Breast Implant Replacement Surgery9th March 2011
Implant Removal / ReplacementMr Richards of Aurora Clinics show a procedure to move a breast implant from behind to in front of the muscle. He discusses the reasons for this Implant Exchange and shows the results of surgery. For more information please contact one of our patient advisor s on 01844 214362.
Breast Implant Replacement Surgery
Hello. My name is Adrian Richards. I’m a plastic and cosmetic surgeon based in the United Kingdom, and I’m the Surgical Director of Aurora Clinics. In this video, I’m going to be showing an operation I did to remove a breast implant from behind the muscle to in front of the muscle. As you’ll see in the pictures I’ll show you before the operation, the implant lies in a very high position. It’s being held up by the muscle, so I’m going to move it to the front of the muscle to relieve that muscle pull. So I’ll be taking you through each of the operation. I hope you find it useful and informative.
So here we are before the operation. We can see that the right breast implant is much higher than the left. There’s actually some redness on the inner aspect of that right breast there.
So I’ve done some markings, and here I am actually in the operation opening up the old incision on the lower part of the breast. So I’m just very carefully using that same scar so as not to give her a second scar. The yellow tissue you can see there is the fatty tissue, and here you can see this is the muscle. So this is the muscle layer that’s covering the implant. It’s this muscle that is holding the implant up in that abnormal position. If the implant is put in front of the muscle, the implant will become lower with the natural breast tissue, but under the muscle it’s held up unnaturally.
Here I am just cutting through that muscle. You can see here there’s fluid around the implant. This is quite common; slightly more probably in this case than usual as you can see, and this is the cause really of the redness. There may be some mild infection going on there around the implant.
Here’s the implant coming out. It’s actually in quite good condition, a low profile, textured implant. I’m just cleaning the whole area out there, and you can see on the front there, that’s the muscle. So it’s completely behind the muscle in this case and, as I said, that’s why the implant was so high.
Here I am just sewing up the old pockets. I’m sewing the muscle back together again with an absorbable stitch. Then the next stage is to infiltrate some local anaesthetic with adrenaline mixture in front of the muscle where I’m going to make the new pocket and then make a new hole, a new cave really for the implant there.
Then my next step is to insert a temporary inflatable implant into that pocket, again, in front of the muscle with a much more natural contour to the breast. I slowly increase this in size so that I can adequately gauge the optimum fill for that breast pocket. I can actively gauge the best size for this lady’s skin to fill up without overstretching the skin because we’re very reluctant to overstretch the skin.
Here I am. I’ve determined the size. I’m just putting some iodine ointment around the skin, putting some antibiotics in the pocket. Both of these are to really reduce the infection risk.
Here we are just putting the brand new implant in, in front of the muscle in this case. As I mentioned, it won’t be held up by the muscle and it will have a much more natural appearance.
Here I am sewing up the skin with absorbable stitches. So I’m just sewing up the pocket here. I do this in three layers so everything is nice and secure and the implant is held very nicely in there. These internal stitches don’t need to be removed. They will absorb on their own in approximately three months. The final stitch which is in the skin will just need its ends trimmed, which I tend to do normally a week to ten days following surgery.
This is the final stitch in. I’ve used a drain in this case just to drain off any excess fluid around the implant.
Here we are before the operation, really quite a high, red implant. This is a couple of weeks afterwards, a much lower, more normal appearance. From the side, a high implant before. Afterwards, a lower position. Again, we can see from the side a lower position. Again from the side, a high, unnatural position before the operation. Better after the operation and much softer breast. Here we are again, high before the operation, and here we can see a more natural contour to the breast following surgery.
Thank you very much for taking the time to watch this video which I hope you found useful and interesting. If you’d like any information on any other plastic procedure, please feel free to contact us either via our website, which is Aurora-Clinics.co.uk, or by phoning us directly on 01844 214362. Thank you.