TECHNIQUE AND REMOVAL OF RUPTURED SALINE
The video below indicates how a ruptured saline implant is removed.
In my practice, I prefer to use the incisions that were previously made. If they are my patients specifically, the periareolar incision sites will be reused. If they were done through an inframammary approach, the inframammary incision is used.
The incision is opened with a 15-blade. Dissection is carried down to the capsule, at which time the implants are removed. Note, the degree of deflation depends upon the amount of time that has elapsed since the original rupture. Slow leak ruptures may lead to diffusion of fluid out of the valve at a slower rate versus a complete fracture of the shell of the implant that may lead to a complete ruptured within a very short period of time. Once the implant has completely leaked out of the normal saline solution, the fluid that surrounds the implant will start to appear yellow which is consistent with a protein fibrin that may be found in the fluid itself. This is often associated with a chronic rupture.
The video will show a specific implant that had ruptured. This implant had been placed over 7 years ago. Notice the saline solution is clear, which indicates that these are acute ruptures and most likely occurred within the last four to six weeks.
Once the implants are removed, scar tissue is often released and an open capsulotomy is performed. Once the capsulotomy is performed, and the capsulectomy and scar tissue removed as necessary, the implant can then be replaced with a silicone or saline prosthesis. Ruptured saline implants can be determined clinically by simply examining the chest noting the significant asymmetry. Diagnostic tests are not indicated.
Saline breast revision patients usually have minimal postoperative pain. They are continued on oral antibiotics for seven days.
Ruptured 20-Year-Old Saline Implant Removal
A patient from Oklahoma traveled to my Beverly Hills practice to consult with me about the lost volume in her left breast.
During the consultation, it was apparent that she had a deflation (see pre-op photo) and, during our discussion, she stated that she had a primary augmentation about 20 years ago.
After listening to her and setting the expectation, we agreed to schedule surgery to remove both implants and replace with 390 cc saline implants.
The video below is part of the surgery where I removed the left ruptured implant. I removed the implant through a periareolar incision—the implant was a textured saline implant that was completely deflated.
The post-op photo is one week out, and as you can see, both breasts are now symmetrical. She will be wearing a LINDERBRA™ for four to six weeks to keep the implants in the correct position.
To find out more information about breast revision surgery, contact our office by calling 310-275-4513.