Replacement of Ruptured Right Breast Implant29th June 2012
Hello, my name is Adrian Richards. I’m the Surgical Director of Aurora Clinics, and I’m just going to be taking you through an operation in which I remove some ruptured PIP implants.
Our patient today had her PIP implants, which are 270cc, high profile implant, in 2005. She’s had an ultrasound, which implies that the left is ruptured. I’m going to be removing the scar here, on both sides. We think this side is ruptured from the ultrasound, so I’m going to be removing that first and then doing the same procedure on the left side.
Can you see? I’ve just opened up the capsule here, and there’s this creamy fluid coming out. Can you see that? That implies that the implant is ruptured. Can you see it just coming through the hole there? See this creamy fluid there? We’re going to send it off and have it analysed. That creamy fluid really shouldn’t be there. Can you see the creamy fluid coming out? I think the implant’s ruptured there. When these PIP implants rupture, they seem to exert quite an inflammatory response, which I’m just seeing here with this fluid, which creates all this fluid. So I suspect the right one is ruptured as well. You can see there’s quite a lot of it there.
Can you see all of this fluid coming out now? This is quite a lot of fluid. I don’t think I’ve seen quite this amount of fluid before. Can you see it all there? It seems that when they do rupture, the silicone, as we know, is not medical grade and causes this inflammatory reaction. No one’s quite sure what the implications are of the silicone. You can see in some of the other videos, we quite often see this milky fluid, and sometimes it’s actually inside the implant as well. Cleaning everything out there. It’s mostly the fluid. I’ve sucked away a lot of the fluid, but you can see there’s still quite a lot there, which we’ll send out to have analysed.
This is the implant removed. Can you see this milky fluid around the inside of the implant? It normally means that the implant is ruptured. I don’t know whether you can see here. When I squeeze it, can you see there’s a little fracture here? That’s where the implant has ruptured there. You get a little break in the shell, and then the silicone comes out, and more importantly the body fluids get in. There’s one rupture there, on the outside. I can’t see any more that easily, just that little rupture there. Can you see the milky fluid inside the implant? We’ll record the serial number just for information. See if I can see the serial number: 07505, I think. It’s an early one. We’ll just put that on one side, and now I’m going to clean everything out, take a biopsy of the capsule, and remove the inflamed capsule.
I’m just removing this implant, which is intact. See it hasn’t got that yellowy stuff within it, but it has quite a lot of gel bleed. Although it’s not ruptured now, this is a very, very firm and really roughly textured implant. It’ll be interesting to check that batch number. It feels very grainy and horrible and has quite a lot of gel bleed. There’s no rupture, but it probably wouldn’t be long before it did rupture. The implant feels like sandpaper when you rub it. We’ll record the numbers on that and clean everything out.
We’re going to use an Allergan TSF implant in this lady. I’ve put a sizer in, and the optimum fill was 385cc, which gave her a nice cleavage. We’re going to use that implant now.
This is our patient at the end of the operation. We’ve enlarged the size of the bust and hopefully given her a better shape on the lower part and a better cleavage with those Allergan implants.
I’ve seen this quite a few times. When you get this creamy fluid within the implant shell, that means it’s ruptured. I don’t know whether you can see here, but there’s the rupture. What happens is the shell ruptures and this nasty industrial silicone, or whatever it is, is exposed to the body fluids. The body fluids seep in. They make this creamy fluid. Then the creamy fluid also forms around the implant. I think this is what makes the people feel quite unwell, this inflammatory response around the implant. As you see, a very early rupture. With body movement that would have gone on to spread throughout the capsule, and it would eventually end up like some of the other PIP implants we’ve seen, completely split and completely opened up.
Just look at the other side there. This is intact. There was gel bleed. It’s a different lot number. So this is from an earlier implant, 7505, that ruptured. The 13205 lot number was intact and not in too bad condition, although the texturing on it is very rough. So this was lot number 7505 that was ruptured in this case.
Thank you for watching the video. If you’d like any information about PIP implants, please get in contact with us via our phone number or our website. Thanks very much for watching.