29 janvier, 2007 16:07

Explantation photos, explained

I've received several questions about the photos that I recently sent. I hope the following will explain: To understand the photos, you must first understand the mastopexy procedure. In order to have breast implants removed using the "enbloc" procedure a mastopexy must be performed after explantation. The photos that I provided show how the breast is surgically cut and opened up and what the implant looks like with the capsules or scar tissue surrounding it. The "enbloc" procedure is the recommended method of implant removal because if the implant has ruptured, the majority of the leaking silicone is contained within the capsule. The more silicone that leaks into a woman's body the more health problems she will have - this is why this procedure is preferred.

Mastopexy or breast lift procedure.

White broken lines outline the area where the skin is cut, the dark area outlines the area
where the skin is removed & the new higher position for the areola and nipple. Note: the
areola and nipple are removed completely and reattached.

Skin formerly located above the nipple is brought down together to reshape the breast.
Sutures close the incisions, giving the breast its new shape and contour.

After surgery, the breasts are higher and firmer, with sutures indicated by the white lines -
around the areolas, below it, & in the crease under the breast.

Drawings of mastopexy/breast lift surgical procedure. (from the American Society of Plastic Surgeons website)

Mastopexy usually takes one and a half to three and a half hours. Techniques vary, but the most common procedure involves an anchor-shaped incision following the natural contour of the breast.

The incision outlines the area from which breast skin will be removed and defines the new location for the nipple. When the excess skin has been removed, the nipple and areola are removed and reattached to the higher position. The skin surrounding the areola is then brought down together to reshape the breast. Stitches are usually located around the areola, in a vertical line extending downwards from the nipple area, and along the lower crease of the breast.
Some patients, especially those with relatively small breasts and minimal sagging, may be candidates for modified procedures requiring less extensive incisions. One such procedure is the "doughnut (or concentric) mastopexy," in which circular incisions are made around the areola, and a doughnut-shaped area of skin is removed.

After surgery, you'll wear an elastic bandage or a surgical bra over gauze dressings. Your breasts will be bruised, swollen, and uncomfortable for a day or two, but the pain shouldn't be severe. Any discomfort you do feel can be relieved with medications prescribed by your surgeon.

Within a few days, the bandages or surgical bra will be replaced by a soft support bra. You'll need to wear this bra around the clock for three to four weeks, over a layer of gauze. The stitches will be removed after a week or two. Or you may request stitches that dissolve.

You can expect some loss of feeling in your nipples and breast skin, caused by the swelling after surgery. This numbness usually fades as the swelling subsides over the next six weeks or so. In some patients, however, it may last a year or more, and occasionally it may be permanent.

Implant removed "enbloc" from breast and placed on top of the woman's stomach.
This shows what the implant, with capsules surrounding it, looks like upon removal.

This shows what the breast looks like when it is cut open. It shows the breast
implant with the capsules surrounding it - still inside the chest/breast.

This shows what the implants look like when they are removed using the "enbloc
procedure.

These two photos show what the capsules and implants look like when the capsules are cut into, exposing the implant inside.

Note that the photo on the left shows an intact implant and the next photo shows that the implant is ruptured.

Also note what the inside of the capsules look like, they have calcified - they have a very rough and uneven surface and texture.

The capsules, in this condition, can contribute to rupture because they can act as an abrasive - like a grater on the surface of the implant. I believe calcified capsules are a major and contributing factor in silent ruptures.

This is a picture of a women in Southern California who had her implants removed incorrectly. Her implants were ruptured and the surgeon tried to remove them from her breast by cutting into her breast and pulling out the implant. Because they were ruptured it created a huge mess. She is on disability and cannot function normally either physically or cognitively because her implants were removed incorrectly.