Questions to ask ps before being explanted. By Dr. Edward Melmed, MD

[lisamarie4Jesus]

Edward P, Melmed, MD

It was asked of Dr. Edward Melmed, plastic surgeon, Dallas, Texas what questions a woman should ask a doctor before being explanted. This is his response.



Saturday, April 06, 2002 9:46 PM



Subject: Re: explant - tram flap - replacement, etc



In 1968 the late Dr Jack Penn stated: " Breast augmentation is not an operation. It is a procedure whereby you make a space, implant a large foreign body, the women all have complications and they are all happy"



Well, the complication is capsular formation. and even though reports state that "94% of women are happy with their implants", even if this is true, 6% of 2 million is a large number. And in fact, a lot more are unhappy but do not complain - for many reasons including ignorance (This is how they believe it should be) guilt (Maybe I should never have had the implants) husbands like it (dumb reason but valid) etc.



We'll talk about silicone problems separately, but I have stated in print that "after 10 years, all women have alteration in shape, size, contour or feel" Most implants are ridiculously too large. After 10-15 years women have put on some weight and are 'matronly" and almost need a reduction. Breast sag. They get hard. They can't sleep on their stomachs. They don't like to be hugged tightly - and so it goes.



I am one of the few who seriously believe that a certain, albeit small, percentage of women have symptoms from silicone - memory loss, joint and muscle pains, flu like symptoms etc., etc. you all know them. And I feel that, like Gulf War Syndrome, this is an "industrial toxic" effect although I have no proof.



What do women need to know?



After 10 years, over 55% of silicone implants are ruptured. By 15 years it is 75% and by 20 years 94%. So mamograms (not too reliable) sonograms (better) or MRI (best but not 100%) should be done after 10 years.



If you go to a doctor who says "There is nothing to all this silicone nonsense" find someone else.



If a doctor has not done a lot of explantation, find one who has. Women are told that " a lot of breast tissue will have to be removed to scrape out all the leaked silicone" - that's pure BS. Most times the implants can be removed "en bloc" which means still contained in the capsule. Find a doctor who can. Also, find a doctor who will show you pictures (and lots of them) of post-explantation results, or better still have his former patients talk to you. Unless you are as thin as a rail, women can look normal after explantation. If a lift is necessary, and it sometimes is, this can be done using your own tissues. Do NOT allow an "inverted T" incision for a lift. Its barbaric, and out of date. There is a technique for breast lifting from South America by Ruth Graf which uses the fallen tissue that is replaced high up and gives wonderful results. This uses a "lolipop incision". You should never need a latissimus flap or a TRAM flap after augmentation explantation. These techniques are reserved for major breast reconstruction after cancer (and not always so either)



What are the results like after removal? Well most women not only look better albeit somewhat smaller, but they ALL say how much better they feel. Not all symptoms disappear. But they feel good. They have energy. and life is good for them again. Pity the few whose husbands/ boyfriends who worship a bag of silicone rubber and only want women with huge breasts. Women deserve better.



You have my e-mail. I shall be happy to reply to all who have questions. No matter the question, it is never stupid, trivial or insignificant.



Sincerely



Edward P, Melmed, MD

emelmed@aol.com














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My Special Thanks to Rogene for getting Dr. Edward Melmed to help with the many questions that we implanted women have. Often we have no one to give us guidance.

Thank you, Dr. Melmed, for caring.

Kathy Nye

[goldy]

This is all very uplifting and yes, nearly every boob job I see, I think the breasts are unnecessarily too big which also makes them look more unnatural. I see lovely shaped natural B cups in the before shots and think, Why on earth did that women want plastic bags and scars to blow her boobs up bigger?!!! It's sickening. I've seen flat chested women going up to unnatural looking C cups covered by just skin.
What I dream of, is men worldwide finding out about all the problems with implants, not wanting women to have fake big boobs, and launching a campaign to stop this operation. Then women will REALLY take notice...but that's in my dreams!!!

[LizS]

"After 10 years, over 55% of silicone implants are ruptured. By 15 years it is 75% and by 20 years 94%. So mamograms (not too reliable) sonograms (better) or MRI (best but not 100%) should be done after 10 years."

