Procedure Date: 6/12/2014
Assistant(s): None
Preoperative Diagnosis: ruptured right saline implant
Postoperative Diagnosis: same
Procedure Performed: removal of bilateral implants, pocket revision, Bilateral submuscular silicone breast augmentation
Anesthesia:General
Antibiotics:vancomycin 1 gm and cleocin 900mg IV within 1 hour of incision time
Complications: none
IV Fluids: 1000ml
Estimated Blood Loss: Minimal
Specimens: None
Condition of Patient:
The patient was transferred in stable condition.
Summary:
Patient was transferred to the Operating room and placed in a supine procedure. General LMA anesthesia was induced. The Patient was prepped and draped. A formal timeout procedure was then performed. Using the preoperatively placed marks the right breast was addressed first. A 5cm incision was made in the IMF. Electrocautery was used to divide the subcutaneous tissues and the pocket was identified and entered. The saline implant was removed. A lighted breast retractor was then used to release the pocket superiorly. A 425cc HP silicone sizer was then placed into the pocket. Once the implant position was noted to the be appropriate the sizer was removed and the pocket was irrigated with antibiotic containing solution. A 425cc silicone implant was then placed in the subpectoral pocket. The pocket was the closed with interrupted 3-0 polysorb. Deep subcutaneous layer was approximated with interrupted 3-0 polysorb followed by skin closure with a running subcuticular 4-0 polysorb.
Then left breast was then addressed. A 5cm incision was made in the IMF. Electrocautery was used to divide the subcutaneous tissues and the pocket was identified and entered. The saline implant was removed. A lighted breast retractor was then used to release the pocket superiorly. The pocket was noted to be too large laterally, therefore a slip of the lateral pocket was excised sharply and the pocket was closed with a running 3-0 surgipro. A 425cc HP silicone sizer was then placed into the pocket. Once the implant position was noted to the be appropriate the sizer was removed and the pocket was irrigated with antibiotic containing solution. A 425cc silicone implant was then placed in the subpectoral pocket. The pocket was the closed with interrupted 3-0 polysorb. Deep subcutaneous layer was approximated with interrupted 3-0 polysorb followed by skin closure with a running subcuticular 4-0 polysorb.
Steri-strips were applied to the incisions followed by a dressing consisting of circumferentially placed kerlix and ace wraps. The patient was allowed to awaken from anesthesia, the LMA device was removed and she was transferred to PACU in stable condition. Patient tolerated the procedure well, no complication. Counts were correct x2
Assistant(s): None
Preoperative Diagnosis: ruptured right saline implant
Postoperative Diagnosis: same
Procedure Performed: removal of bilateral implants, pocket revision, Bilateral submuscular silicone breast augmentation
Anesthesia:General
Antibiotics:vancomycin 1 gm and cleocin 900mg IV within 1 hour of incision time
Complications: none
IV Fluids: 1000ml
Estimated Blood Loss: Minimal
Specimens: None
Condition of Patient:
The patient was transferred in stable condition.
Summary:
Patient was transferred to the Operating room and placed in a supine procedure. General LMA anesthesia was induced. The Patient was prepped and draped. A formal timeout procedure was then performed. Using the preoperatively placed marks the right breast was addressed first. A 5cm incision was made in the IMF. Electrocautery was used to divide the subcutaneous tissues and the pocket was identified and entered. The saline implant was removed. A lighted breast retractor was then used to release the pocket superiorly. A 425cc HP silicone sizer was then placed into the pocket. Once the implant position was noted to the be appropriate the sizer was removed and the pocket was irrigated with antibiotic containing solution. A 425cc silicone implant was then placed in the subpectoral pocket. The pocket was the closed with interrupted 3-0 polysorb. Deep subcutaneous layer was approximated with interrupted 3-0 polysorb followed by skin closure with a running subcuticular 4-0 polysorb.
Then left breast was then addressed. A 5cm incision was made in the IMF. Electrocautery was used to divide the subcutaneous tissues and the pocket was identified and entered. The saline implant was removed. A lighted breast retractor was then used to release the pocket superiorly. The pocket was noted to be too large laterally, therefore a slip of the lateral pocket was excised sharply and the pocket was closed with a running 3-0 surgipro. A 425cc HP silicone sizer was then placed into the pocket. Once the implant position was noted to the be appropriate the sizer was removed and the pocket was irrigated with antibiotic containing solution. A 425cc silicone implant was then placed in the subpectoral pocket. The pocket was the closed with interrupted 3-0 polysorb. Deep subcutaneous layer was approximated with interrupted 3-0 polysorb followed by skin closure with a running subcuticular 4-0 polysorb.
Steri-strips were applied to the incisions followed by a dressing consisting of circumferentially placed kerlix and ace wraps. The patient was allowed to awaken from anesthesia, the LMA device was removed and she was transferred to PACU in stable condition. Patient tolerated the procedure well, no complication. Counts were correct x2