The saga of managing the PIP implants continues. I am seeing about 5 to 10 patients a week. This is obviously a small number compared to the NHS. Most women do want the implants replaced. Very often they take the opportunity to have slightly larger implants.
Scenario 1. When the implants are not ruptured, the surgery is relatively straightforward. The old skin scars are removed. The PIP implants are then removed and checked for the labelling, code and size which is on the back of the implant. Photographs are taken and the implants are kept in biohazard proof boxes and either kept in the hospital or given to the patients if requested. The capsule (scar) surrounding the implant pocket may need to be enlarged if larger implants are being put in. The new skin cut is closed, the whole procedure taking about 45 minutes.
Scenario 2. If the implants are ruptured, there will be silicone contaminating the capsule. This is thoroughly washed with iodine followed by at least 1 to 2 litres of saline using a pressure device (pulse lavage). If the capsule shows signs of chronic inflammation (unhealthy grainy tissue), the capsule will need to be removed and a specimen sent for biopsy. A decision is then made whether it is safe to replace the implants or delay this. The majority of women can have the implants replaced immediately. This whole procedure can take up to one and a half to two hours.
I suspect a significant proportion of women are delaying any decision until they receive clearer medico-legal advise about their entitlement for compensation from their original surgeons/clinics.
My personal advice remains unchanged and mirrors that of BAAPS(British Association of Aesthetic Plastic Surgeons), ISAPS(International Society of Aesthetic Plastic Surgeons) and several of the European Governments. It is better to remove the implants before it ruptures. The rupture rates have been confirmed to be unacceptably high. The quality of the implants are also very variable.
The following 2 photographs are from a patient I operated on 3 days ago. Shehad her PIP implants in 2008 by Harley Medical Group. The right side was ruptured and the appearance and quality of the implant was completely different from the left side.
Due to silicone contamination, the right capsule was unhealthy so the whole capsule had to be removed. To achieve symmetry, a similar procedure had to be done on the left side even though this was healthy. This increased the complexity of the surgery significantly.
You want to be in scenario 1 and not 2. Check out BMI Healthcare’s offer which I think is very reasonable.
