by Yale M. Kadesky, MD

Director

The H-Art of Plastic Surgery

After 34 years of performing breast augmentation with implants, I have encountered 0 patients with illness due to their breast implants. Why? One word: Saline. Saline implants are solid silicone shells filled with salt water. They emit tiny amounts of this salt water and absorb a slight amount of serum or lymph from the body. Emissions of silicone molecules from the solid envelope are very minimal.

Silicone gel filled implants are another matter entirely. The solid silicone envelope emits silicone gel molecules that elicit a very pathologic foreign body response from the body over time. The body forms capsules around these implants. The capsule of a saline implant is usually smooth, pink and shiny like silk. The capsule surrounding a silicone implant after 20 years is often calcified like thick egg shells or filled with scar and inflammatory tissues filled with old gel.

Silicone implants first went on the market in 1962 before the FDA required proof that all medical devices be safe and effective. 30 years later, they were banned amid misgiving about their safety. After 14 years, they were approved by the FDA despite lingering safety concerns.

A 2013 study from the Netherlands found that 69% of women who had their implants removed experienced reduction in symptoms and almost 20% experienced full recovery after explanations.

In 2001, the FDA reported that women whose ruptured breast implants leaked silicone were significantly more likely to have been diagnosed with fibromyalgia, pulmonary fibrosis and connective
tissue disease such as dermatomyositis. Fibromyalgia is thought to be an autoimmune disorder that causes wide spread pain and fatigue.

Bottom line – Silicone breast implants can be ticking time bombs.

The solution – Remove the diseased silicone implants and
diseased capsules. This is a complicated procedure with risks. En bloc surgery excises the implant and capsules as a single unit. This has the advantage of containing as much silicone gel inside the capsule as possible, avoiding spillage into the cavity. Sometimes this is not possible because of badly ruptured implants with free gel oozing out of the capsule.

The capsule can be stuck to the under surface of the skin, jeopardizing the circulation to the skin. It can also be adherent to the pectoralis muscle and ribs and remaining breast tissue. These are very long, complicated, meticulous procedures requiring large incisions in the breast fold, general anesthesia and drains. Although done as an outpatient procedure, pain pills, antibiotics and cold packs are needed post op.

The final “deflated” appearance of the breasts is usually acceptable to most patients and considered a very good tradeoff for relief of symptoms. Re augmentation with smooth saline implants or a breast lift can improve breast esthetics in women not pleased with their explant appearance.

I have known the dangers of silicone implants for 34 years and I sympathize with every woman suffering bad health from them.

Please see me for a consultation. Hopefully relief is just a procedure away.

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