These are the style 20 silicone implants, very, very nice. We’ve used them for twenty years. To keep them from being firm they are under filled and so even, even though she has subcutaneous tissue when she leans forward because there’s fluid in there you can see, you can see rippling and so what we’re going to do is exchange these for the gummy bear implants which are semi solid and therefore they can’t ripple ’cause they don’t, there’s no flow pattern.
So what we’re first going to do is mark the incision. We have 550 cc implants in and we’re gonna go for 605 gummy bear. First, we make a 5cm incision right in the old incision from the previous transaxillary breast aug. Then we numb it up. Now she’s already asleep so that numbing it is not a necessary thing to do, however, the lidocaine also carries the epinephrine to decrease the bleeding and there are those that say even though you’re asleep your brain recognizes pain. And so, by numbing it we decrease the chance of any pain and therefore any memory.
And again, we’re gonna go in our old crease. And again, numbing it. With 1/2% lidocaine. 1:200,000 epinephrine. This is about 1/4 the strength of what the dentist uses in your mouth.
And this instrument helps us to spread tissue very nicely. And we’re aiming for the implant pocket which is right up here. And the iconoclast has an upward tilt so we can get up into staying well away from nerves, arteries and of course the lungs. We go right into the area where the implant is housed opening it from above.
And I’m in it. I feel the implant. So, now we’re going up in the armpit. There we are. Implant number one out. As you can see, at least right now, there is minimal to no bleeding.
And here’s the second pocket and we’re gonna open it again with a number 15. And of course, armpit scars don’t show. They’re amazing ’cause armpit lines are called Langer’s lines and they have very little to no tension at all. Less tension the less chance of scaring.
And here’s the second implant. Ok, so we’ve got…we’ve cleaned out the pockets, we’ve removed the old implants, we’ve got new implants ready to go.
Jason changes his gloves, I change mine.
Isn’t the Keller Funnel amazing? This one’s a little tighter. This may be a little more exciting. 605 SCF as advertised. Wow, ain’t that amazing?
Back tab correct. Back tab correct.
With the bottom layer, we usually close with three stitches. Then we do a running intradermal stitch with 4-0 prolene. This one normally comes out at about five days.
We’re done. So this was an implant exchange. Went through the armpit. There was no scar on the armpit previously and there should be none now. Removed the other implant from the armpit put in a new implant into the armpit and did it in one hour.