S. Larry Schlesinger, MD, FACS is performing a breast augmentation revision surgery so that both breasts are even. Over the course of healing, one breast settled lower than the other, so he is raising one side so they are even. In part one, S. Larry Schlesinger, MD, FACS removes the implant (he will replace this implant with a new one once the capsule is raised), and he will lift the capsule from the inside. Part two, S. Larry Schlesinger, MD, FACS reinforces the capsule with Seri, inserts the implant, adds the drain and stitches the patient up.
OK, we’re going to numb it with some xylocaine. More importantly, we’re putting epinepherine in which will decrease the amount of bleeding when we make the incision. And of course, blood around the implant increases the chance of the implant going hard and that’s the last thing we want.
OK, we’ve cut through some breast fat and now, we’re into breast tissue. And we’re now down to the capsule which is nice and soft.
So now that we’ve opened our capsule. Spread it a little bit with the fingers, grab the implant and pull the implant out. Its entirety is nice and sterile. We’re going to use this as a sizer during the case. What we’re going to do is make a cut all the way across here. We’re going to advance it about a centimeter and a half because it will drift down a little bit. Then we’re going to sew it in. Then we’re going to put the old implant in as a sizer then we’re going to lavage everything out. Then we’re going to put the Seri in and then we’re going to sew everything up.
And so we’re going to make a little cut right into the capsule. Very thin. Now, we’re going to release this little incision because we’re going to undermine.
What we’ve done is we’ve made an incision all the way across the bottom of the breast, about a centimeter out. Now, we’re going to lift it up and release it all the way across and down. It’s most important down. And there’s some fat underneath which is good because the thicker this capsule is the better.
See, this is the capsule and we’re going to move it up this way. OK, we’re going to sew the capsule to the periosteum of the ribs. See, we brought that up and sutured it up to the rib, we brought that up and sutured it up to the rib, and now we’re going to bring this one up and suture it up to the rib.
We’re going to use a Keller funnel and use the old implant as our sizer. Putting the implant back in.
Eleven and Eleven and a half. This will come down a bit. They always do. Because it’s going to drift down a little bit, we got it made.