Should I go back & have my capsules removed?

[Guest guest]

long story short I got salines Jan 30, 2004 & w/2wks started having

every symptom finally after 6 months, I decided to get them removed &

I went back to my original PS to have them removed but I left in my

capsules because I thought since they were only in 6 months I would be

okay, its been since Aug 2004 since my explant & I am getting better

slowly but surely, w/water, fruits/veggies, supplements etc but

everytime I hear to have the capsules removed no matter what, I get

worried & fear sets in that I made the wrong choice to keep the

capsules in......although my PS did say my capsules were very thin &

transparent..........?

Thanks

Jen

[Guest guest]

Jen,

It's always best to remove the capsules, but getting

most doctors to do it is something else.

Since you've already been through the surgery, (if it

was me) I would continue working on getting healthy.

If you reach a point where you feel you aren't getting

anywhere, or you start getting sicker, I would

consider having the capsules removed.

I know that's not what you want to hear, but I want to

be honest.

This is what Dr. Blais has to say . . . Dr. Blais has

examines thousands of implants and capsules every

year. He's considered the authority!

==========================

" 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

" reusing " tissue

from an existing capsule may seem more " gratifying "

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 theobject of publications. Some are

cited in FDA

Reaction Reports. Others appear in theU.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 " prostheses " 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 micro-

organisms 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 organs "

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 structures " 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. "

--- cnjcramer <cnjcramer@...> wrote:

>

> long story short I got salines Jan 30, 2004 & w/2wks

> started having

> every symptom finally after 6 months, I decided to

> get them removed &

> I went back to my original PS to have them removed

> but I left in my

> capsules because I thought since they were only in 6

> months I would be

> okay, its been since Aug 2004 since my explant & I

> am getting better

> slowly but surely, w/water, fruits/veggies,

> supplements etc but

> everytime I hear to have the capsules removed no

> matter what, I get

> worried & fear sets in that I made the wrong choice

> to keep the

> capsules in......although my PS did say my capsules

> were very thin &

> transparent..........?

>

> Thanks

> Jen

>

>

>

>

[Guest guest]

Jen

I agree with rogene. Since you are improving well, I would keep up

what you are doing and go from there. The women who go back and get

their capsules out are usually not getting any better. You are.

That is a real good sign. I think you will be fine.

Hugs

kathy

> >

> > long story short I got salines Jan 30, 2004 & w/2wks

> > started having

> > every symptom finally after 6 months, I decided to

> > get them removed &

> > I went back to my original PS to have them removed

> > but I left in my

> > capsules because I thought since they were only in 6

> > months I would be

> > okay, its been since Aug 2004 since my explant & I

> > am getting better

> > slowly but surely, w/water, fruits/veggies,

> > supplements etc but

> > everytime I hear to have the capsules removed no

> > matter what, I get

> > worried & fear sets in that I made the wrong choice

> > to keep the

> > capsules in......although my PS did say my capsules

> > were very thin &

> > transparent..........?

> >

> > Thanks

> > Jen

> >

> >

> >

> >