Replacement of High Profile PIP Implants with Release of Breast Capsule
21st February 2012Facelift Surgery
Surgical video of high profile PIP breast implants removal and replacement procedure, performed by plastic and reconstructive breast surgeon Adrian Richards at Aurora clinics in Buckinghamshire, UK. For more information, or should you wish to speak to any of our highly specialised plastic surgeons, please call our free office number 0800 3285743 or book a free consultation.
Transcript
My name’s Adrian Richards, and in this operation we’re going to be exchanging some PIP implants. The patient thinks they’re intact, but we don’t obviously know until we go in and have a look. We’ll see if there’s that silicone gel bleed that I’ve found on so many PIP implants that I’ve taken out recently.
So I’m going to be exchanging this lady’s implant. She’s got PIP high profile implants. Now she’s quite broad shouldered and broad chested, so high profile implants aren’t probably the ones for her anyway because they’re too narrow and they’re not giving her a good cleavage. So the plan is to take out the old scar, which is long and wide back to normal tissue, free up inside here so we get more of a cleavage there, and take out the PIP implants at the same time.
So I’ve removed this implant. It’s a PIP. Just checking the numbers here. 405cc, so she was right. We’ll record the silicone number. But interestingly, this one I think is a better quality PIP implant, because there’s not much silicone bleed. Can you see? See if I lift up, there’s not much silicone on the outside. So this is actually quite a good quality PIP. 90% of the ones I remove have a lot of gel bleed. But this one is a very good quality PIP implant. And we are recording all the serial numbers, so we can try and trace exactly which batch has the problems. But this is probably the one in ten that is okay. Although it’s still not a great implant, I think the layering is quite good on this one.
That was where the capsule was attached to the white area to the right here. So what I’ve done is I’ve freed it up. Can you see that? Much wider here. So it was constricted there. So I’ve freed it up here. So the implant will move more that way to give her more cleavage more towards the centre. So our patient will have much more cleavage.
I’m inflating now with the temporary implant, and as you can see, I’ve gone up to 520. I don’t know if you can see that the area that I’ve released inside here, it was sort of constricted down there is now sort of past the breast, so that will give much better cleavage. I’ve got to free up a little bit more up here. But if I don’t free up too much here, but free up here, that means that the slightly wider implant can only go towards the centre to improve the cleavage.
So our patient today’s also got slightly a double bubble effect. The old inframammary fold was there. So the way you release this to give more volume to the lower part is just release this capsule from inside. So that sort of releases the tethering here, so our patient had tethering here. So I’ve released it so that it can also sit a bit freer there. So that’s the way you normally correct tuberous breasts from the inside.
I’m now going to use a Nagor implant which is much wider than that old PIP implant. So the PIP implant was much thinner and higher, which wouldn’t really suit this lady’s physique at all. I’m going to use a much wider implant which is more suited to the dimensions of her chest to try and give her a better cleavage.
So now I’ve released that, and I’ve got the proper implants in. Let’s do some measurements. So this is actually the middle here of our patient, and you can see we’ve got the implant 1.5 centimetres away from cleavage this side. But this side, which I haven’t operated on yet, was 6 centimetres away. I don’t know whether you can see the cleavage is better on this side. What I’ve got to do now is release all of this here the same way as I’ve done that, put a wider implant in which suits this patient’s physique better. I think that’s going to be a much better result, much more natural for our patient today.
So there was a bit of fluid around this one. I’ll just show you here. Just a little bit of fluid, not too much. I think the implant is intact again on this side, I’ll just take it out. It feels like a PIP implant. I’m just going to take it out. There we are. Yes, it is intact. Slightly light colour on the top actually. And again it is a PIP 495cc implant.
So I’ll just show you here. Can you see how I’ve freed everything up on this side? And the implant now lies instead of being very central here, it’s better cleavage here and the same on this side as well. We’ve got nice natural cleavage, where before it was here. So overall, good results, and then I’ve stitched up the scar with absorbable stitches on either side.
So here’s the implant from the right side. We’ve got the serial number here. We’re collecting all the serial numbers so we can try and trace which lots of the PIP implants had the most problems. This actually looks quite good. It didn’t have that much of a silicone bleed. I don’t know if you can see there, but it says PIP 405cc. That was the right one.
Now I don’t know if you can see there is slight difference between the right one and the left one. Can you see this sort of white haze on that left one towards the top there. I’m not exactly sure what that is. That’s quite unusual. I haven’t seen that very much before. It maybe something to do with the silicone in there. Can you see again? It’s a little bit paler. Again, this is a slightly larger implant. It’s a PIP. Don’t know whether you can see that. It’s a bit difficult to read, but it’s a 495cc. Again, we’ve got the lot numbers. So what we’ll do is we’re collecting all the lot numbers so we can really trace back which batch will have the main problems. We’re trying to decipher the batch numbers, but it’s generally 11607 and then 224 is a different number. So we’re looking at the records to try and identify which ones were the problem implants.
So thank you very much for watching the video. I hope you found it interesting. If you’d like any more information about PIP implants or you’re considering having them changed, please contact us either via our website or email or phone in the office directly and we absolutely love to talk to you about the options available for you. Thanks for watching.