PIP Breast Implant Exchange Surgery & Scar Revision28th February 2012
Implant Removal / Replacement
Hello, my name is Adrian Richards, and today I’m going to be taking you through a PIP breast implant exchange operation. Our lady’s got the implants under the muscle. She’s got some change in shape, particularly the left side, and she is very worried about the PIP implants and the question of the quality. So she has elected to have them replaced.
So, this lady is quite an interesting breast enlargement. Can you see this scar here? She has actually got a scar that’s very, very high, whereas the breast is lying here. So, because the scar has been designed too high in the beginning, it’s lying on the under surface of the breast rather than down here where it should be in the fold. Now, I could make another incision here, but probably better to not have two incisions. So I am going to have to make an incision here, even though it’s in the wrong place, so she only has one scar.
So I am just going to cut now onto the implant. Can you see here? Just cutting through the implant capsule, and this implant actually looks okay. First impressions are it’s okay. Not too much fluid around it. So I will just remove the implant now. Sometimes there is quite a lot of fluid around the implant, but it doesn’t look like there is in this case.
So this implant is intact. It is a 245cc PIP implant. We will keep the serial number, and it’s got quite a lot of gel bleed. It’s moderate gel bleed, I would say. It’s oily on the outside, but not too bad. This is the type of implant that ruptures because you get a fold in the shell. I am finding a lot of the older PIP implants are slightly different. This feels like one that would be prone to rupture and has moderate gel bleed.
Now what I am going to do is dissect inside, modify the pocket to accept a wider implant. I have just put a temporary inflatable implant in, which I have shown in all of my other videos, and I just blow the pocket up to see what suits our patient the best. She has actually selected a 360cc implant. That’s what I have blown it up to and that looks really good. So we are going to use a 360cc implant in the same position under the muscle in the patient today.
Now, I am going to put a new Nagor Impleo 360cc implant in via this incision. It is in position. I think we got a much better shape and better cleavage on this lady. The scar is going to be a little bit high, but I can’t do much about that I’m afraid. This implant is sitting well. So I am just going to sew this up and do the same procedure on the other side.
So, again, if we look on this side, there are a couple of problems. Number one, there is a sort of a dent in here. Can you see where the muscle hasn’t been released? So I am going to release that. The other thing is that the incision again is high, so the bottom of the breast is here, but the incision is here, 2 centimetres higher. So really, again, I would like to make my incision in the fold, so incisions could be hidden in the fold. But unfortunately it is already on the lower part of the breast. I can’t do anything about that. So rather than making two incisions, I am going to use this incision here. I am actually going to remove the old scar and remodel it. Although I can try and make the scar better, I can’t move it unfortunately.
This is the implant removed. Can you see the gel bleed? There is gel on my gloves. It’s slipping. We are finding this a lot with PIP implants. They are sort of sticky. Can you see the gel? I don’t know whether you can see that on my fingers. The end of the strand is coming from the implant to the fingers. So it’s intact. This is again the type of implant that is very prone to fracture. So it’s good our patient had it out. It’s the same as the other one, a 245 high profile implant, but it’s just slippy and quite a lot of gel bleed. That’s again because the sealing layer wasn’t put in, so the shell is lacking layers and that’s why it’s permeable to silicone. Anyways, so we are going to record that, and then I’m going to wash everything out, free it up, and put another implant in.
That’s the end of the operation. You can see we’ve filled out this area here, which wasn’t full before. I don’t know if you can see that there. Filled up there. The incision, as I mentioned, is still going to be slightly high, but I can’t do very much about that unfortunately. Once the incision is made, it’s made. I think we are going to get a good result.
I just want to show you how the implants looked again. So this is the right implant. It’s dry now. It had quite a lot of gel bleed on it when it was taken out. It’s 245cc. This is the lot number. We are tracing all of these to try and work out which of the implants have had problems. Now, this implant feels quite characteristic, like one of the ones that might rupture, because the shell doesn’t feel of good quality. It is pretty underfilled, and these are the implants that we are finding are getting these creases in and then rupturing. It just doesn’t feel like a great implant.
Then, on the left, we’ve got another implant, which is 245cc implant, high profile. But again, you can’t feel the gel bleed now, because it’s been taken out of the body. Quite coarse texturing and again quite a rim there that it is going to probably rupture. So it’s probably good our lady had these out.
This is just the implants I put in, which is the Nagor implants. So, if you’re having Nagor implants, this tells you all about the warranty program for them. We tend to use either Nagor or Allergan implants, and then you will be given a card like this with your implants with details on it. So, if you get one of those, please keep it safe because it is very useful to have this information at a later date. Nagor is the number one UK company for breast implants, and Allergan is probably the largest company worldwide.
Thanks very much for watching the video. I hope you found it useful and interesting. If you have got PIP implants, or any type of breast implants, and you’re worried, please contact us either via email or via phone. We will be absolutely delighted to talk to you about the options available for you, which may involve scanning or possible surgery or just keeping an eye on you. Thanks very much for watching.