Can you help me find support? - Breast Implant Removal
Date: Wed, 9 Aug 2000 20:23:34 -0700 (PDT)
From: ruby rahn
rubyrm@yahoo.comTo: Marilyn H
highserenity@hotmail.comMarilyn,
I was forwarded your request for help and support with breast implant removal.
First, a few questions.
- Do you have insurance?
- Can you drive?
- Do you have anyone who can take care of you during and after surgery?
- What is your situation? Are you working? Can you get off work?
- Do you have a MRI, mammogram? Have you documented a leak/rupture?
- Are you committed to having your implants removed?
The reason that I'm asking if you are committed to having your implants removed is this process will take a lot of planning, organizing and follow through. You have to be physically and emotionally ready. I know it is very scary - many of us have been throught it and it takes a lot of courage. Take heart in knowing that you are making the right choice for your body. Take heart in knowing that you are making the right choice for a healthier future for yourself and your family.
Contact me if you would like the name of a good plastic surgeon in the Bay Area who will remove your implants correctly.
Ruby Rahn
(415) 512-7730 (evenings only)
Here is some homework to get you started on the process...
Print out this e-mail and many of the url links and read carefully.
Implant and scar capsule(capsulectomy)removal - some of the risks
Removal of the scar capsule that forms around all breast implants
is called a capsulectomy.
1. There is the risk of general anesthesia (possible reactions to anesthesia such as nausea, drowsiness, and fatigue); however, there have been many changes for the good in the types and quantities of drugs that are used during surgery. You can also sit down and discuss your questions and concerns with the anesthesiologist involved in your case.
If you have general anesthesia it is important to tell the anesthesiologist that you are sensitive to anesthesia and that you do not want to throw up after surgery. (It hurts and is more stress) Eat soda crackers and drink ginger ale as soon as possible after surgery to get something in your stomach. Ask for a shot that will prevent you from throwing up and have whoever is with you to talk to the nurses to make sure they can get a shot to you at a moments notice. Many hospitals will not let you leave until your kidneys are working. If you throw up, you can dehydrate and it can be hours before you pee. In the meantime you keep drinking water to try and go pee and you can over drink and then you'll have to get up every twenty minutes to go to the bathroom. You'll need help getting up and it will be a big pain. So, do what you can not to throw up. Take these precaustions.
2. There is more blood loss involved. However, a plastic surgeon who has performed many capsulectomies and works well with the other members of the surgical team in the operating room knows about minimizing blood loss. In addition, blood vessels are cauterized during the procedure. You can talk with the plastic surgeon who performs the capsulectomy about her/his views about potential blood loss. Many implant patients store blood a month ahead just in case.
Depending on your situation this is usually not necessary but if your implants have adhered to your chest wall it would be a good idea. Talk to your doctor.
3. There is the risk of the plastic surgeon cutting more tissue than is absolutely necessary beyond your implants and scar capsules. However, a plastic surgeon who has performed many capsulectomies and performs them routinely with good technical ability will be careful to give you a good surgical result, medically and cosmetically.
Getting a recommendation of a trusted surgeon who has performed many explantations with scar capsule removal is very important.
4. There is the risk of infection after surgery; however, this risk can be minimized with the use of drains and antibiotics (intravenously and orally) before, during and after surgery. You can check with the plastic surgeon performing the capsulectomy about her/his techniques to minimize the risks of infection. This is also one time that you really want to take antibiotics.
5. There is the risk of the change of sensation and/or coloring of a woman's nipples, areolar, and breast tissue. The most extreme reaction is nipple death due to poor circulation. A well-trained, qualified plastic surgeon will take all precautions to avoid this occurrence. At the same time, there is a very good chance that you may regain sensation in your nipples and areola once your breast implants and scar capsules are removed.
Most women feel better after having their implants removed. Most women also go through a healing crisis as well. It is to be planned, prepared for and expected. You may even have several.
6. There is, of course, the reality of the pain following the surgery; however, each woman's recovery process is different and each person's experience with pain and pain threshold is different. You can check with the plastic surgeon performing the operation about the types of pain medicine she/he recommends after surgery.
