Re: Scar tissue removal-Dr. Melmed responds

[Guest guest]

DR Schnarrs said the same thing, Dr Kolb did too....they said they would get as much of the capsule as they could without doing harm.

[Guest guest]

Okay, I am forwarding this to everyone. Do with it what you will, but I forwarded some of what was said to Dr. Melmed because I truly want to know what he thinks and feels about this issue, especially if I am going to have him do it. The attachment is from him. He has been very communicative with me. __________________________________________________

[Guest guest]

It sounds like what Melmed has said all along, though he is more militant in your email about saline capsules not needing removal. My guess is that with you he'd recommend capsule removal because you have a strange implant filler.

From what I have heard, Feng would definitely disagree with him-- she says she takes out all the capsule no matter what. She also charges twice what he does, but she is known as a perfectionist,so you would know you are in good hands with her, if you could afford it.

I guess you will have to gather all the info you can and trust your gut on this one. The fact is, there is still little conclusive research on exactly what causes the illnesses we women get from implants, and the explant docs differ in their opinions. There is one study that I think Dr. Blais was involved in, in Canada, that showed a correlation between retained capsules and continuing symptoms. I think the study was done with women who had silicone implants.

Does Melmed know you had Misty Gold? I am curious what he thinks should be done about the capsules for those. When I told him I had silicone, he insisted on capsule removal. He said that the silicone molecule is small enough to slip through the implant shell, so that even without rupture, one could still have silicone migrating throughout one's body.

Bindi

Fwd: Re: Scar tissue removal-Dr. Melmed responds

Okay, I am forwarding this to everyone. Do with it what you will, but I forwarded some of what was said to Dr. Melmed because I truly want to know what he thinks and feels about this issue, especially if I am going to have him do it. The attachment is from him. He has been very communicative with me.

__________________________________________________

[Guest guest]

Hi Bindi, This is what he said below when I first emailed him and told him what they were made of and that one has contracture and the other has completely leaked out. It sounds to me like he tries to get all, but that in some cases you can't...especially with those under the muscle, which is what I have. Dear , Misti gold was a hydrogel implant. I have heard of them getting larger (they retain water) but never heard of them going away. Your symptoms are typical of someone with reaction to silicone That plus you physical findings means one thing - get them out. I suggest you write to Kathy ston. I have copied her so you have her address. She may know of a good doctor in your area Dr Mfreebindi <bindi@...> wrote: It sounds like what Melmed has said all along, though he is more militant in your email about saline capsules not needing removal. My guess is that with you he'd recommend capsule removal because you have a strange implant filler. From what I have heard, Feng would definitely disagree with him-- she says she takes out all the capsule no matter what. She also charges twice what he does, but she is known as a perfectionist,so you

would know you are in good hands with her, if you could afford it. I guess you will have to gather all the info you can and trust your gut on this one. The fact is, there is still little conclusive research on exactly what causes the illnesses we women get from implants, and the explant docs differ in their opinions. There is one study that I think Dr. Blais was involved in, in Canada, that showed a correlation between retained capsules and continuing symptoms. I think the study was done with women who had silicone implants. Does Melmed know you had Misty Gold? I am curious what he thinks should be done about the capsules for those. When I told him I had silicone, he insisted on capsule removal. He said that the silicone molecule is small enough to slip through the implant shell, so that

even without rupture, one could still have silicone migrating throughout one's body. Bindi Fwd: Re: Scar tissue removal-Dr. Melmed responds Okay, I am forwarding this to everyone. Do with it what you will, but I forwarded

some of what was said to Dr. Melmed because I truly want to know what he thinks and feels about this issue, especially if I am going to have him do it. The attachment is from him. He has been very communicative with me. __________________________________________________

[Guest guest]

Okay,

Can anyone answer why I was positive on both occacisions for

silicone in the capsules,breast tissues, is it because I had

bilumen? Because I had saline implants, First explant in Aug 04

pathology was positive for silicone in the capsule, second surgery

in sept 05 was to remove the capsule that was left behind by a

different surgeon also positive for silicone? just wondering if it

is because double bilumen is actually silicone and not saline? Not

sure about anything anymore.

