The Real Housewives of Cheshire and Botched Operations
In my day job as Lead of the Breast Reconstruction Unit at The Christie Hospital, I perform Breast Reconstruction surgery regularly, but I am also called upon to deal with some very difficult secondary surgeries similar to Dr Terry Dubrov and Dr Paul Nassif, the team of Surgeons in the hit TV show from America, Botched.
When patients have had their surgery go wrong or have perhaps had Breast Implants in for a number of years, they can develop problems which are complex to treat and correct. If an inexperienced surgeon takes them on they often make decisions that can make the problem worse in the long run. I have had to perform a number of very challenging cases in my NHS breast surgery practice. This really helps to keep me at my very best for performing surgery in my cosmetic practice.
Tanya Bardo’s Breast Surgery
In The Real Housewives of Cheshire (RHOC) recently we saw Rachel Lugo undergo a Mummy Makeover and this was in part to treat problems she had with breast implants that were done 20 years ago. She had a ruptured Breast Implant on one side and had also developed sagging due to the sheer weight of the implant stretching the skin on her other breast. These are complications that can happen over time and especially if a patient has had intervening pregnancies which can cause significant changes in their breasts.
One of the other reasons for undergoing revision breast surgery includes capsular contracture (again mentioned in the show) this is when the normal scar that develops around an implant becomes tight and this can cause ripples and pain. I deal with these sorts of problems on a regular basis in my NHS practice and take numerous precautions to avoid them in my cosmetic practice. I am scrupulous in my techniques when performing Breast Augmentation and to avoid capsular contracture I change my gloves, re-prep the skin and use a “No Touch Technique” using the Keller funnel. This minimises any contact with the Breast Implant with the skin that can cause it to become contaminated with very low counts of bacteria. we believe this is what causes the problem is the long-term with the Breast Implants.
Choice of Breast Implants
I also use Polytech Breast Implants which have a special coating which also considerably reduced the potential for capsular contracture. The outer silicone coating is textured (not smooth which is commonly used in the United States) and has a textured feel, or can be seen as textured under the microscope. This helps the breast implant to stay in position too which can be a problem especially with round implants.
In The Real Housewives of Cheshire we saw a heated argument with Dawn Ward after she was discussing the recent Breast Augmentation I performed on her daughter Darby Ward. We saw how upset Tanya Bardo became as it brought up her own memories of problems she had had when she had revision Breast Surgery. Tanya had problems of stretched skin and sagging and opted for an increase in the size of her breast implant as well as a Breast Uplift.
These 2 options tend to increase the risk and she had problems with her wounds healing post-operatively where she said that one of her breasts turned purple and she was really frightened of losing it. This would have been devastating for her and indeed any lady.
Pico Dressing
To prevent future complications, I use a special dressing, known as a PICO to decrease the problems I have with wound healing and I have not seen any issues recently since using it. Tanya should have been advised to avoid an increase in the size of her Breast Implants as bigger Breast Implants tend to lead to an increased risk of capsular contracture and stretching of the skin in the long term.
Textured Breast Implants
I have developed different ways of dealing with these problems and one technique I use is the use polyurethane coated Breast Implants as they have a very low incidence of capsular contracture and have a unique property of sticking to the chest wall. In addition, this means they have less tendency to push down on the skin and are less prone to droop.
Tanya had problems with wound healing after her surgery due to the difficulty of trying to close tight stretched skin over bigger Breast Implants.
When considering any revision breast surgery, it is essential to do your research and to see a Breast Surgeon who deals with the difficult problems that I see. Plastic Surgeons are often called upon to help with problems that other Breast Surgeons cannot solve and so we are best placed to give advice on how to avoid the serious problems Tanya had.
Mr Gerard Lambe MD, FRCS (Plast)
Consultant Plastic and Reconstructive Breast Surgeon
Clinical Lead for Plastic Surgery