Some risks involved with leaving the capsules in at the time of implant removal.
1. There is the risk of leaving the silicone-gel " bleed" comprised of many different chemicals inside the scar capsule in the body.
You want the scar capsules that forms around the implant and the implant removed all in one piece. This proceedure is called "en bloc". You do not want any scar capsules to remain. This is important!
2. There is the risk that the silicone-gel " bleed" may cause further complications such as infection, pain (because it is a hard fixture), neurological damage (i.e. leaving your nerve endings exposed).
(You want the scar capsules that forms around the implant and the implant removed all in one piece. This proceedure is called "en bloc". You do not want any scar capsules to remain. This is important!)
3. There is the risk that the " bleed" may be linked to autoimmune diseases. Whether or not a woman actually develops a specific autoimmune illness, the scar capsule puts a strain on her immune system (i.e. working against her globulins and connective tissue).
(You want the scar capsules that forms around the implant and the implant removed all in one piece. This proceedure is called "en bloc". You do not want any scar capsules to remain. This is important!)
4. There is the risk that the scar capsule may shrivel up or " ball up," which, in turn, may put a woman at risk for misdiagnosis by an oncologist or radiologist for " cancer" or a " tumor" in her breasts.
(You want the scar capsules that forms around the implant and the implant removed all in one piece. This proceedure is called "en bloc". You do not want any scar capsules to remain. This is important!)
5. There is the risk that the scar capsules may contribute to the implosion (or drawing in) of a woman's breasts.
(You want the scar capsules that forms around the implant and the implant removed all in one piece. This proceedure is called "en bloc". You do not want any scar capsules to remain. This is important!)
6. There is the risk that the scar capsules may create a foreign body reaction that may eventually generate other problems.
* Pierre Blais of Innoval Ltd. Ottawa, Ontario, Canada believes these are some of the potential risks of leaving a woman's scar capsules in her breast tissue. He has come to his conclusions based on his experience, his analyses of women's breast implants and scar capsules, and through his conversations with women who did not have scar capsules removed during their breast explantations.
Related articles by Pierre Blais
http://www.info-implants.com/Blais/index.html
http://implants.clic.net/tony/Blais/index.html
Pierre Blais, PhD
Innoval
496 Westminster Ave.
Ottawa, Ontario
Canada KeA 2V1
Residual Capsule And Intercapsular Debris As Long Term Risk Factors
http://www.info-implants.com/Blais/02.html
Canadian Site - Index
http://www.info-implants.com/Ontario/index.html
Silicone Holocoust Site
Silicone City links
http://www.homestead.com/siliconecity/index.html
Michelle Lambert's Story
http://www.info-implants.com/english.html
Questions to ask your doctor before surgery
1) Ask about the plastic surgeon's education and background (i.e. where s/he did her/his training, etc.). Ask for a copy of her/his Curriculum Vitae.
2) Ask the plastic surgeon about the frequency with which s/he has performed breast explantations/capsulectomies. Over how long a period of time? Ask if there are other women you can talk to who had their explantations and capsulectomies performed by this surgeon.
3) Ask the plastic surgeon is s/he is currently involved in any breast- implant research. If so, what type of research? With whom? Who is gathering and analyzing the data? For what purpose? Ask to see a copy of the study or proposal.
4) Does the plastic surgeon do the procedure on an in-patient or out- patient basis? In which hospital does the plastic surgeon perform the surgery? Ask about the hospital if it is unknown to you. Ask about the expenses.
5) Be sure that you are informed of all possible risks and complications involved with the breast explantation/capsulectomy. Make sure the plastic surgeon outlines everything for you.
6) Upon examination, what are the plastic surgeon's feelings about the injuries and complications to your breasts and what does s/he think about the status of your implants? Ask the surgeon to examine your lymph nodes.