Terri P

--- In , <waltjenking@...>

wrote:

>

> Okay, I am forwarding this to everyone. Do with it what you will,

but I forwarded some of what was said to Dr. Melmed because I truly

want to know what he thinks and feels about this issue, especially

if I am going to have him do it. The attachment is from him. He

has been very communicative with me.

>

>

> __________________________________________________

>

[Guest guest]

Terri, I wish I could help you, however, if your doctor told you you were receiving saline and they found silicone couldn't you sue? You should be able to. Peake <peaketeresa@...> wrote: Okay,Can anyone answer why I was positive on both occacisions for silicone in the capsules,breast tissues, is it because I had bilumen? Because I had saline implants, First explant in Aug 04 pathology was positive for silicone in

the capsule, second surgery in sept 05 was to remove the capsule that was left behind by a different surgeon also positive for silicone? just wondering if it is because double bilumen is actually silicone and not saline? Not sure about anything anymore.Terri P>> Okay, I am forwarding this to everyone. Do with it what you will, but I forwarded some of what was said to Dr. Melmed because I truly want to know what he thinks and feels about this issue, especially if I am going to have him do it. The attachment is from him. He has been very communicative with me. > > > __________________________________________________>

[Guest guest]

I had saline implants for six years. I had them removed by Dr. Feng. My pathology report of the capsules stated that I indeed had silicone in them. <waltjenking@...> wrote: Okay, I am forwarding this to everyone. Do with it what you will, but I forwarded some of what was said to Dr. Melmed because I truly want to know what he thinks and feels about this issue, especially if I am going to have him do it. The attachment is from

him. He has been very communicative with me. __________________________________________________

[Guest guest]

So, how do you get silicone in saline implants? And why can't you sue the doctor that put them in because he claimed they were silicone? Thanks for you input. Lamse <wannabe_proverbs31@...> wrote: I had saline implants for six years. I had them removed by Dr. Feng. My pathology report of the capsules stated that I indeed had silicone in them.

<waltjenking > wrote: Okay, I am forwarding this to everyone. Do with it what you will, but I forwarded some of what was said to Dr. Melmed because I truly want to know what he thinks and feels about this issue, especially if I am going to have him do it. The attachment is from him. He has been very communicative with me. __________________________________________________

[Guest guest]

- The shells of saline implants are made of silicone - using platinum as a catylst to for a semi-solid, semi-permable shell. As the implant ages, microscopic bits of silicone (any polyurethane) are broken away as the body seeks to destroy an alien object. . . . A considerable amoint of this junk is contained by the capsule - the rest is distributed throughout the body. Rogene

[Guest guest]

Terri, You might have had silicone gel implants - it's possible the silicone found in your capsules was from the shells. However, didn't double lumen implants have a gel filled shell INSIDE a saline-filled shell?. Rogene

[Guest guest]

Well that really sucks...so even if they find silicone in our "non-silicone" implants we still have no recourse to sue the doctors or have a case for anything?? Rogene S <saxony01@...> wrote: - The shells of saline implants are made of silicone - using platinum as a catylst to for a semi-solid, semi-permable shell. As the implant ages, microscopic bits of silicone (any polyurethane) are

broken away as the body seeks to destroy an alien object. . . . A considerable amoint of this junk is contained by the capsule - the rest is distributed throughout the body. Rogene

Any questions? Get answers on any topic at Answers. Try it now.

[Guest guest]

Patty,

I totally agree with this. I contacted Dr. Melmed for my explant. He said, no need for capsule removal so I ran to Dr. Kolb. I Thank God I did.

Donna

[Guest guest]

Oh my, my my. I must jump in here. I do not want to oppose the good Dr. Melmed, but I do have some issues with his claiming "Facts", when there is some evidence to the contrary! I believe he is simply mistaken! Oh, this is upsetting to say the least.

