We have a removable replacement on the breasts. She’s got capsules on her breasts, from surgery she had a few years ago. It’s capsular so the breasts are really hard, they’re deformed and so she wants them removed, replaced, get rid of the capsule, and hopefully, implants being put in each. We’re going to do that and then we do a tummy tuck on her afterward so that’s what we were starting out on.
I just made an incision in the scar that he had previously from the surgery she had. I took the implant out, I took it out it was a 330 moderate-sized implant and we’re gonna replace it with a larger one but first I’m taking out the capsule.
The capsule is what the body created around the implants that made it feel very hard and deformed. So it’s a meticulously slow process of taking out this capsule from surrounding tissue and so that’s what we’re working on right now.
It’s a slow process but that is how you have to do it. The good news is it is a small implant so the capsule is small. If it would be like an 800 here with the hole they can’t take out that capsule but since this one is small it’s a lot faster to take out the capsule.
So on the right side, I took out the implant, and then I took out the capsule. That tissue surrounding the implant contracted it to deform it and would not allow further expansion to put in a larger implant.
Placing new implants
So we’re putting in a larger implant now – wonderful 330 go up to 550 she really wants to be big so that’s doubled in size she had.
And we again used the same incision that she previously had from the doctor who did her surgery. So we are not making any additional incision, what I did was I made it nicely. She did have a scar, so I cut out the scar because the scar didn’t look good. So I cut out the entire star to make it look a lot better.
Right now we’re going to go to take the implant it’s a 550 high-profile implant. We took out all the air, we’re just gonna now inserted it into the pocket that we’ve created and we’ll blow it up to 550. We’ll see how it looks.
550cc’s of saline that comes from IV bag, full sterile it’s a closed system that there’s no exposure to air and it goes through tubing into a 60cc syringe. So with a 60cc syringe, they fill it up 9 times + 10 extra cc’s. It’s rerouted once it goes into the syringe, with it valve that we have here to redirect into another tubing that’s being placed.
We’re going to take out the tubing from the implant and it will self-seal in. Then we’re going to close this by just putting up the scar that she had previously.
So I’ve taken out the implant on the left side now, and the capsule that scaring tissue that the body created around the implant to cause a deformity of the breast, to make the deformity, so now we’re just given antibiotics and we will put the new implant 550cc, close it and then we are going to do the tummy tuck.
We seal the implant which I just did, and we finished up on the breasts and closed and beautiful so now we’re gonna start the tummy tuck.
The tummy tuck
What I’m going to do first, what I’ve been doing here is when she stands up, she’s got a big imprint of skin and fat that just falls down you know, to legs so we’re gonna not only take out the extra skin and fat, we’re going to tie in the muscle and make it very flat.
Because she has a bulging stomach from the extra skin and fat, the abdominal cavity itself it’s very loose because, with the pregnancy, she’s had her muscles separated and went sideways so that allows the abdominal contents to kinda spill over like it is a beer belly.
So tying and bringing the muscles together it’s going to flatten everything out and feel amazing.
So she had three sections three c-sections already, she has a large big scar over here so what I’m going to do right now is to put in some tumescent fluid to cut down on bleeding as I do the surgery and it’s just going to make it speed it up and not very very little bleeding during the procedure.
Cutting out the fat and excess skin
I’m going to isolate the belly button. Because it is going to be separated from the surrounding skin so I’m just going to separate it. Okay so we’ve already isolated the belly button over here, and I’ve made my incision around the marking area for the extension of the skin and then I raised that flap all the way up to the ribcage. The ribcage is over here and so what we’re going to do now is I’m gonna mark where the muscles are to the midline and very far apart from the midline.
So I’m going to bring these together into the midline and that’s going to bring the area to become flattered. I’m putting in some antibiotics, and these are permanent sutures, you know, eventually scaring will start over and it’ll bring the muscles together but this will absolutely reinforce the scarring.
Okay, you can see now how tight is up the belly button and how loose it is below, so we’re going to do the same thing we did above, below and bring the muscles together.
I have my marking where the skin’s gonna be removed and so that’s what we do now.
A very good sign is that she’s going to heal really good because the blood supply down here is really good and that’s what I like. So this is a very good sign that she should be really excellent quick healing
What I’m doing now is I just brought the belly button up into its new location and I’ve just anchored it before so it stays in position.