TECHNIQUE AND REMOVAL OF RUPTURED SALINE
The video below indicate how ruptured saline implant is removed. In my practice, I prefer to use the incision sites 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 specific implant that have been ruptured and that have 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. The patients usually postoperatively from the saline breast revision surgery have minimal pain. They are continued on oral antibiotics for seven days.