need tips on questions to ask PS

[Guest guest]

I'm new to the group. BA in 2005, diagnosed with Sjogren's in 2007 - ANA level was quite elevated, along with other auto-immune markers. Asked my Rheumatologist if there was any way my saline implants could have caused this and he said "no - only silicone." I dropped it. Symptoms seemed to get better, so I attributed it to stress with work, ailing parents, and building a home all at once. Had another flare-up a few months ago (brain fog, constant low-grade fever, knots in my neck and shoulder area, pain in hips and knees), so went back to my Rheumatologist. My ANA level was triple what it had been back then. He then diagnosed me with "Mixed Connective Tissue Disease" which is a mixture of symptoms from lupus, rheumatoid arthritis, and

poly Did some research on CTD and the Mayo Clinic's website indicated that exposure to vinyl chloride and silica were known causes of CTD. The first thing I thought of was my implants, so got busy on the internet.. This time I was able to have a more educated discussion with my Rheumatologist. (All of his text books indicated silicone implants cause this, but not saline, so I had to find literature to support that the outer lining was made of.) Aha! I found Mentor's Physician Product insert (or "packing slip") on the internet and it states it is made of "room temperature vulcanized silicone elastomer, made of polydimethylisiloxane." I looked that long word up, and of course it's a form of silicone. I was particularly worried with the care they took to say it was made of "room temperature" ingredients. WHY? Is it dangerous when greater than room temperature - as in a human body that is

98.6 degrees or higher??

Other interesting things in that Physician Product insert mentions some reports of "Connective Tissue Disease" reported by breast aug patients but that "without a comparison group of women with similar characteristics (age, race, etc.) and without breast implants, no conclusions can be made about the relationship between breast implants and these CTD events." What a crock of bull!

I gave my physician that information, along with reference to THIS SUPPORT GROUP, and I've earned a believer! My Rheumatologist now does believe my implants are the cause - due to the time of my onset of symptoms and the fact that I have no family history of CTD.. (I had already determined that, and was going to remove them without his advice, but it was SO important to me for him to connect the two so he might consider this for his other patients.) My Rheumatologist did more than just read my info - he did more research on his own and shared with me an article published in 2004, "Decision and Management Algorithms to Address Patient and FDA Concerns Regarding Breast Augmentation and Implants." It states that if a board-certified Rheumatologist and/or Immunologist thinks the CTD symptoms may be associated with the implants, they should be removed and that the capsules should also be removed to afford the best

opportunity to improve or eliminate symptoms if they are due to silicone.

I have appointments scheduled with my original plastic surgeon in a few days, and then my Rheumatologist 2 days later. My plastic surgeon is well-respected, so I am hoping my visit with him goes smoothly and that he will respect my wishes and do the explant himself. I will not lay blame - I just want them OUT. It is important to me that HE do the explant, because he is the only plastic surgeon who practices at the hospital where I work. I implanted at a surgery center in a nearby town for privacy, but now I am adamant I want to do the explant at my facility, because I want people I trust in the operating room during my procedure - to make SURE I am getting a proper capsulectomy with drains. This is very important to me. I am humiliated knowing what I looked like before the implants and that people I see every day at work will see what my chest will look like - even worse than before, but I

feel it is important to swallow my pride to re-claim my health.

Sorry so lengthy - I hope to help new-comers, as you all have been such a help to me in making my decision and my support in knowing I was not crazy. You gave me strength to challenge my physician into looking into this further. I suspected this 2 years ago, and had I done more research on the internet back then, I would have explanted 2 years ago.

Now, for my questions:

What questions do I need to ask my plastic surgeon? (I will see him on 9/30/09).

For those of you who had explants: How long should I expect to be out of work?

And: If anyone was a flat-chested "A" cup - how bad is it going to look afterwards? I have no scars now (my implants were inserted via the areola). I picture myself with a scar below my breast - only now a scar below a sagging piece of skin. Is that accurate?