Dr. Myhil - Great Britain - on breast implants and injections

[Guest guest]

" Second Generation Effects There is every reason to

expect silicone to cross the placenta into the unborn

child. The effects of this are uncertain. Prof

Shanklin has looked at a group of 190 women who had

babies before and after their implant. There were 127

pre-implant children of which 100 were in good health,

27 in fair health (minor transient problems) and none

sick. This compares to 252 post-implant children, of

which 78 were in good health 81 in fair health with 93

WHO WERE MORE SERIOUSLY ILL (compares to none in the

pre-implant group!). "

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Silicone Breast Implants and Injections

I have now been consulted by over 100 patients with

chronic ill health following silicone breast implants

or injections. Silicone leaks (so called " gel bleed " )

out of the implant where it is picked up by the

reticulo-endothelial cells and distributed widely

throughout the whole body. The government body

responsible for licensing silicone, the Medical

Devices Agency, claims that silicone is inert and does

no harm despite this gel bleed. My clinical experience

and the scientific literature suggests otherwise.

There are many problems with implants, of which the

most obvious is infection at the time of insertion.

However, the long term effects are far more malign.

This stems from the fact that silicone cannot be

broken down by any enzyme system in the body, is

engulfed by macrophages, carried to distant sites by

embolisation and there it acts as an immune adjuvant,

stimulating autoimmune disorders. This means that

these patients suffer from multisystem autoimmune

disease. In particular, clinically one sees:

mixed connective tissue disease, demyelinating

conditions such as MS autoimmune endocrinopathies,

vasculitis, myopathies,

- all of which eventually leads to a chronic fatigue

syndrome often including multiple chemical sensitivity

My clinical impression is that the silicone poisoned

patients suffer more from pain than the virally or OP

induced CFS. I have concluded from my own observations

that silicone causes a new disease unique to silicone

but resembling other diseases.

All of these cases I have reported to the MDA. None of

these cases were reported to the MDA by either their

plastic surgeon or rheumatologist or oncologist. This

simply reflects the level of gross under-reporting of

side effects.

It is well recognised that the silicone bleeds out of

the implants very readily and is widely distributed

throughout the body by the reticulo-endothelial

system. Silicone leaks out as soon as the implants are

put in. I know this because the Medical Devices

Agency, which is the government body responsible for

licensing these products, tells me so. However, where

we disagree is what happens to the silicone then. The

MDA maintains that it is inert, but actually silicone

is well recognised as being an immune adjuvant and I

suspect in susceptible individuals we get an

inflammatory reaction against the silicone which

results in multi-system disease. The Louisiana ruling

on 19.8.97 showed that Dow Corning was developing

silicone for use as an active pharmaceutical agent at

the same time as when it was being declared " inert " .

There is no known mechanism by which silicone can be

excreted from the body. Silicone leakage is

accelerated when implants rupture, of which 50% do so

by 12 years and 95% by 20 years. Most of these

ruptures are spontaneous but some follow closed

capsulotomy, road traffic accident or whatever. A

recent Lancet paper November 1997) recommends that all

implants are replaced every 8 years. Silicone leakage

can be a problem locally whereby the body throws up a

scar capsule against the implant to try to prevent the

silicone from leaking. As this scar contracts this

causes local hardening of the breast, often with pain.

Surgeons treat this by crushing the breast between

their hands (often with no anaesthetic!) to rupture

the scar capsule (this unproven, extremely painful

procedure has been sanitised by giving it a name:

closed capsulotomy). The implant may also be ruptured

by this procedure. Once ruptured, the silicone may

migrate in a lump to the axilla and brachial plexus

causing pain and blockage of lymphatics, across the

breast causing a mis- shapen breast (one patient had

to have her nipples surgically re-sited), or down the

chest wall.

Generalised effects of silicone are caused by silicone

migrating via the reticulo-endothelial system to the

rest of the body and causing inflammatory reactions

wherever silicone ends up. In the brain this causes a

multiple sclerosis-like syndrome, in the body it can

cause a range of autoimmune disorders, chronic fatigue

syndrome, chronic pain and multiple chemical

sensitivity.