7) If you feel comfortable with the plastic surgeon and decide to proceed with an explantation and capsulectomy, ask the plastic surgeon about the time he/ she thinks you will be in the operating room? How does s/he plan to do the procedure? What type of incision will be made? What type of scarring does s/he anticipate? What type of sutures does s/he use (i.e. will they dissolve or will you have to come back to have them removed)?
8) What type of bandaging will s/he use (i.e. cotton or a polyester and synthetic blend--for people who may be allergic to synthetics)? If you are concerned about having a reaction to the dressing, ask about another alternative (i.e. bringing a cotton sports bra to be used after your surgery). How will the plastic surgeon apply your bandaging to minimize swelling?
Many women who still have their implants are allergic to plastic tape. Tell everyone at the time of your surgery that you are, even if you are not sure, to avoid having your skin turn red and raw from having plastic tape. It is a precaution and a comfort.
9) Does the plastic surgeon use drains? If so, what type? Ask to see one, if possible. How long does s/he anticipate that you will have to use the drains after surgery? If the surgeon does use drains, ask her/him to let you know when s/he will remove them. Ask to have them removed as quickly and as painlessly as possible.
10) Does the plastic surgeon use antibiotics (intravenously and orally) to minimize the possibility of infection? If so, what type? When? And for how long does the surgeon believe you will need to take them after your surgery?
11) What type of pain medication does the surgeon recommend for you after surgery (intravenously and orally)? (For example, does the surgeon prescribe a " pain pump" if you are staying overnight in the hospital?) Ask about the pros and cons of different narcotics so that you can make an informed choice.
12) What type of antiseptic precautions in the O.R. does the surgeon take to sterilize your breast tissue and to help to minimize the possibility of infection?
13) Ask the plastic surgeon to feel and look for masses, cysts, or any other possible anomalies once s/he has removed your implants and scar capsules.
14) Ask the plastic surgeon about the type of procedure s/he will perform if s/he discovers your implants are ruptured? Will this delay your time in the O.R.?
Ask to what lengths they will go to remove all of the silicone if they are ruptured. What won't they do?
15) Ask the plastic surgeon about your anticipated blood loss. Does the surgeon feel an autologous blood transfusion needs to be done ahead of time? Has the plastic surgeon ever had to perform a blood transfusion on a woman during or after surgery?
16) Ask the plastic surgeon if s/he works with one anesthesiologist or several?
Ask to speak to one of these doctors before the day of your surgery so that you can discuss the best types of narcotics, pain reducers, etc. for you, particularly if you are concerned about becoming nauseated after surgery. If you would like a specific anesthesiologist to work on your case, call and/or write to the anesthesia department (about two weeks before your surgery, if possible) of the hospital to request that s/he be put on your case.
17) Ask the surgeon what medications you should avoid before and after surgery?
Let her/him know what medications you are currently taking. Ask the surgeon if you can have your post-operative prescriptions filled ahead of time so you will already have them when you leave the hospital (so you don't have to go to a pharmacy when you are feeling tired or in pain after your surgery).
Asprin, vitamin E and other herbs can thin the blood. Ask about this. You do not want to take anything that thins the blood before surgery.
18) Ask the plastic surgeon to outline all of the " Do's" and " Don'ts" for you before surgery. (i.e. ask her/him when you need to stop eating and drinking before surgery.)
19) Ask the plastic surgeon to describe for you a realistic picture of what s/he anticipates you will look like after surgery ( your breast size, scarring, drains, sutures, etc.) If s/he replies: " Well, you may not like your appearance," that is her/his projection. Keep asking (if you choose to) so that you will have an idea for your clarification and peace of mind.
20) Ask the surgeon what your immediate post-operative care will be through her/him and the hospital. Ask the surgeon to see you and talk with you after your surgery (not when you are groggy in the recovery room) to let you know how your surgery went. Will s/he see you the morning after surgery?
After the surgeon sees you initially, what will the course be of your post- operative follow-up care? Will you see the surgeon again in a week, a month, and will you have follow-ups at three months, etc.?
