Guest guest Posted September 10, 2001 Report Share Posted September 10, 2001 , I will thinking of you and I will keep my fingers crossed for you. I too want to have PS done. But scared to even go to an appt. The pictures I have seen make my stomach turn. However, they look lovely when it is all said and done with. I don't think I have the courage... =(. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 10, 2001 Report Share Posted September 10, 2001 , I have to agree with you. I just know my insurance will not pay for it.. Nor will my physician ever agree with it. I have spoken to her once about PS she said if she could it she would, but they will not help out the pt in any way of getting approval for this. My stomach is hanging at my pelvic area also and I have ozzing gunk from my belly button. It is very painful at times. I have been thinking about trying to contact Dr Maxwell and doing the lower body lift instead of just the tummy tuck. I think that would lift my thighs also.. I would also like to have something done to my breast.. not quite sure what though. My breast size is fine, but they do hang and have no fullness to them. I dont like the extra flap that is on the side of my body that is under my arms. it doesn't hang or look bad.. I have to pull it into my bar to help with the fullness.. I have no idea what I am trying to say.. if i dont have a bra on.. i look fine on the sides.. but if i do have one on it has to be a little wide thoug h there to control the exta skin or fat that is there. I have been wearing a two piece and I really have to work the bra for it to look right. The bottoms come up over my belly button and doesn't look bad. But as always, things could always look better. I use to worry about my arms and the horrible streach marks that I have that sag now at my arm pits and look wrinkly. Even if I did have my arms done it would not fix that problem. So the arms will have to stay. I don't want a thigh lift either, if I have anything done it will be the lower body lift. I have really have looked into this and I know what I want, just very scared to do it. I hope my rambling and thoughts make some sense. chris Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 10, 2001 Report Share Posted September 10, 2001 I wish you the best of luck. =) Chris Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 10, 2001 Report Share Posted September 10, 2001 , The pictures don't do much for me either but the results are usually terrific. I know there will be pain involved but I figure I can stand anything for a couple of weeks. Also, the thought of living with this hanging skin I think is worse! Re: Plastic surgeon , I will thinking of you and I will keep my fingers crossed for you. I too want to have PS done. But scared to even go to an appt. The pictures I have seen make my stomach turn. However, they look lovely when it is all said and done with. I don't think I have the courage... =(. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 10, 2001 Report Share Posted September 10, 2001 Good luck with whatever you decide - I am hoping for a breast lift, brachioplasty (arms), lower body lift (front and rear hopefully) and thigh lift but we will see ------ RE: Plastic surgeon , I have to agree with you. I just know my insurance will not pay for it.. Nor will my physician ever agree with it. I have spoken to her once about PS she said if she could it she would, but they will not help out the pt in any way of getting approval for this. My stomach is hanging at my pelvic area also and I have ozzing gunk from my belly button. It is very painful at times. I have been thinking about trying to contact Dr Maxwell and doing the lower body lift instead of just the tummy tuck. I think that would lift my thighs also.. I would also like to have something done to my breast.. not quite sure what though. My breast size is fine, but they do hang and have no fullness to them. I dont like the extra flap that is on the side of my body that is under my arms. it doesn't hang or look bad.. I have to pull it into my bar to help with the fullness.. I have no idea what I am trying to say.. if i dont have a bra on.. i look fine on the sides.. but if i do have one on it has to be a little wide thoug h there to control the exta skin or fat that is there. I have been wearing a two piece and I really have to work the bra for it to look right. The bottoms come up over my belly button and doesn't look bad. But as always, things could always look better. I use to worry about my arms and the horrible streach marks that I have that sag now at my arm pits and look wrinkly. Even if I did have my arms done it would not fix that problem. So the arms will have to stay. I don't want a thigh lift either, if I have anything done it will be the lower body lift. I have really have looked into this and I know what I want, just very scared to do it. I hope my rambling and thoughts make some sense. chris Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 10, 2001 Report Share Posted September 10, 2001 Hi Good luck at your appointment. I have a consultation appointment this Friday for a tummy tuck and maybe a thigh lift. My PCP is behind it 100% and gave me a referral to the plastic surgeon. My insurance is Aetna/US