Here is what I have issue with:

He says "Facts:

Saline implant capsules do NOT contain any silicone."

I believe there is plenty of evidence to the contrary. Saline implants have silicone shells, and those silicone shells can have silicone particles gnawed off by the macrophages, and they can be found in not only the capsules, but in the bloodstream and various parts of the body. Please, please ask him to provide an explanation for what happens to the silicone in the shell of the saline implant, and provide and explanation for those women who have had their shells analyzed and found that part of it is missing?

He says, "Facts:

Capsule left behind dissipates within a year"

NOWHERE is that proven. Absolutely NOWHERE! Please ask him to provide a reference that proves this beyond all doubt. We have articles that state the opposite...not only do the capsules NOT dissipate or dissolve, they actually grow and evolve into more highly riskier forms. See Dr. Blais's article in our files section on Residual capsules in which he states the following, in direct contrast to what Dr.Melmed states:

"A residual capsule is not a stable entity. It may collapse uponcompletion of surgery and remain asymptomatic for some time, however, it willfill with extracellular fluid and remain as a fluid-filled space with addedblood and prosthetic debris. As the wall matures and the breast remodels toaccommodate the loss of the prostheses, the capsular tissue shrinks. Water aswell as electrolytes are expelled gradually from the pocket or else themixture is concentrated from leakage of water from the semi-permeable capsularmembrane wall.In most cases, calcium salts precipitate during that stage and may render thecapsule visible as a radiodense and speckled zone in radiographic projections.Prosthetic debris is also radiodense and may be imaged to further complicatethe presentation. The average size of the residual capsules after 6-12 monthsis in the 2-7 cm range: most are compact, comparatively small and

dense.Surgical removal should present no difficulty for most patients if adequateradiographic 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 ofnodules which actually become calcifies follows for some patients. A fewmimic malignancies. Others appear as small "prostheses" during mammographicstudies. They are alarming to oncologists and are habitually signaled forfurther studies or biopsies by oncologic radiologists.In light of the present knowledge and considering the probable contentof the residual closed capsules, an open or needle biopsy is not advisable.The risks of releasing significant amounts of hazardous contamination andpossibly spreading infective entities outweighs the advantage of thediagnostic. At any rate, such a capsule requires removal for mitigation ofsymptoms and a more direct

surgical approach appears more economical and lessrisky.In summary, a capsule with a dense fibro-collagenous wall behaves as abioreactor. Worse yet, it is fitted with a semi-permeable wall that mayperiodically open to release its content to the breast. The probability offinding the space colonized with atypical microorganisms is elevated and thecontrol of infective processes by classic pharmacologic approaches isdifficult if not impossible."

Third, he states:

Facts:

It is not possible to get all the capsule out from under the muscle.

This is a flat out lie. It certainly is possible...my implants were under the muscle and all of my capsule was removed. Dr. Feng removes all capsule under the muscle. Dr. Kolb removes all capsule under the muscle. To state it is not possible is just plain WRONG in light of the fact that these other doctors do!

Please proceed with caution with your explant, and make sure you go to someone who is going to do this right, with full knowledge of explant.

Patty

Re: Fwd: Re: Scar tissue removal-Dr. Melmed responds

I had saline implants for six years. I had them removed by Dr. Feng. My pathology report of the capsules stated that I indeed had silicone in them.

<waltjenking> wrote:

Okay, I am forwarding this to everyone. Do with it what you will, but I forwarded some of what was said to Dr. Melmed because I truly want to know what he thinks and feels about this issue, especially if I am going to have him do it. The attachment is from him. He has been very communicative with me.

____________ _________ _________ _________ _________ __

[Guest guest]

,

Most likely it was because you had breast implants, period. All breast implants have a silicone shell, and they can shed silicone particles, which can be found in the capsules. I do not agree with what Dr Melmed has said.