21) What is the surgeon's fee? What does her/his fee represent? Does it include your pre-operative, operative, and post-operative care? Does the plastic surgeon expect a deposit? Does the surgeon recognize and accept your insurance? Will s/he help you with your insurance (write a letter on your behalf, if necessary)? If your insurance will not pay for your surgery, will the surgeon reduce her/his fee or work out a payment plan with you? Or does s/he want her/ his fee up front before your surgery? Does the hospital offer a reduced fee?
22) Will the surgeon help you to send your implants and scar capsules and associated tissues to where you want them to go (i.e. to Pierre Blais)? Or do you have to contact the hospital's pathology/histology departments yourself?
(It is always a good idea to find out who in the pathology labs will be examining the tissue and implants - talk to them ask them if they have examined implants and scar capsules. Ask them to do a complete and thorough report. Ask them to take photographs.
(It is important to prepare a letter of directive or an alternative form or letter to outline what you would like the hospital to do with your implants, scar capsules, and associated tissues after your surgery.
DO NOT THROW THEM AWAY. BE SURE TO READ AND CROSS OUT AND INITIAL ANY PORTIONS OF THE HOSPITAL'S CONSENT FORM THAT ADDRESSES THE DISPOSAL OF YOUR TISSUE.
Will the hospital send your implants and tissue directly for you?
Or do you need to pick them up and send them yourself? Have them put in formalin to preserve them, after the pathology report is done. Once formilin is used it is considered a biohazard and you may have to ship them via Fed-X if your surgeon is not close to your home.
23) Does the plastic surgeon have a consent form for you to read and sign actually outlining what the surgeon will do before you have your surgery?
If so, request to have time to review it before you sign it. Take it home after your first visit if you can.
* It is to your advantage to bring copies of your blood tests, mammograms, and other related medical reports with you, including the original surgeon's post- operative notes and description of how s/he did your original breast implantation, when you have your consultation with a new surgeon. Of course, if the original plastic surgeon agrees to take out your implants and scar capsules and you feel comfortable with this person, it is still a good idea to show the surgeon all of your current tests, mammograms, xeromammography, MRI's and medical reports.
After Surgery
1) Ask the surgeon about your immediate dietary (if applicable) and physical limitations. For how long? Can you drive? What types of activities can you do? What can't you do? When can you go back to work?
2) As soon as you are able to, ask the hospital for a copy of all your medical records including any pre-operative testing, your surgical procedure, and any post-operative notes and write-ups about your care.
3) Ask the plastic surgeon for a copy of the consent form you signed, her/his operatice and post-operative write-up about your surgery, and a copy of the picture the surgeon and pathologists took of your implants, scar capsules, and associated tissues. Check with the surgeon.
For more information. . .
Silicone Holocoust Site
National Center for Policy Research
Diana Zuckerman, Ph.D., Executive Director
National Center for Policy Research for Women and Families
1444 Eye Street, NW, Suite 900
Washington, DC 20005
202 216-9507
http://www.center4research.org/
Great Canadian Site - Info Implant Mammaries
http://www.info-implants.com/IAS/index.html
http://www.info-implants.com/BC/indexbc.html
Wisegroup Webring
It may take you a couple of tries to gather up the courage to have your implants removed. That is OK. You are feeling scared and you may need to build up to it. Or you may be ready now.
Whatever your state of mind, keep working a little each day to the goal of having your implants removed. The sooner the better. It will take time, do a little something each day and you will get there. It is OK if you have a few setbacks. Just begin again and don't give up.
Ruby
--- Marilyn H
highserenity@hotmail.com wrote:I need to immediately do something about my 18yr. old implants leaking and don't know where to turn. I am about 1 1/2 hrs. n/e of Santa Rosa in Lake County and am desperate for direction. Doctors/attorneys, survivors to help me. I am so scared of making the wrong choices, that I have become immobile
__________________________________________________
Do You Yahoo!?
Kick off your party with Yahoo! Invites.
The following article has been converted from .txt files to .html files.
By:
Sandy Bussières, Amqui
Membre I.I.M. Inc.
We want to say "Thanks Sandy" for your wonderful work.