Healthcare. I figured it was time to get the insurance process started, too. We'll see if they approve. I'll keep you posted. See you at the picnic! Hugs, Bern TX MGB 7/24/00 248/158 > I finally broke down and did it ---- I made a consultation appointment > with a plastic surgeon (even though they told me on the phone they have > never had CIGNA HMO approve the surgeries). I figure I have to start > the process somewhere. If they deny the surgeries I guess I will just > have to keep all this skin unless I win the lottery! My appointment is > on the 24th so wish me luck! > > in GA > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 10, 2001 Report Share Posted September 10, 2001 , I hate all the extra skin hanging around...... Are you thinking of having PS? Chris Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 10, 2001 Report Share Posted September 10, 2001 , Good luck with your consultation. I had a tummy tuck with liposuction of the hips in May. I am soooo glad I did it. My body image psyche got a big boost! I still can't believe it sometimes, there is no belly to grab anymore, or hang down under my hi cut briefs! Not to mention what a joy it is to try on clothes. It was worth every penny. I am going to have a thigh lift within the next year if I can swing it. Karin Eby > I finally broke down and did it ---- I made a consultation appointment > with a plastic surgeon Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 10, 2001 Report Share Posted September 10, 2001 >good luck julie > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 10, 2001 Report Share Posted September 10, 2001 Hey julie! i have an appt on the 26th....we can swap notes at the picnic! cathy s in va > I finally broke down and did it ---- I made a consultation appointment > with a plastic surgeon (even though they told me on the phone they have > never had CIGNA HMO approve the surgeries). I figure I have to start > the process somewhere. If they deny the surgeries I guess I will just > have to keep all this skin unless I win the lottery! My appointment is > on the 24th so wish me luck! > > in GA > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 10, 2001 Report Share Posted September 10, 2001 I don't mean to continue to harp on my age, but I will certainly be seeking the skills of a plastic surgeon. I'm not going to go around for the next few decades with these granny flaps I call arms. My thighs bother me a lot too. And my FAT BACK. Even though our fertility specialist doesn't put much stock in me becoming pregnant by my husband, I am still holding out and hoping for my miracle. So I'm going to wait to have the boobs and tummy done. manda > , > > I hate all the extra skin hanging around...... Are you thinking of having PS? > > Chris > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 11, 2001 Report Share Posted September 11, 2001 shannon, I too have BC/BS and hoping they will pay for this. But I don't have my hope up to high. I did speak to my hubby last night about taking about a second home owners loan. I have heard many good things about Dr Maxwell in TN and thinking of going there just to do a consult and seeing if he is willing to do the PS on me. I have also thought about going to Coasta Ricia that too is a thought in my life right now. I know I want to have the tummy done with out a doubt. but my arms will have to stay as they are. and my thighs are horrible.. but if I cant get a full lower body lift without them cutting on my legs, then they will have to stay also.. At least that is what I am thinking as of now. Maybe we should become a team and look into this together and see what the options are... Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 11, 2001 Report Share Posted September 11, 2001 , My mother and cousin have used the same PS in Tuscaloosa for a breast reduction. I saw him as a teenager when I had skin peels done. He was a very nice Dr with a great staff. I'll have to try to remember his name:) manda > > > I am not sure, there is a wonderfully talented PS here in town and if my > BC/BS will pay for it I may have it done over the summer when I am off > work (I am a teacher). I am really thinking about it. My breasts, my > underarms, and thighs all need major tightening...My face and neck seems > to have melted into the rest of my body LOL!!! I do not have > documentation for PS yet, but as I lose more maybe the flaps and floppy > skin (how attractive this all sounds!!!) may cause some irritation. I do > have some moles I am going to have removed soon (when it gets colder). I > was wearing my hubby's pants (I guess I am wearing the pants in the > family now LOL!!!) earlier because all of mine are huge on me!!! His > were a little big as well, but not falling off like mine... > > B. Boyd > ________________________________________________________________ > GET INTERNET ACCESS FROM JUNO! > Juno offers FREE or PREMIUM Internet access for less! > Join Juno today! For your FREE software, visit: > http://dl.www.juno.com/get/tagj. