tubular breast augmentation uk

my name is adrian richards, and inthis video i'm going to be showing you a pip replacement of a lady who had her pips insertedin 2005. she's got a couple of problems. number one, her breasts feel like they're tetheredand pulled inwards, and they're not lying naturally on the side. that's obviously somesort of a muscle contraction, and i'll have a look at that. mri indicates that probablythe implants are intact, and again we'll have a look at that during the operation. can yousee this fluid coming out here, that creamy fluid? if you get that creamy fluid, thatmeans the implant's ruptured. so, immediately, we know that's ruptured. can you see thisfluid coming out now? can you see it just dripping out? that is not normal to have aroundbreast implants. almost like pus. can you

see it? so i'll suck away all the rest. cleanit all away. can you see? see all that fluid that was just lying around her implant, andthere was more than that. so if you've got that creamy material, we know it's ruptured.can you see here? that's where the rupture is. a very small rupture. but can you seehow you get a rupture on the rim? so she's got a rupture along the rim there, and thenthat's the silicone gel within. so she's got just a small rupture there. the next stageis just to clear all the remaining silicone away. then we'll change our gloves, changeall the instruments, and put a sizer in. but first of all, it's to remove all the capsule,remove all the infected silicone for this lady. so i've cleaned everything out now,and the reason our patient was getting the

pulling from the side is this bit of musclewasn't released. so this bit of muscle was here, and it was pulling the implant over.so i've released the muscle. the muscle wasn't released in the first operation, and that'swhy it pulls across. so i've released it, and then the implant will be able to sit furtheron the side, where it should do, rather than being pulled in all the time by this musclecontraction pulls it inwards. so i've put a sizer in, and i'm going to go for 285ccimplant. i've cleared out all the silicone and the capsule, and now we're just goingto go for a slightly larger implant. this is the end of the operation. so we've gota good cleavage, much bigger implant, and because, basically, the muscle which comesdown here is the pectoralis major, the muscle

that comes in here is the serratus anterior,and hadn't been released properly, so it was pulling all the time inwards. so i've separatedthe muscles and given, hopefully, a better line here and also done the same on the otherside. this is the side that had the ruptured implant. so i've cleared the whole area out.here we've got a better cleavage, more natural appearance laterally, and hopefully that shouldgive her the results she wants. can i just show you the implants here? this is the rightimplant, which was normal, which had gel bleed. so you can see the difference in the coloursof the implants. this one, normal and pale, this one yellowy. and you can see there'sthe rupture. it's a small rupture in the outside of the rim there. that's slowly gets bigger,opens up, and then the implant completely

opens up like a shell. you can see the creamyfluid within the capsule there, within the cavity. i think the mri didn't pick it upbecause it was such a small rupture. maybe it wouldn't notice that. it would pick upif there was more fluid around the implant, but it doesn't pick up an early rupture likethat. doctor: robin normal.dot robin microsoft office word doctor: title microsoft officeword document msworddoc word.document.8