The Risk of Ruptured PIPs - Implant Replacement Surgery16th February 2012
Video of PIP Implant Replacement Surgery after symptoms of swelling and pain in the breast as described by the patient, leading to discovery of a ruptured PIP, and fluid around the breast capsule during surgery. What are the risks of industrial silicone leaking inside the the breast pocket? Why do PIP implants are best replaced even if they are not ruptured? Our specialist breast surgeon explains these questions as he extracts the ruptured implant. The Implant replacement operation was performed by plastic surgeon Adrian Richards at Aurora clinics in High Wycombe. For any information, or answer to concerns regarding PIP implants, please call us on our free office no. 0800 3285743 or book a free consultation with any of Aurora's qualified specialist breast surgeons.
Hello. So, I’m going to be taking out the PIP implants out of this patient who’s got quite a lot of swelling in her chest. It’s going to be interesting to see if they are ruptured. Clinically, with the swelling, they do appear as if the PIP implants have ruptured.
I’m just going to make an incision along the old scar. It’s quite a good scar in this case, and I’ll show you what we find as we approach the PIP implant.
I have removed the implant. It is intact. It’s a PIP 350, but it was very folded, sort of like that inside the patient. So that might have been responsible for some of her symptoms. It is intact. As always, with PIPs there’s quite a lot of gel bleed, which means silicone is getting out into the body. We’ll record the serial number of that. I’m now going to wash everything out and go for a slightly smaller implant.
So, this one unfortunately has ruptured on this side. I don’t know if you can see all of this fluid here. This is normally a telltale sign of rupture with fluid coming out, because if they rupture, they seem to set up quite an inflammatory response in there. So we’ll see in a minute. There is some pussy fluid here. Can you see all of that fluid there? Then I can see free silicone there as well. This one has ruptured. There’s a bit of free silicone. See it just lying there. If it ruptures, you seem to get all of this horrible fluid around there. I’ll show you in a minute.
This lady was very, very lucky because this implant, I don’t know if you can see . . . can you see it’s got this sort of fluid inside it, this yellowy stuff, but it’s only just ruptured. It’s only got a very small little break here. It’s just got a tiny little fracture on the surface there, and then that allows fluid, the body fluid in, which mixes with the silicone, and that’s when you get the puss forming around there.
So, can you see, it’s only got a really small little break, and the break is at the outside of the implant, which is where you tend to get the folds. So that, I think, this has probably only happened maybe a few months ago. If this had been left any further, every time you move, it breaks a little bit more, fractures a bit more, and a bit more silicone comes out until you get to the stage that we’ve seen in the other videos with the implants being completely ruptured.
This is some of the fluid I’ve just collected from around this implant. So there were 10 mils of fluid. Can you see it? I’ll show you. See? It looks like pussy liquid. I think it’s just the body’s fluids reacting with the silicone, you see, giving you that sort of pussy fluid.
I’m going to show you now the implants we just removed from this patient. So, down here you can see this is the implant we took from the right, and this is the implant we took from the left. On the right, lighter colour, intact, a little bit prone to rippling but intact. What would happen though is as the implant folds, you get a weakness here and that’s where it rips. That’s exactly what’s happened on this one. Can you see it’s a different colour? It’s got yellow bits of pus inside it, and basically because what’s happened, this is just in the very early stages. You’ve got a fold there. The shell has fractured. Can you see all the fluid and horrible stuff in there that’s coming out?
So, the implant shell is ruptured, yep, because of a fold, and then that fold will then progress all the way through the implant as I showed you in my other videos. But you can see how the body fluids really mix with the silicone in there. So, I think the problem with the implant is . . . see, look, there’s another little split here. Can you see? There’s two splits. So what happens is you get a little split from the fold, and then it just gets more and more. Every time you move, the split gets wider until it completely fractures right open like I’ve shown in the other videos.
This is very interesting because it’s very early stage. The implant has just fractured, and I think this one, the normal one, would probably go like that in probably the next year or so. Our patient was left-handed, so perhaps she using that side more. So perhaps this is the one that goes first. But you get a little fold there, that rips, and then we progress to this, which, as you see, the left implant that will all open up, silicone is all free, and it spreads. You get discomfort in the breast and swelling under the armpits.
I’d just like to say thanks very much for watching the video. I hope you found it useful and informative. If you have got a PIP implant and you’re worried about it, please contact us either via phone or via email. We’ve got myself and lots of other very experienced surgeons who are really happy to help and advise you as to the best way forward for you.
Thanks for watching.