Patty

Fwd: Re: Scar tissue removal-Dr. Melmed responds

Okay,Can anyone answer why I was positive on both occacisions for silicone in the capsules,breast tissues, is it because I had bilumen? Because I had saline implants, First explant in Aug 04 pathology was positive for silicone in the capsule, second surgery in sept 05 was to remove the capsule that was left behind by a different surgeon also positive for silicone? just wondering if it is because double bilumen is actually silicone and not saline? Not sure about anything anymore.Terri P>> Okay, I am forwarding this to everyone. Do with it what you will, but I forwarded some of what was said to Dr. Melmed because I truly want to know what he thinks and feels about this issue, especially if I am going to have him do it. The attachment is from

him. He has been very communicative with me. > > > ____________ _________ _________ _________ _________ __>

[Guest guest]

Hi Patty,

I certainly don't know anything about explant but do have a question. Could

it be that Dr. Melmed is saying that it isn't always possible to get all of

the capsule out without causing risk or damage to a woman? I can see how

that might be the case in some instances.

Kenda

>

> Third, he states:

> Facts:

> It is not possible to get all the capsule out from under the muscle.

>

> This is a flat out lie. It certainly is possible...my implants were under the

> muscle and all of my capsule was removed. Dr. Feng removes all capsule under

> the muscle. Dr. Kolb removes all capsule under the muscle. To state it is not

> possible is just plain WRONG in light of the fact that these other doctors do!

>

> Please proceed with caution with your explant, and make sure you go to someone

> who is going to do this right, with full knowledge of explant.

> Patty

[Guest guest]

I suspect the difference lies in how much one doctor considers safe to attempt to remove, compared with another. This most likely stems from weighing how much risk he/she perceives retained capsules pose versus how much risk of more extensive surgery. This appears to be the primary difference between surgeons. Hopefully no surgeon would put a patients' life at risk to get portions of capsules that are too deeply embedded. Dr. Melmed has been an outspoken advocate on breast implant implant issues for years - And he has taken a huge amount of flack from his peers as a result. From all reports, the cosmetic result of his surgery is outstanding. Women repeatedly report that he has treated them with the utmost kindness and consideration. He also turns patients away if he feels their needs are greater than he feels comfortable in dealing with. IMHO, this honesty is good. Dr. Melmed's profile is much higher than

most plastic surgeons. His standard regarding removing capsules is as high, or higher than most. I hope he is treated with the respect he deserves. All plastic surgeons have had negative reports at one time or another. Even the best surgeon cannot honestly guarantee 100% satisfaction. Even the best surgeon can get bad results because of any number of factors - some they can control, some they have no control over. The question that must be answered by any woman seeking explant from ANY doctor is if they believe the doctor they choose will do what is in the patients' best interest. This is a decision each woman must answer for herself. I believe the discussion on Dr. Melmed has gone on long enough - Maybe too long. Let's stop! Rogene

[Guest guest]

Kenda,

I am sure that is what he is saying, but to say that "it is not possible to get all the capsule out from under the muscle is a little too stark". It would have been better to say that it is not possible in every case, or in some cases. I have heard other doctors mention that in some cases it is not easy to remove the capsule, and some must be left in due to possible complications or risk of excessive bleeding, but certainly I think it would be better to say they'll try their hardest to get it all.

Patty

Re: Scar tissue removal-Dr. Melmed responds

Hi Patty,I certainly don't know anything about explant but do have a question. Couldit be that Dr. Melmed is saying that it isn't always possible to get all ofthe capsule out without causing risk or damage to a woman? I can see howthat might be the case in some instances.Kenda> > Third, he states:> Facts: > It is not possible to get all the capsule out from under the muscle.> > This is a flat out lie. It certainly is possible...my implants were under the> muscle and all of my capsule was removed. Dr. Feng removes all capsule under> the muscle. Dr. Kolb removes all capsule under the muscle. To state it is not> possible is just plain WRONG in light of the fact that these other doctors do!> > Please proceed with caution with your explant, and make sure you go to someone> who is going to do this right, with full knowledge of explant.>

Patty

Any questions? Get answers on any topic at Answers. Try it now.