****Any plastic surgeon who tells women..... all the cohesive silicone gel will be contained in the capsule in the event of a rupture is either IGNORANT, STUPID OR FLAT OUT LYING.****

We all know there is seepage, leakage and diffusion of microscopic silicone droplets (especially over time as the implant ages) and capsules rupture just like the implants. Cohesive gel has been found on the outside of capsules. You cannot control outside forces like car wrecks, blunt force trauma to the chest or ruptures from mammograms. Or....there could be weak spots in the capsule and it breaks on its own.......exposing the body to a massive microscopic chemical dump. You can't just focus on the cohesive gel you can see with your eyes.

Women don't understand that their good health is hinging upon the integrity of the capsule surrounding the implant. And these twenty something year-old women getting these implants have to ask themselves.........is this something I want to expose my fetus to when I decide to have children? All experts agree that environmental toxins are contributing to the rising rates of autism and these new "cohesive gels" emit chemicals 24/7 that the body constantly has to detox. Something to think about............

[lisamarie4Jesus]

Yes, I agree with you, Goldy! I was implanted with silicone breast implants to become a full B cup! How stupid. God made me nearly perfect to begin with--although, an A cup. Now, I've been wanting to go to Dr. Feng to get nearly the same thing back for 15,000.00 or more--after the expenses of the entire trip. But I don't have $15,000.00 dollars on-hand anyhow--so still stuck with them. B cup women should never even consider getting breast implants! Mine are big enough and i want them OUT! Wish I still had my natural A cup & never went through with BA with silicone! I agree, most women look much better natural! I very much appreciated Dr. Melmed's realization that these things are hurting women, and doing something about helping women instead of suggesting re-implanting as the solution after breast implant removal.

The average ps:

"These old ruptured silicone bags sure made you sick, but I suggest you put some new ones in to make you much more sicker!"

[LizS]

Yes, the COHESIVE gel can move from a intracapsular rupture to a extracapsular rupture. Any plastic surgeon who tells you all the gel will be contained in the capsule in the event of a rupture is not telling the truth and you should NOT use this surgeon. Your cells will start to uptake these microscopic silicone gel droplets and then they will be distributed throughout your body/tissues/organs via your lymphatic system......where it becomes impossible to remove. The droplets can also start to seep through the capsule and that is why we are seeing women get sick about 7-8 years later, after the shell of the implant starts to decenergrate/degrade.

It is equally outrageous for surgeons to tell young women it is rare event to get sick from breast implants. We don't know that answer and we don't know the long term health consequences of these devices. Women are walking around with silicone gel ruptures and they don't even know it! Only MRI's can detect them and they cost upwards of $2,000.

Taken from Allergan cohesive silicone gel breast implant manual.

"Additional Information on Consequences of Rupture from Literature Since silicone implants were not available in the United States for many years but were used in Europe during that time, some information on rupture rates comes from studies conducted in Europe. Studies of Danish women evaluated with MRI involving a variety of manufacturers and implant models showed that about three-fourths of implant ruptures are intracapsular and the remaining one-fourth are extracapsular.

Additional studies of Danish women indicate that over a 2-year period, about 10% of the implants with intracapsular rupture progressed to extracapsular rupture as detected by MRI. 5 This means that for women with silicone gel rupture within the scar tissue capsule detected via MRI after 2 years, 1 in 10 of these women had PROGRESSION of the gel outside the scar tissue capsule. In about half of these cases of progression from intracapsular to extracapsular rupture, the women had experienced trauma or mammography. In the other half, no cause was given.

In the women with extracapsular rupture, after 2 years, the amount of silicone outside the scar tissue capsule increased for about 14% of these women. This means that for 100 women with silicone gel rupture outside the scar tissue capsule, the amount of gel outside the scar tissue capsule increased for 14 women 2 years later. This type of information pertains to a
AUG Patient Labeling Rev 4/6/09 page 15 variety of silicone implants from a variety of manufacturers and implant models, and it is not specific to Allergan implants."

I'm sure this has been worded in the best possible light. Needless to say, it can and does happen.