Episode 55: Saline Deflation: Managing Complexity and Challenges

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Dr. Rob Whitfield, the board certified plastic surgeon specializing in explant surgery. Breast implant illness is a topic that is not often talked enough about, especially in medical community, but is something that affects many women. In this podcast I'll be discussing the latest research, treatment options and personal stories of women who have undergone explant surgery in an effort to heal breast implant illness. In this podcast, we'll explore the symptoms of breast implant illness and delve into the latest surgical techniques for explantation and the recovery process. Whether you are currently experiencing breast implant illness or are considering explant surgery, this podcast is a valuable resource for anyone looking to take control of their health and wellness. So let's dive in.

So today I want to talk about saline devices and a way to manage what can be pretty complicated given what I find. In our experiences we see a lot of saline devices that are, we'll say over 400cc, over 500cc's I've had sailing devices up to 900ccs. I want everybody to understand it's a little complicated in terms of operating through especially the incision underneath the breast in the fold when you're trying to remove those and and take all the caps from material out intact, which is our goal. The problem is you can't compress the saline implant. So it's a very unlike a silicone gel implant, the filler, which is gel and a silicone device compresses because the saline device won't compress. It's very hard to work around and get over the top of and see on the other side of it within the pocket, especially if you're going from below. And then if it's very large and overfilled, you can't do it through a periareolar approach. You can do it through a vertical approach, of course. So I had a really, really good discussion with a patient and her partner about this and I want to highlight philosophically what I was trying to explain so people can understand it. So for instance, over the course of my career I I've been working in our office. We'll get a call that someone was in town visiting and they had their saline device rupture and they want to be seen to make sure there's an exam done and anything else that we can help provide assistance with because it's pretty alarming to have that happen. So of course over the years I've seen patients who've had a saline rupture and basically within a week, depending on how and where that rupture is it usually it drains the saline which is sterile when it's put in in the operating room, will absorb into the body, won't have any consequences. I let the patients know it's best if you can have arrangements made with your surgeon about that if they want to do an exchange. So that was kind of traditional and you would want to do it relatively quickly because the pocket starts collapsing down as soon as you remove the pressure of the implant. Whether it's saline or silicone, the pocket starts to close down because it's being held open by the pressure being exhibited by the device.

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So if I have somebody with overfilled saline implants like I will say that 900cc device I referred to, I won't operate on them without deflating their device and people will ask, well how can you deflate it and is it safe? Of course it's safe because just in the example I mentioned before, if you had a rupture and it deflated, nothing's going to happen untoward to the patient in a typical case. And so sterile in the office is an optimist procedure. We cleanse the area, use, you know, a sterile technique and withdraw the saline. Many times patients don't have their card or can't remember their exact fill volume. So then we're trying to measure that as well. But over a two to four week period after that controlled deflation in the office, the tissues start to Contract back down and you'll get a preview of the tissues. It's obviously not exact because it's kind of a short term, but it, it really helps from a standpoint visually of where you can see, you know, okay, well, this is the situation now visually. And then if someone wants to have other procedures done, you can counsel them about what options regarding different types of skin lifts or fat transfer or combination of those things. But it's for reference. Most people can't remember what their breasts look like prior to implantation because it was either so long ago, they don't have any before and afters. They can't get those because of issues with maybe where they had it done, maybe that person who was their implanting surgeon retired and. Or maybe they only had paper records. In our system, basically everything's electronic and there's an app and there's always access to your records as long as you've maintained your username and password. On our app, we use Simplast Health. I make everybody a little video of their surgery. After I have the implants out, I get asked to do videos intraoperatively of this surgery. But that's really hard to do. I used to wear like a helmet cam and it really was hard on my neck and it's really hard to get good pictures. So whenever I can, you know, get something, I, I get it. But definitely at the conclusion of each procedure, we go back, we make a short video about removal of the capsules and what we found and examine the implants. We always have still photos, of course, so those are all maintained in the chart. But the point of discussion is deflation can be a very useful technique to help give a visual preview. The actual breast, it hasn't obviously recovered completely because that's not enough elapsed time, but it can be very helpful. So I hope this is a helpful tool. Make sure to click that you like the episode and subscribe to the pod. If you have any suggestions, you can make them or DM them to us on Instagram or in the comments on YouTube.

All right, thanks for joining me today. I hope you found the information and stories shared on this podcast helpful and informative. Remember, taking control of your health and wellness is key to recovery from breast implant illness. If you're looking for additional resources and support, be sure to visit our online store, Dr. Rob's Solutions at drrobsolutions.com myshopify.com you'll find a wide range of wellness products and supplements to support your journey to recovery. From specially formulated detox supplements to personalized skincare products. We have everything you need to aid your recovery.

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Rob's Solutions today at DrRobs Solutions myshopify.com thank you for listening and we'll be back with another episode soon. Remember, you're not alone in this journey and and together we can overcome breast implant illness. Take care.