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Adrian Richards: So our patient today had 290 cc implants back in 1999. She thinks that
they're PIPs. So if they are PIPs, they are likely to be old style PIPs, which have a
different back plate.
The first stage is just to remove the scar. This is in real-time, just removing the scar
there. You can cut through the scar, but cutting through the scar makes a worse scar, if you
see what I mean, because it's wider. So we remove the scar. Generally, plastic surgeons
will attempt to remove the scar. A bit of bleeding there.
This is called a cutting diathermy, which basically just uses electrical current to
stop blood vessels bleeding. In the old days, before they invented it, they used to have
to tie off all the blood vessels individually. It would be very laborious.
Do you know, Aggie, how they found cutting diathermy?
Aggie: No.
Adrian Richards: No, nor do I. But it really revolutionised . . . I wonder type of implants
these are actually.
So this is a bit of the implant here. Yes, it is a PIP. Then this is the silicone. This
should be, obviously, encased within the implant. So that's the silicone there. Then interestingly
there wasn't very much in the way of yellowy fluid around these implants, which there normally
is. So these early PIPs didn't have quite the same . . . much better silicone than the
later PIPs, but obviously still have the same rupture problem.
This implant certainly has got some fluid around it. It's difficult to say exactly.
It's a creamy fluid, so it may well be ruptured. But I'll have a look at it in a second, a
bit closer and show you.
This is a similar appearance on this side. You can see that's the silicone. So this is
a double rupture. On the right side, the silicone was in three pieces, the shell. On this side,
there's another bit there. Again three pieces and another very serious rupture. It's the
poor quality of the shell of the PIPs that make them do this.
Now they're out. This is the silicone that was lying inside the patient. The silicone
shell, which we pieced together, is in three parts. So we've actually carefully pieced
it together, but it's broken around the base plate. This is the base plate here. I don't
know whether you can see this round bit there. That's where it's broken away from. That's
always the weak point. So this is the first one we've ever seen, out of the 260 we've
done this year, that have both been in three parts.
The left one there, that's one part with the base plate. They always seem to break around
that base plate. That's where the base plate joins. Can you see that circle there, like
that? So that's where that fits together, and that's the point of weakness on the back
of the implant. This is the final piece of the jigsaw, which goes in the front.
So both of these implants in three parts with silicone. I think they've been ruptured for
a long time, and they were both batch number 98257. That is not a good batch to have with
both implants ruptured. So this case is bilateral. We've treated a lot of bilateral ruptures,
but this is the first one with both in three parts.
Anyway, if you would like to watch more videos and find out more about PIPs, please have
a look. Click on the link below. That will take you straight through to our website where
you'll find lots of information on PIPs.