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 11, 2001 Report Share Posted September 11, 2001 You sound like you are describing my skin!!! LOL!! I have that droopy hanging flesh, no irritations yet, but I really need to get it tucked or velcroed away!!! I look like a flying squirrel with all this extra skin. B. Boyd ________________________________________________________________ GET INTERNET ACCESS FROM JUNO! Juno offers FREE or PREMIUM Internet access for less! Join Juno today! For your FREE software, visit: http://dl.www.juno.com/get/tagj. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 11, 2001 Report Share Posted September 11, 2001 I am not sure, there is a wonderfully talented PS here in town and if my BC/BS will pay for it I may have it done over the summer when I am off work (I am a teacher). I am really thinking about it. My breasts, my underarms, and thighs all need major tightening...My face and neck seems to have melted into the rest of my body LOL!!! I do not have documentation for PS yet, but as I lose more maybe the flaps and floppy skin (how attractive this all sounds!!!) may cause some irritation. I do have some moles I am going to have removed soon (when it gets colder). I was wearing my hubby's pants (I guess I am wearing the pants in the family now LOL!!!) earlier because all of mine are huge on me!!! His were a little big as well, but not falling off like mine... B. Boyd ________________________________________________________________ GET INTERNET ACCESS FROM JUNO! Juno offers FREE or PREMIUM Internet access for less! Join Juno today! For your FREE software, visit: http://dl.www.juno.com/get/tagj. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 12, 2001 Report Share Posted September 12, 2001 , Sounds good to me. I am just thinking about it all right now..I am flabby, but if exercise works I will try it first. BC/BS will pay if there are health concerns documented (I have heard). I still am not to that point. I am still about 50 lbs from my goal. I saw my son's kindergarten teacher today (from last year) and she made me feel so good!! She told me that she almost did not recognize me, she told me that I looked like I have lost all my weight... I wish!! It sure made my day...Especially after today!! Where do you live? What about Costa Rica? Is it inexpensive and are the surgeons good? On Tue, 11 Sep 2001 09:31:04 EDT lolipop32@... writes: > shannon, > > I too have BC/BS and hoping they will pay for this. But I don't > have my hope up to high. I did speak to my hubby last night about > taking about a second home owners loan. I have heard many good > things about > Dr Maxwell in TN and thinking of going there just to do a consult > and seeing if he is willing to do the PS on me. I have also thought > about going to Coasta Ricia that too is a thought in my life right > now. I know I want to have the tummy done with out a doubt. but my > arms will have to stay as they are. and my thighs are horrible.. > but if I cant get a full lower body lift without them cutting on my > legs, then they will have to stay also.. At least that is what I am > thinking as of now. > Maybe we should become a team and look into this together and see > what the options are... > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 30, 2003 Report Share Posted June 30, 2003 SUSAN dO YOU MIND ME ASKING WHOM YOUR INSURANCE COMPANY IS AND HOW DIFFICULT YOUR APPROVAL WAS TO OBTAIN. CHRISTY IN NC DR R 2/26/01 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 2, 2003 Report Share Posted July 2, 2003 Christy, I just replied to someone on here about how I got insurance approval for plastic surgery, so if you look back you will see that. If you don't see it, write me personally and I will share all of that with you. My insurance company is very small.....it's Gateway Health Alliance. It is a PPO plan through Dan River, Inc, where my husband is an electrician. They approved and reimbursed me for the MGB with Dr. R also back in 2001. I have found that one thing that helps is to get someone on the inside to listen to you and get them on your side. Then call them directly everytime you need to speak to someone. I talked to the same lady for the PS that I talked to and dealt with for the MGB. She did remember me! It does help! Thanks, Custer from VA Re: Plastic Surgeon > SUSAN > dO YOU MIND ME ASKING WHOM YOUR INSURANCE COMPANY IS AND HOW DIFFICULT YOUR > APPROVAL WAS TO OBTAIN. > > CHRISTY IN NC > DR R 2/26/01 > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 18, 2003 Report Share Posted July 18, 2003 I have been able to find your information on the surgery. If you don't mind please send me any info you have. Thanks Christy in NC Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 22, 2004 Report Share Posted January 22, 2004 Hi! This is Kennedy and the surgeon you are asking about is Ted Lockwood. Here is his info: Ted Lockwood, MD 10600 Quivira Road, $470 Overland Park, Kansas 913-894-1070 www.tedlockwood.com He is awesome! Have a great day. Smiles ~ Kennedy in KC Dr. Hargroder/Joplin 05-06-03 311/213 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 15, 2006 Report Share Posted May 15, 2006 Margie, The ps is speaking the truth. It is standard practice amongst most plastic surgeons to remove only the implants. What we are saying on our group is that for any woman who is sick, the scar capsule needs to come out too, and only a handful of plastic surgeons realize this. It is a sad state for women to be in when the doctors