Tests For Silicone Poisoning Prof Garry's lab

in the USA offers antibody testing. He measures the

anti-polymer antibody levels. However, this is

expensive and is not specific for siliconosis. So I

rarely do this test nowadays. His address is Dept of

Microbiology and Immunology, Tulane University School

of Medicine, New Orleans, LA 70112 tel 001 504 587

2027 fax 001 504 584 1994. I can arrange the test if

this is easier - I can post the kit to the patient for

the blood to be taken locally and make arrangements to

dispatch the sample to America via a courier. The cost

is œ150 for the test and œ20 for the transport.

I have just had an extract of silicone made up for

skin testing and am getting interesting results! This

test is designed to look at the body's immune response

to silicone. The extract is a very dilute solution

(1:100) which is injected intradermally to bring up a

weal of about 7 by 7mm. Ten minutes later this is

measured. A complete non-reactor would have no growth

and flattening of the weal. Reactors show a growth in

the size of the weal. A positive reaction supports the

idea that the body is reacting positively to silicone.

Again I don't know the medico-legal aspects of this

test until I have done a reasonable number including

controls (i.e people who have never been exposed to

silicone). I don't see why it should not be possible

to try a desensitisation technique called

neutralisation from the test extract.For a list of

practitioners, visit www.bsaenm.org

The most sensitive test available in this country to

assess the reaction of white cells to silicone in the

body is a lymphocyte chemical sensitivity (silicone)

test This just involves sending a blood sample to

Biolab in London. My clinical impression of tests done

so far is that the worst affected women have the

highest levels of sensitivity.

Treatment I have been in direct contact with Professor

Radford Shanklin from the States who has been most

helpful with clinical management. We had a long

meeting at the Royal Society of Medicine where I could

pick his brains. The priority is to have the silicone

removed by a surgeon skilled in explantation. However,

the problem with explantation is that it is thought to

stir up a reaction against silicone and patients often

see a worsening of their symptoms which may last up to

3 years. Prof. Shanklin tells me that reactions

against silicone are medicated by T cells and

interleukin 2. He has been trying Plaquenil 200mgs

twice daily for 90 days before surgery and believes

this damps down the T cell activity and prevents this

post operative flare. Plaquenil is a standard

immunosuppressive drug used to treat rheumatoid

arthritis and systemic lupus erythematosis. It is a

fairly benign drug and it is felt that for short term

treatment no special monitoring is required although

it is probably medically prudetn to check a white cell

count and eye test before and during treatment.

Explantation needs to be done by a skilled surgeon

aware of the need not to rupture the capsule

inadvertently. Furthermore, the scar capsule also

needs removing because it will be impregnated with

silicone. Insist on being given the implant after

surgery and don't allow the surgeon to make up an

excuse. I had one patient who was told the implant was

removed intact, but it was " scrubbed " to make it look

better and ruptured in that process, therefore it was

not available to be seen! Let's face it - you've paid

for it - it belongs to ysu!

The CFS side of things I treat in exactly the same way

as I treat all my other CFS patients with fatigue

caused by viral infection or pesticide poisoning or

whatever. Namely rest, nutritional supplements,

elimination dieting, magnesium injections where

appropriate (blood test needed), B12 injections,

avoiding chemicals, etc.

Second Generation Effects There is every reason to

expect silicone to cross the placenta into the unborn

child. The effects of this are uncertain. Prof

Shanklin has looked at a group of 190 women who had

babies before and after their implant. There were 127

pre-implant children of which 100 were in good health,

27 in fair health (minor transient problems) and none

sick. This compares to 252 post-implant children, of

which 78 were in good health 81 in fair health with 93

WHO WERE MORE SERIOUSLY ILL (compares to none in the

pre-implant group!). This experience certainly accords

with what I am seeing in my patients. However, I would

like to repeat this research in all my patients and

hope to attract some modest funds to allow me to do

this. I would do it myself if I had the time, but I

don't. I would need to employ somebody short term to

contact women. Any volunteers?