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Adrian Richards: Hello. Our patient had breast implants
some time ago, in 2003 and would ideally like to increase the size of the implants during
surgery today. Her nipples are in a slightly low position so I'm going to be elevating
her nipples as well during this procedure.
So our patient today is quite a tall lady, with quite a broad chest and you see how her
implants are just going to the sides, like that. So her implants need to be wider for
her and held more to the centre. And that is what an uplift tends to do, tends to pull
them more to the centre.
So the first stage is to take out her old scar, look at the implants, see what sort
of condition they are, put a temporary sizing implant in to blow it up and then decide on
the formal size and then do an uplift and sort of tailor the skin around the implant.
Well, I'll show you the procedure at each stage during the operation.
So I've just opened up the capsule and I can feel the implant here. And the implant only
comes to here which is why it really should be wider. So if I pull it out I suspect it
will be a quite narrow implant for our patient. So can you see? It's got a lot of gel bleed,
a lot of deflation as you can see here on the capsule, a lot of deflation with the gel
bleed, the stringy stuff between my fingers and the implant is deflated in the top here
as you can see. And it was also moved to the side so what I'm going to do is a larger implant
and move it towards the middle but I'll show you that in a second.
I've finished the right side and I've just opened the capsule on the left and can you
see all this creamy fluid coming out? That means that the implant on this side has ruptured.
Sorry. Just hang on there. I'll just show you. So you see all that creamy fluid? That
means that the PIP on this side has ruptured. As soon as you see that fluid you know that
you've got a ruptured implant. So I'll just get the implant out and I'll show you that
in a second.
So I've just removed the implant and it's got a rupture just here on the baseplate.
Where they normally rupture. Can you see that? This is a bit of free silicone that's come
out and that's the rupture there. I'll just clean everything up and I'll show you the
rupture in a second.
This is the end of the operation with the larger implants and uplift performed and I'll
show you the implants in a second.
Just going to show you the implants now. This is the right one. A 495cc. Now it's deflated,
it's got a lot of rippling but it is intact. Let's compare that to the left one. You can
see the left one you see, immediately you see all that creamy material, you know the
implant's ruptured and I'll just show you where the rupture is. There it is,can you
see and there we've got a lot of creamy fluid around as ell. Can you see the creamy fluid?
So there we are. So you can see that the implant ruptured. And it's the typical place, which
normally happens is the back of the baseplate here. The baseplate is where the implant is
made. This is actually an opening normally, the implant is made around it. This area sort
of glued or adhered to the implant and that's an area of weakness and that's where we're
seeing a lot of the implants rupture, just at the join of the baseplate there and then
the silicone can come out.