[Guest guest]

That's a bunch of crap and really angers me.Rogene S <saxony01@...> wrote: No recourse! . . . Women were given "consent" forms to sign that relieved everyone, but themselves, from responsibility. . . .The settlements had timelines under which you had to file, or be forever excluded. Not right - but a fact! Rogene

Any questions? Get answers on any topic at Answers. Try it now.

[Guest guest]

Rogene, I think this is very well said. I have read article after article on Dr. Melmed and he seems to be a wonderful surgeon. He doesn't even do implants anymore. I feel more comfortable going to someone like that. No offense at all, but it's got to be hard to go to a plastic surgeon to do an explant that is still doing implants. How do we justify that one? Dr. Melmed has been writing to me every day. He has been wonderful in answering any questions I may have. While it's good to get info from everyone, and I do appreciate it, I think that it's possible that it could be taken too far as well. It's difficult to not let our emotions come into play here. This is an emotional issue. Thanks to everyone who has responded. Rogene S <saxony01@...> wrote: I suspect the difference lies in how much one doctor considers safe to attempt to remove, compared with another. This most likely stems from weighing how much risk he/she perceives retained capsules pose versus how much risk of more extensive surgery. This appears to be the primary difference between surgeons. Hopefully no surgeon would put a patients' life at risk to get portions of capsules that are too deeply embedded. Dr. Melmed has been an outspoken advocate on breast implant implant issues for years - And he has taken a huge amount of flack

from his peers as a result. From all reports, the cosmetic result of his surgery is outstanding. Women repeatedly report that he has treated them with the utmost kindness and consideration. He also turns patients away if he feels their needs are greater than he feels comfortable in dealing with. IMHO, this honesty is good. Dr. Melmed's profile is much higher than most plastic surgeons. His standard regarding removing capsules is as high, or higher than most. I hope he is treated with the respect he deserves. All plastic surgeons have had negative reports at one time or another. Even the best surgeon cannot honestly guarantee 100% satisfaction. Even the best surgeon can get bad results because of any number of factors - some they can control, some they have no control over. The question that must be answered by any woman seeking explant from ANY doctor is if they believe the doctor they choose

will do what is in the patients' best interest. This is a decision each woman must answer for herself. I believe the discussion on Dr. Melmed has gone on long enough - Maybe too long. Let's stop! Rogene __________________________________________________

[Guest guest]

I've met Dr. Melmed personally . . I was very impressed with how real he is! .. Not like some doctors who think they're God and speak down to their patients. Rogene

[Guest guest]

You're right!!! But to give energy to anger takes it away from the energy you need for healing. We have to find a way to Let Go and Let God. He will exact His punishment! Rogene <waltjenking@...> wrote: That's a bunch of crap and really angers me.Rogene S <saxony01 > wrote: No recourse! . . . Women were given "consent" forms to sign that relieved everyone, but themselves, from responsibility. . . .The settlements had timelines under which you had to file, or be forever excluded. Not right - but a fact! Rogene Any questions? Get answers on any topic at Answers. Try it now.

[Guest guest]

-Rogene,

That is why in my opinion the whole thing is fraud, women still

think saline is saline and not silicone.,

Terri P

-- In , Rogene S <saxony01@...> wrote:

>

> -

>

> The shells of saline implants are made of silicone - using

platinum as a catylst to for a semi-solid, semi-permable shell.

>

> As the implant ages, microscopic bits of silicone (any

polyurethane) are broken away as the body seeks to destroy an alien

object. . . .

>

> A considerable amoint of this junk is contained by the capsule -

the rest is distributed throughout the body.

>

> Rogene

>

[Guest guest]

-Rogene,

Oh by the way and not just patients but other Doctors as well, they

are just shocked when I tell them I had saline but my pathology was

positive for silicone.

Terri P

-- In , Rogene S <saxony01@...> wrote:

>

> -

>

> The shells of saline implants are made of silicone - using

platinum as a catylst to for a semi-solid, semi-permable shell.

