Tuesday, 31 July 2012

PIP implants- Fat Transfer as an alternative

The PIP scandal surfaced after regulators launched an investigation into the PIP implant manufacturing process.  This was in reaction to findings that the implants had been made from industrial grade rather than medical grade silicon.  The implants were banned in 2010.
It is feared that 300'000 women have been fitted with the implants worldwide with 40'000 in Britain and 30'000 in France.

There has been controversy in how authorities have recommended management of these cases.  France has offered and recommended removal and replacement of the implants on the national health system.  British authorities have not offered the same recourse.  At this stage the evidence does not suggest that early removal is required and the investigation is ongoing with new reports awaited early 2013.

If you have any concerns regarding your implants or are not sure whether you have the PIP implants, it is best to contact your treating surgeon or clinic and clarify what implants you have.  Alternatively your GP would be able to guide you on what steps to take.

If you have any of the following signs or symptoms, you should discuss them with your GP, who will refer you to a specialist.
Symptoms to watch for
  • lumpiness of the breast
  • lumpiness or swelling in the area around the breast
  • change in shape of the breast
  • deflation of the breast
  • redness
  • tenderness of the breast
  • swelling of the breast
  • pain or sensitivity

If you are worried
  • Find out if you have PIP implants by checking your medical notes.  You can get these free from your clinic or GP. If you had a PIP implant on the NHS, you will receive a letter.
  • Speak to your GP, if you had them done on the NHS, or your clinic if you had them done privately.
  • Agree what’s best for you – get advice on whether or not you need a scan then discuss removal with your doctor.
  • If you decide you want your implants replaced, the NHS will do it free if your original operation was done on the NHS.
  • If your original operation was in a private clinic you will need to speak to the clinic to see if they will replace them free.
  • If your private clinic no longer exists or refuses to remove the implants, speak to your GP. The NHS will remove your implants if your doctor agrees there is a medical need.

Alternative treatment options

In the private sector the PIP implants will mostly be removed and replaced with other implants (Mentor, Allergan etc.) giving you the desired result.  Alternative options are not to have the implants replaced at all.  This would probably be the least favourable option as the removal will result in loss of volume, emptiness and poor aesthetic result.
An alternative option becoming more popular now is fat transfer breast augmentation.  This procedure involves removing fat from one part of the body (e.g. abdomen, flanks, thighs)  and transferring it to the breast for augmentation.  The procedure is performed through tiny puncture holes so won't leave you with any further scars.

When can the procedure be performed?
Prior to having the implants removed its best to have a few consultations with surgeons that perform the fat graft procedure and get an idea of suitability.
If suitable then the implants should ideally be removed and 6-12 months of healing allowed before the fat graft is performed.  This will allow for scar tissue to settle.

What size can I expect?
Realistically 1-2 cup sizes, depending on how much fat is harvested and how much of the graft survives.  If large (200ml+) implants were removed then you may not regain the size that you were before.  There is a possibility of performing serial injection over a period of a few months.  This may then enhance the shape a little more.  This all depends on the amount of fat that can be extracted.

What will the breast feel like?
As it is your own fat that is transferred into the breast the tissue will feel soft and natural and take on a very natural shape too.

How much fat do I need to have?
Ideally you need to have a BMI of more than 22-23.  If you are in doubt whether you have enough fat then its best to go for a consultation with a surgeon for an assessment.

Other benefits.....
The procedure is performed through tiny puncture holes which leave you with almost no scar.  The downtime is very short with patients returning to normal routine in a few days.  You get a bit of body sculpting where the fat is harvested from.
Often the original implant scars will fill out and the skin may take on a rejuvenated appearance due to the stem cells in the fat.  If there is some contracture in the original scar this may improve too.

I use the PureGraft system as it is gentle on the tissue, filters out any unwanted constituents (blood, local anaesthetic, serum) and leaves me with pure fat.  It gives me a slightly drier graft which allows for a much more accurate assessment of breast size.

Come see our website www.DrWolf.com 

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