who are responsible for the problem in the first place can't even be intelligent enough about the proper removal to be able to help us. That is why it is so important to choose a good plastic surgeon when undergoing explant. That is why we have a list, and why we are always searching for more good plastic surgeons to add to it. I thank God for the few men and women we do have on there that we can count on to do a good job of explanting us so we can get better. I would really love to see some government agency or oversight committe with clout approach the plastic surgeon societies, or all the plastic surgeons who under the umbrella of the plastic surgery field, with a demand that they learn to do a proper explant for the welfare of women with implants. Somebody needs to make them do their job right! Your plastic surgeons' response just proves that he doesn't understand the seriousness of the risk he placed upon you when he inserted your implants or when he removed them. He is trying to pass off the problem onto other doctors, which of course, if you have an immune system issue, needs to be addressed by other doctors. But he should be aware of the dangers that are evident with implants. They are listed in every insert. Patty majolicajones <margiehoran@...> wrote: Hi everyone, I finally talked with the ps that explanted me last Aprilwithout the capsules removed. He said it was standard practice toremove only the implants. I would like to know how many ps said thisto other woman in the group. I continued to tell him that I have beenreal sick,he just kept saying that saline cant make me sick! Howeverat the end of the conversation he asked if i had saw a rhemmatoid doc,I thought that was strange if I can't be sick! Also, I had mentionedthat i have had many strange things on my mammagrams and he just saidto go to breast doctor to get a biopsy. Again, if this can't berelated to the implants, then why did he say that too? Get amazing travel prices for air and hotel in one click on FareChase Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 15, 2006 Report Share Posted May 15, 2006 Since the mid 80's at least ... the myth that the capsule would melt away or 'resolve' has been proven to be untrue ... This is an important piece to share with your doctor ... Anyone who is going to be explanted ~ please read and pass on to your doctor! Residual Capsule and Intercapsular Debris As Long Term Risk Factors Contamination of the space between the capsule and the implants by micro-organisms, silicone oils, degradation products and gel impurities constitutes a major problem which potentiates the risk of implants. Such problems include inflammation, infection, deposition of mineral debris, as well as certain auto-immune phenomena. These problems can be present when implants are in situ (in the body) and are often attributable to the implant. The logical expectation is that, upon removal of the implants, adverse effects will cease. This is an unjustifiably optimistic view. It is well documented from case histories that removal and or replacement of implants without exhaustive debridement of the prosthetic site leads to failure and post surgical complications. Plastic surgery procedures tend to favor speed and immediate cosmetic results. For these reasons, leaving or „reusing¾ tissue from an existing capsule may seem more „gratifying¾. However, adverse effects resulting from the practice are widespread but have not been well documented. Typically, patients who require removal of faulty implants and undergo immediate re-implantation in the same prosthetic site habitually relapse with the same problem which motivated the previous surgery; the most common example is exchange of implants and/or sectorizing or bisecting the capsule without removing it completely. Such patients rarely achieve a significant capsular correction and habitually return for more similar surgery. A more illustrative situation is that where patients do not receive replacement implants. They form the basis of knowledge for evaluating the risks that arise from remaining capsules. An example is described in a paper published in 1993 (Copeland, M., Kessel, A., Spiera, H., Hermann, G., Bleiweiss, I. J.; Systemic Inflammatory Disorder Related To Fibrous Breast Capsules After Silicone Implant Removal; Plastic and Reconstructive Surgery: 92 (6), 1179- 1181, 1993): reported problems derived primarily from immune phenomena and inflammatory syndromes with pain, swelling, serologic abnormaladies and alarming radiologic presentation. Numerous similar cases have been noted amongst implant patients but have not been the object of publications. Some are cited in FDA Reaction Reports. Others appear in the U.S. Pharmacopoeia Reporting Programs. A residual capsule is not a stable entity. It may collapse upon completion of surgery and remain asymptomatic for some time, however, it will fill with extracellular fluid and remain as a fluid-filled space with added blood and prosthetic debris. As the wall matures and the breast remodels to accommodate the loss of the prostheses, the capsular tissue shrinks. Water as well as electrolytes are expelled gradually from the pocket or else the mixture is concentrated from leakage of water from the semi-permeable