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Hello, my name’s Adrian Richards, I’m a plastic and cosmetic surgeon based here
in the United Kingdom and the surgical director of Aurora Clinics. In this short video, I
will be taking you through each stage of a procedure which I recently performed on a
lady, inserting a teardrop shaped implant in a dual-plane position and that’s partially
behind the muscle. I’ve used this approach in this lady because she’s very slim and
hasn’t got sufficient breast tissue to cover the implant if I place it in front of the
muscle. So the muscle is acting as another layer in front of the implant. So I hope you
enjoy the video and thanks for watching. Here you can see the video with the lady asleep
and with my markings on, just showing you the outline of the muscle, that’s where
the pectoralis major muscle comes down and this is the outline of where I’m going to
place the implant. So really the first stage is to put local anaesthetic mixture where
I’m going to make the incision. This numbs everything up and gives very good pain relief,
about 12 hours following the surgery. I then create a tunnel of which I’m going to put
some local anaesthetic in so you can see here I’m putting local anaesthetic in with an
adrenaline mixture under the breast gland where I’m going to be dissecting. This has
the joint benefit of reducing any bleeding and also giving very good pain relief as I
mentioned previously. So I’m just making the incision here, typically
a five centimetre incision in the inframammary fold, sometimes I do need to lower the inframammary
fold if there isn’t one already in situ. Here I am just dissecting and here you can
see in my forceps, I’ve got the muscle so I’m going underneath the muscle there. So
in my forceps in the left hand, I’m holding the muscle and then I’m just gradually going
underneath the muscle and here I am just elevating it. So I’m showing you the muscle here which
I’m going to go under. So in front of the muscle, you go in front of that and then behind,
as in this case. Here’s my implant, sizer implant, this is a temporary implant which
I’m going to put in just to check that the pocket size is okay and everything looks good.
But again, this is temporary so I’m just checking everything there, everything looks
good, breast looks good, I’ve dissected the pocket sufficiently. Here I am just irrigating
everywhere so I always wash out the pocket, the cavity, just to make sure there are no
small amounts of tissue in there, antibiotics go in and then Betadine put on the skin. This
is an antiseptic to reduce the risk of any infection. I always put new gloves on before
I touch the implant so everything is fresh and the implant is as uncontaminated as possible.
So new gloves on, implant opened and as you can see, it’s a teardrop shaped implant.
These are markers, which I’m just showing you there, to denote the lower part of the
implant so I can orientate it correctly, here’s the implant just going in gently into the
pocket and it’s important just to check that those markers are completely orientated
and the implant was in the correct orientation. So we make the pocket quite nice and snug
so that the implant just sits in there nicely and there are the markers I’m just showing
you there, just to show that the implant is orientated absolutely correctly. Then the
closure is very similar to other types of implant; three layer closure with absorbable
stitches just to give the wound good support. The stitches don’t need to be removed, they’re
absorbable but do need to be trimmed and then the last phase is just to put some Dermabond
glue on, which is tissue glue, just to seal the wound.
Thank you for taking time to watch the video, I hope you found it interesting and informative.
If you’d like any more information about breast augmentation, please feel free to visit
our website aurora-clinics.co.uk and we also have a number of podcasts, talking to patients
who’ve had these procedures which you may find helpful to listen to. So thank you very
much again for listening to the video, please feel free to contact us if you’d like any
more information.