Removal and Replacement of Ruptured PIP Breast Implants10th July 2012
Hello. My name’s Adrian Richards. I’m the Clinical Director of Aurora Clinics. I’m just going to show you an operation in which a lady had PIP implants, and she’s got the most problems on the left, which she thinks may be ruptured.
So our patient today has had bilateral breast augmentation with PIP implants. She’s never had any problem with the right. So we’re just going to exchange that and take a biopsy of the capsule. The left she’s had problems at the centre, and it’s painful afterwards. This side is swollen, has always been swollen and tender. An ultrasound has shown it’s ruptured. So what we’re expecting to find is an intact implant on this side and a ruptured implant on this side. But we’ll see what we find in surgery.
Going down through the capsule now on this right side. there’s quite a lot of . . . can you see that? That’s an old haematoma. See that blood there. Do you see that? So this side isn’t very good . . . can you see that? There’s blood around, old blood, it looks like, and this one is ruptured. We didn’t see this one was ruptured, but it is. So this is [inaudible 1:32], bode that well for the other side. I mean, this is probably an old haematoma. It looks like old blood. It’s dark. It’s not fresh blood. Then I can see the free silicone there, as well. This implant is ruptured. It is ruptured.
I’ll just take out the implant now. So, can you see this implant is coming out now, and it’s not only bloody, it’s ruptured? Can you see? One of these typical sorts of ruptured PIPs, and we just check the lot number now. So we really just need to clean all this mess up now.
Now, I’m just going to cut down onto this implant. Trust me, first impression are that it isn’t that bad. It’s not as bad as the other side. Not so much free fluid around there. It doesn’t look quite as bad actually. That’s interesting. This implant is intact. It’s got gel bleed in it. In fact, this is the one our patient thought was the worst, so interesting that this one is intact, but it has got gel bleed on it, but intact. So this is normal appearance of a PIP implant. On the right, obviously it was very inflamed.
This is the end of the operation. I think we’ve got much better breast symmetry, increased the size slightly on both sides, but decreased the difference between the sides. I’ve released that, this one is going to sit lower, and cleaned everything out. Obviously, this was the one that had the problems with the haematoma.
It’s very interesting that although our patient had most of her symptoms on the left, in fact it was the right breast implant that was most affected. So, we’re just going to have a look at the breast implant here. We’ve recorded the lot number. So it’s 50307051. So that’s 50307, that’s the batch number, and the serial number is 051. We can see that it’s got quite a bad rupture. There’s also obviously a bit of haematoma, which you saw me remove, and the shell is really very fragmented. Then it will actually go one like other ones we’ve seen to rupture more and more and more. Then the whole lot of silicone comes out. But you can see it’s really quite badly ruptured. It normally starts on the rim, on the edge of the implant and then goes to the back.
On the other side we’ve got quite a good implant on this side, but the lot number is 50207. Just compared to this one 50307 here and this one 50207. So a different batch number, and this is number 200 of that. This implant is intact. It has some gel bleed like we always see with PIP implants, but it was largely intact. So that side intact, but this side a bit of a mess. The interesting thing is that you can’t . . . our patient didn’t have symptoms on the right side. So it’s silent rupture on this side.
Thank you very much for watching the video. As you can see, silent ruptures are quite common with these PIP implants, and sometimes even scans aren’t that effective at diagnosing them. So, if you have got any questions or queries regarding PIP replacements, please don’t hesitate to contact us either by ringing us or e-mailing us. Thank you very much.