capsular membrane wall. In most cases, calcium salts precipitate during that stage and may render the capsule visible as a radiodense and speckled zone in radiographic projections. Prosthetic debris is also radiodense and may be imaged to further complicate the presentation. The average size of the residual capsules after 6-12 months is in the 2-7 cm range: most are compact, comparatively small and dense. Surgical removal should present no difficulty for most patients if adequate radiographic information is available. Later stages of maturation include the thickening of the capsule wall, sometimes reaching 0.5-1cm. Compression of the debris into a cluster of nodules which actually become calcified follows for some patients. A few mimic malignancies. Others appear as small „prostheses¾ during mammographic studies. They are alarming to onocologists and are habitually signalled for further studies or biopsies by oncologic radiologists. In light of the present knowledge and considering the probable content of the residual closed capsules, an open or needle biopsy is not advisable. The risks of releasing significant amounts of hazardous contamination and possibly spreading infective entities outweighs the advantage of the diagnostic. At any rate, such a capsule requires removal for mitigation of symptoms and a more direct surgical approach appears more economical and less risky. In summary, a capsule with a dense fibro-collagenous wall behaves as a bioreactor. Worse yet, it is fitted with a semi-permeable wall that may periodically open to release its content to the breast. The probability of finding the space colonized with atypical microorganisms is elevated and the control of infective processes by classic pharmacologic approaches is difficult if not impossible. Such closed capsular spaces may be comparable to „artificial organs¾ of unpredictable functions. Their behavior will depend on the content and the age of the structure, its maturity and the history of the patient. There is a high probability that these capsules will continue to evolve for many years, adding more layers of fibro-collagenous tissue and possibly granulomatous material. If bacterial entities are present within the capsule space, they can culminate in large breast abscesses with will resist conservative treatments. Even with less active capsules containing mostly oily and calcitic debris, the thickening of the wall leads eventually to solid „tumor- like structures¾ and are, by themselves, alarming on auscultation and self examination. At best, such structures are unique environments for protein denaturation and aberrant biochemical reactions with unknown long term consequences. Pierre Blais, PhD Innoval 496 Westminster Ave. Ottawa, Ontario Canada KeA 2V1 613. 728-8688 613. 728-0687 Fax Pierre Blais, PhD received his undergraduate and graduate degrees in physical-organic polymer chemistry from McGill University in Montreal, Canada, and a Post-doctorate Fellowship in biomaterials engineering at Case Western University in Cleveland, Ohio. In 1976 he became one of the first scientists to join the medical devices and radiological health program of the Department of Health and Welfare in Canada. He left the department in 1989 as Senior Scientific Advisor and formed Innoval Consultants, a firm engaged in the design, testing and failure analysis of high risk medical systems. He has authored over 250 publications on medical materials and their interactions with living tissues. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 15, 2006 Report Share Posted May 15, 2006 Margie, Most plastic surgeons make a quick buck just tearing out the implant and letting all the bacteria just stay in your body. I have been here short time and seen this too much. Also, I have got 2 lumps on my left breast and my PS acted like once again all my 33 symptoms don't have anything to do with the implants. Even though I have only had them a little over a year. I was well when he put them in or he would not have given me implants???? So figure that out. Perfect and healthy then implants now one year and 4 months later with 33 symptoms in all so far. Thank God I get these DAMN toxic implants and the capsules removed next week I have 8 days left. It's like counting down to Christmas Day!!! I get a present I have needed for so long now. I have 8 days until my worst nightmare will be over, then probably years to regain what they screwed up, go figure Margie these Dr's Lie and they need to grow a heart and get a clue. Donna Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 15, 2006 Report Share Posted May 15, 2006 You know what I fear? That alleged plastic surgeons like the idiot Robtold he Oliver on Wikopedia won't pay any attention to this. They write off people like Dr. Blais as being bought by plaintiff's attorneys. I have seen what this idiot has written on his blog, and tried to on Wikopedia (I successfully stopped him) and it is frightening -- he tells people that implants are safe and any suggestion to the contrary is just part of the " Tort " conspiracy. One woman wrote in on a student medical blog, and asked if silicone implants might be dangerous. Rob Oliver (I refuse to call him Dr.) essentially told her that silicone implants are not