>

> As the implant ages, microscopic bits of silicone (any

polyurethane) are broken away as the body seeks to destroy an alien

object. . . .

>

> A considerable amoint of this junk is contained by the capsule -

the rest is distributed throughout the body.

>

> Rogene

>

[Guest guest]

-Patty,

Thank you Patty, This is my case exactly, My residual capsule

certainly didn't dissapear in fact it contained silicone and blue

nodules and the surgeon had to go in the top of my breast to get at

it. She couldn't get it from the bottom. The whole thing is a big

fat lie

Terri P

-- In , Tricia Trish

<glory2glory1401@...> wrote:

>

> Oh my, my my. I must jump in here. I do not want to oppose the

good Dr. Melmed, but I do have some issues with his

claiming " Facts " , when there is some evidence to the contrary! I

believe he is simply mistaken! Oh, this is upsetting to say the

least.

>

> Here is what I have issue with:

> He says " Facts:

> Saline implant capsules do NOT contain any silicone. "

>

> I believe there is plenty of evidence to the contrary. Saline

implants have silicone shells, and those silicone shells can have

silicone particles gnawed off by the macrophages, and they can be

found in not only the capsules, but in the bloodstream and various

parts of the body. Please, please ask him to provide an explanation

for what happens to the silicone in the shell of the saline implant,

and provide and explanation for those women who have had their

shells analyzed and found that part of it is missing?

>

> He says, " Facts:

> Capsule left behind dissipates within a year "

>

> NOWHERE is that proven. Absolutely NOWHERE! Please ask him to

provide a reference that proves this beyond all doubt. We have

articles that state the opposite...not only do the capsules NOT

dissipate or dissolve, they actually grow and evolve into more

highly riskier forms. See Dr. Blais's article in our files section

on Residual capsules in which he states the following, in direct

contrast to what Dr.Melmed states:

>

> " 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 calcifies follows for some patients.

A few

> mimic malignancies. Others appear as small " prostheses " during

mammographic

> studies. They are alarming to oncologists and are habitually

signaled 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. "

>

> Third, he states:

> Facts:

> It is not possible to get all the capsule out from under the

muscle.

>

> This is a flat out lie. It certainly is possible...my implants

were under the muscle and all of my capsule was removed. Dr. Feng

removes all capsule under the muscle. Dr. Kolb removes all capsule

under the muscle. To state it is not possible is just plain WRONG

in light of the fact that these other doctors do!

>

> Please proceed with caution with your explant, and make sure you

go to someone who is going to do this right, with full knowledge of

explant.

> Patty

>

> Re: Fwd: Re: Scar tissue removal-Dr.

Melmed responds

>

> I had saline implants for six years. I had them removed by Dr.

Feng. My pathology report of the capsules stated that I indeed had

silicone in them.

>

>

>

> <waltjenking> wrote:

> Okay, I am forwarding this to everyone. Do with it what you will,

but I forwarded some of what was said to Dr. Melmed because I truly

want to know what he thinks and feels about this issue, especially

if I am going to have him do it. The attachment is from him. He

has been very communicative with me.

>

>

> ____________ _________ _________ _________ _________ __

>

[Guest guest]

Absolutely! There has been so little information made public about salines, it blows me away! Yet, everytime I talk with someone about implants, they know someone who is sick and hasn't made the connection - often they have a sick child too, Rogene Peake <peaketeresa@...> wrote: -Rogene,That is why in my opinion the whole thing is fraud, women still think saline is saline

and not silicone.,Terri P-- In , Rogene S <saxony01@...> wrote:>> - > > The shells of saline implants are made of silicone - using platinum as a catylst to for a semi-solid, semi-permable shell.> > As the implant ages, microscopic bits of silicone (any polyurethane) are broken away as the body seeks to destroy an alien object. . . . > > A considerable amoint of this junk is contained by the capsule - the rest is distributed throughout the body.> > Rogene>