PIP Implant Removal & Replacement Surgery following Symptoms of Pain and Discomfort
27th March 2012Facelift Surgery
PIP implant removal and replacement surgery filmed in Aurora's operating theatre while Mr. Adrian Richards performs the Implant exchange operation. Aurora's patient had her PIP implants inserted in 2008 at a different clinic, she was not sure about the state of her breast implants but she recognised feeling pain and discomfort in her chest. Following recent news about PIP poor silicone quality, she has decided to have her silicone implants exchanged with high quality Nagor breast implants which we use at Aurora. For more information on PIP breast implant replacement surgery, please call us 0800 3285743 or book a free consultation with Aurora's specialist plastic surgeons in Milton Keynes, London, Northampton, and Buckinghamshire.Transcript
What we’re going to do with this lady, she’s had PIP implants in 2008. She’s not sure about the state of the implants. She’s got some generalised pains throughout the chest. So we’re going to exchange them today.
I don’t know if you can see the scar here. Can you see the scar? It’s quite wide. If I just outline it here, it’s wide scar, wider than you’d expect, really. Wide and slightly longer. This dot here, that’s where the drain came out. We don’t use drains anymore, but if you see a scar like that, that’s nearly always the drain site. We’ll leave that one alone. I’m just going to remove this scar so we’re back to fresh tissue on either side, and then we’ll get a much better scar in the long run.
Now can you see this fluid there? That is silicone gel bleed. All this stuff I’m sucking away now is silicone that bled through the implant.
Then the next stage is just to remove the implant. It feels like quite a firm PIP. Here it comes. Okay. We’ve got some capsule on the outside here. It is a 315cc PIP. Quite a high profile. Can you see the silicone gel bleed that we always get on these PIPs? Can you see? Normally, an implant would be dry. They wouldn’t be slimy like this. The reason it’s slimy is because the silicone is coming through the layers of the skin. I think, if you look at this implant skin, it feels much thicker and coarser than normal implants. Normal implants are made up of lots of different layers and are much finer. I think they’ve cut down on the manufacturing quality. This is why we’ve got the silicone gel bleed. It’s a much less high-quality shell, really, which is also more prone to rupture because of the folds you get.
So we just cleaned out the storage, and then I’m just going to wash everything out here with our special solution. So there are two lots of solution. Our first, which is a chlorheptadine, which we’re going to use there. Next we’re going to go to a saline wash, which is salty water.
So the next stage is to get the temporary inflatable sizer. I’ve used the whole length of the incision. This lady had quite a long incision so we’ve used it. This is the temporary inflatable sizer going in now. I’m just going to blow it up now. Our lady would like a 360cc implant. I can see that’s giving her a much better cleavage and much better fullness. So I think we go for 360cc implant. That’s what she wanted. I think it will improve the appearance of her bust quite significantly.
We’re going to put some gentamicin, which is antibiotic liquid, around the implant. Not only are we giving antibiotics in the vein, when the patient went to sleep, so she’s got high levels in her veins right now. We’ve also given her antibiotics actually to sit around the implants. That’s all to reduce . . . and we’re in a laminar air flow theatre, which is the latest in theatre technology. All of those things, hopefully, will really reduce any risk of infection.
That implant’s sitting really well there. That’s good.
It’s just basically a waterproof layer with glue, which makes it so that no bacteria or any contamination can get into that incision. That’s it.
Then at the end of the operation we’ll put some brown tape on that when it’s dry. All our patient will need is just to have these two ends trimmed flush with the skin. The rest of it, which is running all the way along will just absorb.
Now we’re going to do exactly the same on the other side. I don’t know whether you can see, but she’s got a better cleavage. Can you see that? With a slightly larger implant? Slightly better contour here with the slightly larger implant. Slightly larger and wider.
I’ve just opened this one up, and can you see all this fluid coming out here? This is all what we call silicone gel bleed. Can you see? Just hang on there. This is sometimes a sign that the implant’s ruptured. I’ll suck it all out. That’s all silicone liquid combined with the patient’s own liquid and fluids.
It feels like, again, a quite coarse PIP implant. There you are. Again, quite a classical, rippled. You see there? It’s folded inside. They always unfold when they get them out. It’s a 315cc, same as the other side, but I think a different batch number. Again, you can see all that gel bleed. They’re all very similar. A lot of them are very, very similar with this gel bleed that you don’t see on normal implants.
We’ve pretty much gotten rid of all the silicone now. Then lift up there, if you can. That’s the antibiotics going in. That’s the gentamicin that’s going in there. And then we put the implant in. There’s a certain way of getting these in through quite small holes. That’s good. That’s very well.
The next stage is just to make sure that it’s sitting properly for our patient. That’s good. That fits her quite well. Just feel that the back plate is against the back of the chest, which it is. That’s good. That’s sitting perfectly. That’s good. Cleavage looks good. Brilliant.
All we’ve really got to do now is just stitch up and that’s the operation done.
That’s good. Then our patient will just be fitted with a surgical bra at the end. I think it all looks very good. She should be, hopefully, very happy with that. We’ll put the surgical bra on now.
I’m just going to show you the implants now that we’ve just removed. This is the one on the right and you can see it’s a 315cc. This is the lot number, which we’re going to keep. It’s intact. When it’s dried out, you lose the silicone gel bleed, but you still have a little bit of capsule here. It just doesn’t feel like a great implant. The Allergan, Nagor, and Mentor implants feel much smoother, much less rough, and much less coarse on the side.
Now this is the left breast implant, which was interesting. It was very similar to the right, again, intact. This is the lot number. Can you see all that silicone gel that was around it? We’re going to send that for laboratory analysis now. That’s just a portion of some of the silicone that bled through and was lying around the implant there. The lot numbers on both sides were very similar. So both lots were 45007. This one was 123. This was 113. Similar lot numbers, behaved in similar ways, slightly more fluid around that left side.
Thank you very much for watching the video. I hope you found it useful and informative. If you have got PIP implants or any other type of implants and you’d like advice on what to do with them, please contact us 01844 214362 or email us. As I mentioned, we are getting quite a big database now of the types of PIP implants and how each batch are performing.