at all dangerous, and the FDA decision was just political, and a result of fivolous lawsuits. And, he is complaining about me all over the internet. It is pretty funny. But he is very full of himself, and from what I can tell of where he went to med school (Podunk U), he has no reason for such arrogance. But isn't that usually the case? I utterly detest that man. I suspect he is one of many many just like him. > > Since the mid 80's at least ... the myth that the capsule would melt > away or 'resolve' has been proven to be untrue ... > > This is an important piece to share with your doctor ... > > Anyone who is going to be explanted ~ please read and pass on to > your doctor! > > > Residual Capsule and Intercapsular Debris As Long Term Risk > Factors > > > Contamination of the space between the capsule and the implants > by > micro-organisms, silicone oils, degradation products and gel > impurities > constitutes a major problem which potentiates the risk of implants. > Such > problems include inflammation, infection, deposition of mineral > debris, as > well as certain auto-immune phenomena. These problems can be > present when > implants are in situ (in the body) and are often attributable to the > implant. The logical expectation is that, upon removal of the > implants, > adverse effects will cease. This is an unjustifiably optimistic > view. It > is well documented from case histories that removal and or > replacement of > implants without exhaustive debridement of the prosthetic site leads > to > failure and post surgical complications. > > > Plastic surgery procedures tend to favor speed and immediate > cosmetic > results. For these reasons, leaving or „reusing¾ tissue from an > existing > capsule may seem more „gratifying¾. However, adverse effects > resulting > from the practice are widespread but have not been well documented. > Typically, patients who require removal of faulty implants and > undergo > immediate re-implantation in the same prosthetic site habitually > relapse > with the same problem which motivated the previous surgery; the > most > common example is exchange of implants and/or sectorizing or > bisecting the > capsule without removing it completely. > > > Such patients rarely achieve a significant capsular correction > and > habitually return for more similar surgery. A more illustrative > situation > is that where patients do not receive replacement implants. They > form the > basis of knowledge for evaluating the risks that arise from > remaining > capsules. An example is described in a paper published in 1993 > (Copeland, > M., Kessel, A., Spiera, H., Hermann, G., Bleiweiss, I. J.; Systemic > Inflammatory Disorder Related To Fibrous Breast Capsules After > Silicone > Implant Removal; Plastic and Reconstructive Surgery: 92 (6), 1179- > 1181, > 1993): reported problems derived primarily from immune phenomena > and > inflammatory syndromes with pain, swelling, serologic abnormaladies > and > alarming radiologic presentation. > > > Numerous similar cases have been noted amongst implant patients > but > have not been the object of publications. Some are cited in FDA > Reaction > Reports. Others appear in the U.S. Pharmacopoeia Reporting > Programs. > > > A residual capsule is not a stable entity. It may collapse upon > completion of surgery and remain asymptomatic for some time, > however, it > will fill with extracellular fluid and remain as a fluid-filled > space with > added blood and prosthetic debris. As the wall matures and the > breast > remodels to accommodate the loss of the prostheses, the capsular > tissue > shrinks. Water as well as electrolytes are expelled gradually from > the > pocket or else the mixture is concentrated from leakage of water > from the > semi-permeable capsular membrane wall. In most cases, calcium salts > precipitate during that stage and may render the capsule visible as > a > radiodense and speckled zone in radiographic projections. > Prosthetic > debris is also radiodense and may be imaged to further complicate > the > presentation. The average size of the residual capsules after 6-12 > months > is in the 2-7 cm range: most are compact, comparatively small and > dense. > Surgical removal should present no difficulty for most patients if > adequate radiographic information is available. > > > Later stages of maturation include the thickening of the capsule > wall, > sometimes reaching 0.5-1cm. Compression of the debris into a > cluster of > nodules which actually become calcified follows for some patients. > A few > mimic malignancies. Others appear as small „prostheses¾ during > mammographic studies. They are alarming to onocologists and are > habitually signalled for further studies or biopsies by oncologic > radiologists. > > > In light of the present knowledge and considering the probable > content > of the residual closed capsules, an open or needle biopsy is not > advisable. The risks of releasing significant amounts of hazardous > contamination and possibly spreading infective entities outweighs > the > advantage of the diagnostic. At any rate, such a capsule requires > removal > for mitigation of symptoms and a more direct surgical approach > appears > more economical and less risky. > > > In summary, a capsule with