics.co.uk, or by phoning us directly. Thank you.