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bjbjLULU What I'm doing here is using sterile dressings which we term as *** sheets.
We will cover the *** area because quite often we can get discharge from that area,
and it could be a source of infection. This lady first noticed some problems in her left
side. A couple of months after that she noticed she had a lump developing on the right side,
for which she then had biopsy that we can see. We can see a scar on the breast from
where she had that. Fortunately it came back as being benign. Then subsequently, when she
heard about this problem with PIP implants, she decided to go ahead and have them removed.
She has had further lumps on the right breast here, which I am also going to remove at the
same time, and a third one in the axilla. I'm just marking the incision which is just
along the previous scar. We measure that and it's quite a nice well-healed, well-settled
scar that she has, which is about 5 centimetres in length. So I will probably stick to the
same scar. What I'm trying to do is to remove the implant intact within the capsule so as
to avoid any spillage of silicone if the implant has ruptured. What I'm finding is that the
capsule is pretty thin walled, and having released the capsule at one point, there is
silicone that has spilled into the capsule. The implant seems intact. It's not ruptured,
but there's a considerable amount of silicone bleed that is actually onto the surface of
the implant as you can see there. Can you see this? These are what are called silicone
granulomas that she has formed where the lymph nodes have picked up the silicone that has
probably leaked out from the implant into the tissues. This lady to begin with had PIP
implants that were 270 grams, but she also had an associated capsule around it, which
I have circumferentially released, which does make the pocket slightly bigger. So to accommodate
that pocket and of course she also did say that she wanted to go slightly bigger than
what she was, so we've gone for a 300-gram implant on both sides, and these are Nagor
implants. One of this lady's concerns was the fact that her old implants stopped somewhere
there, and there was a big gap between the two. So that is why we made a specific attempt
at increasing the pocket there so she's got better cleavage on the medial side now. I
put some Steri-Strips on to support the wound and then some waterproof dressings so that
she can start showering in a couple of days without getting the dressings wet, and those
stay on for a week and we then change them. So these are the two PIP implants that we
removed from this lady. As you can see, this is the left one. Both of them were intact.
There were no ruptures. But if you compare the two, you can see that they are different
colours. This is definitely darker in colour than the left one, and that is probably because
of the fact that, as I said during the procedure, there was distinct evidence of much greater
silicone bleed on the right side with a fair amount of free silicone within the capsule
that had formed around the implant. The capsule on the right side was also much lighter than
on the right, which was probably due to the fact because there was more silicone irritating
the capsule from inside than the left. These were PIP 270 cc. I don't know whether you
can pick it up on the screen. h0_| what I'm doing here is using sterile dressings which
we term as *** sheets rjd1 Normal.dot rjd1 Microsoft Office Word what I'm doing here
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