a dense fibro-collagenous wall > behaves as a > bioreactor. Worse yet, it is fitted with a semi-permeable wall that > may > periodically open to release its content to the breast. The > probability > of finding the space colonized with atypical microorganisms is > elevated > and the control of infective processes by classic pharmacologic > approaches > is difficult if not impossible. > > > Such closed capsular spaces may be comparable to „artificial > organs¾ of > unpredictable functions. Their behavior will depend on the content > and > the age of the structure, its maturity and the history of the > patient. > There is a high probability that these capsules will continue to > evolve > for many years, adding more layers of fibro-collagenous tissue and > possibly granulomatous material. If bacterial entities are present > within > the capsule space, they can culminate in large breast abscesses with > will > resist conservative treatments. > > > Even with less active capsules containing mostly oily and > calcitic > debris, the thickening of the wall leads eventually to solid „tumor- > like > structures¾ and are, by themselves, alarming on auscultation and > self > examination. At best, such structures are unique environments for > protein > denaturation and aberrant biochemical reactions with unknown long > term > consequences. > > > Pierre Blais, PhD > Innoval > 496 Westminster Ave. > Ottawa, Ontario > Canada KeA 2V1 > 613. 728-8688 > 613. 728-0687 Fax > > > Pierre Blais, PhD received his undergraduate and graduate degrees in > physical-organic polymer chemistry from McGill University in > Montreal, > Canada, and a Post-doctorate Fellowship in biomaterials engineering > at > Case Western University in Cleveland, Ohio. In 1976 he became one > of the > first scientists to join the medical devices and radiological health > program of the Department of Health and Welfare in Canada. He left > the > department in 1989 as Senior Scientific Advisor and formed Innoval > Consultants, a firm engaged in the design, testing and failure > analysis of > high risk medical systems. He has authored over 250 publications on > medical materials and their interactions with living tissues. > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 15, 2006 Report Share Posted May 15, 2006 You know what I fear? That alleged plastic surgeons like the idiot Robtold he Oliver on Wikopedia won't pay any attention to this. They write off people like Dr. Blais as being bought by plaintiff's attorneys. I have seen what this idiot has written on his blog, and tried to on Wikopedia (I successfully stopped him) and it is frightening -- he tells people that implants are safe and any suggestion to the contrary is just part of the " Tort " conspiracy. One woman wrote in on a student medical blog, and asked if silicone implants might be dangerous. Rob Oliver (I refuse to call him Dr.) essentially told her that silicone implants are not at all dangerous, and the FDA decision was just political, and a result of fivolous lawsuits. And, he is complaining about me all over the internet. It is pretty funny. But he is very full of himself, and from what I can tell of where he went to med school (Podunk U), he has no reason for such arrogance. But isn't that usually the case? I utterly detest that man. I suspect he is one of many many just like him. > > Since the mid 80's at least ... the myth that the capsule would melt > away or 'resolve' has been proven to be untrue ... > > This is an important piece to share with your doctor ... > > Anyone who is going to be explanted ~ please read and pass on to > your doctor! > > > Residual Capsule and Intercapsular Debris As Long Term Risk > Factors > > > Contamination of the space between the capsule and the implants > by > micro-organisms, silicone oils, degradation products and gel > impurities > constitutes a major problem which potentiates the risk of implants. > Such > problems include inflammation, infection, deposition of mineral > debris, as > well as certain auto-immune phenomena. These problems can be > present when > implants are in situ (in the body) and are often attributable to the > implant. The logical expectation is that, upon removal of the > implants, > adverse effects will cease. This is an unjustifiably optimistic > view. It > is well documented from case histories that removal and or > replacement of > implants without exhaustive debridement of the prosthetic site leads > to > failure and post surgical complications. > > > Plastic surgery procedures tend to favor speed and immediate > cosmetic > results. For these reasons, leaving or „reusing¾ tissue from an > existing > capsule may seem more „gratifying¾. However, adverse effects > resulting > from the practice are widespread but have not been well documented. > Typically, patients who require removal of faulty implants and > undergo > immediate re-implantation in the same prosthetic site habitually > relapse > with the same problem which motivated the previous surgery; the > most > common example is exchange of implants and/or sectorizing or > bisecting the > capsule without removing it completely. > > > Such patients rarely achieve a significant capsular correction > and > habitually return for more similar surgery. A more illustrative > situation > is that where patients do not receive replacement implants. They > form the > basis of knowledge for evaluating the risks that arise from > remaining > capsules. An example is described in a paper published in 1993 > (Copeland, > M., Kessel, A., Spiera, H., Hermann, G., Bleiweiss, I. J.; Systemic > Inflammatory Disorder Related To Fibrous Breast Capsules After > Silicone > Implant Removal; Plastic and Reconstructive Surgery: 92 (6), 1179- > 1181, > 1993): reported problems derived primarily from immune phenomena > and > inflammatory syndromes with pain, swelling, serologic abnormaladies > and > alarming radiologic presentation. > > > Numerous similar cases have been noted amongst implant patients > but > have not been the object of publications. Some are cited in FDA > Reaction > Reports. Others appear in the U.S. Pharmacopoeia Reporting > Programs. > > > A residual capsule is not a stable entity. It may collapse upon > completion of surgery and remain asymptomatic for some time, > however, it > will fill with extracellular fluid and remain as a fluid-filled > space with > added blood and prosthetic debris. As the wall matures and the > breast > remodels to accommodate the loss of the prostheses, the capsular > tissue > shrinks. Water as well as electrolytes are expelled gradually from > the > pocket or else the mixture is concentrated from leakage of water > from the > semi-permeable capsular membrane wall. In most cases, calcium salts > precipitate during that stage and may render the capsule visible as > a > radiodense and speckled zone in radiographic projections. > Prosthetic > debris is also radiodense and may be imaged to further complicate > the > presentation. The average size of the residual capsules after 6-12 > months > is in the 2-7 cm range: most are compact, comparatively small and > dense. > Surgical removal should present no difficulty for most patients if > adequate radiographic information is available. > > > Later stages of maturation include the thickening of the capsule > wall, > sometimes reaching 0.5-1cm. Compression of the debris into a > cluster of > nodules which actually become calcified follows for some patients. > A few > mimic malignancies. Others appear as small „prostheses¾ during > mammographic studies. They are alarming to onocologists and are > habitually signalled for further studies or biopsies by oncologic > radiologists. > > > In light of the present knowledge and considering the probable > content > of the residual closed capsules, an open or needle biopsy is not > advisable. The risks of releasing significant amounts of hazardous > contamination and possibly spreading infective entities outweighs > the > advantage of the diagnostic. At any rate, such a capsule requires > removal > for mitigation of symptoms and a more direct surgical approach > appears > more economical and less risky. > > > In summary, a capsule with a dense fibro-collagenous wall > behaves as a > bioreactor. Worse yet, it is fitted with a semi-permeable wall that > may > periodically open to release its content to the breast. The > probability > of finding the space colonized with atypical microorganisms is > elevated > and the control of infective processes by classic pharmacologic > approaches > is difficult if not impossible. > > > Such closed capsular spaces may be comparable to „artificial > organs¾ of > unpredictable functions. Their behavior will depend on the content > and > the age of the structure, its maturity and the history of the > patient. > There is a high probability that these capsules will continue to > evolve > for many years, adding more layers of fibro-collagenous tissue and > possibly granulomatous material. If bacterial entities are present > within > the capsule space, they can culminate in large breast abscesses with > will > resist conservative treatments. > > > Even with less active capsules containing mostly oily and > calcitic > debris, the thickening of the wall leads eventually to solid „tumor- > like > structures¾ and are, by themselves, alarming on auscultation and > self > examination. At best, such structures are unique environments for > protein > denaturation and aberrant biochemical reactions with unknown long > term > consequences. > > > Pierre Blais, PhD > Innoval > 496 Westminster Ave. > Ottawa, Ontario > Canada KeA 2V1 > 613. 728-8688 > 613. 728-0687 Fax > > > Pierre Blais, PhD received his undergraduate and graduate degrees in > physical-organic polymer chemistry from McGill University in > Montreal, > Canada, and a Post-doctorate Fellowship in biomaterials engineering > at > Case Western University in Cleveland, Ohio. In 1976 he became one > of the > first scientists to join the medical devices and radiological health > program of the Department of Health and Welfare in Canada. He left > the > department in 1989 as Senior Scientific Advisor and formed Innoval > Consultants, a firm engaged in the design, testing and failure > analysis of > high risk medical systems. He has authored over 250 publications on > medical materials and their interactions with living tissues. > Quote Link to comment Share on other sites More sharing options...
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