Confused about doctor's response regarding my concern of gel bleed

That's correct. Everything I said is based on well-conducted studies, very much unlike the Netherland's study, which included patients with very old, low cohesive implants from decades earlier. One recent study looking to elucidate systemic symptoms from breast implants found no silicone in any tissues, comparing those with silicone gel implants (even ruptured ones), saline implants, and women without implants. Many studies have shown similar rates of cap con between saline and highly cohesive silicone gel implants. Unfortunately, publication of a study does not necessarily mean it was conducted well and has meaningful results, especially with so many journals that want to bulk their contents and publish poor studies, especially with the explosion of 'open source' journals online. Even in well respected journals like PRS and Aesthetic Surgery, some lessor studies are published, but commentaries are quick to point out limitations, or worse, flaws. Your line of questions suggests to me your concern about silicone material in the body, and the potential for harm. I suggest you open Amazon and purchase two books. The first is titled 'Silicone on Trial', by Jack C. Fisher, M.D, professor emeritus UCSD Department of Plastic Surgery. After stepping down from chairmanship, he went on to get a degree in history and published this and other unrelated books. This book, written in 2015, is an excellent source for understanding the amazing history of silicone based materials, and the widespread use in industry, medicine, and food since the 1920's. It goes further in elucidating the trials and tribulations of breast implants. The other book, 'Science on Trial' (yes I know, weirdly coincidental) was written in 1996 by Marcia Angell, M.D., an internal medicine physician and former Chief Executive Editor of the New England Journal of Medicine. This book was written during the whole silicone gel breast implant debacle that began in the early 1990's, and which lead to the wholly unnecessary moratorium of silicone gel breast implants and subsequent avalanche of lawsuits by predatory lawyers that followed. Her book looks at not only the history of breast implants and the science of safety around these devices, but also how the courtroom was not a place where fact or truth matters.. I think these books are an important read for someone concerned about implant safety. The internet (where everything appears to be equally factual) is not a good place for laypersons trying to suss out medical information. I have taken care of tens of women in the last 24 years with old, ruptured silicone gel implants who had radiographically evident silicone in lymphnodes. All these women were healthy and there greatest concern was getting attractive and soft breasts again.

Gel bleed is when a small amount of gel permeates the outer layer. This generally occurs when implants have aged. It is recommended to replace your implants periodically over the course of your lifetime.

Just about all adults in the USA and many other industrial areas have silicone in their bodies even without any implant exposure. Silicone is present in many things, especially in cosmetics, cleaning products, and in many manufacturing companies. If you ever had an IV, you received silicone directly into your blood vessel. Dr. Minniti's statement is true since the new implants are more like "jello" than "honey" and do not bleed.

Silicone or is it common product used in lots of things we are exposed to on a daily basis. All syringes have silicone oil used to lubricate the syringe. If you’ve ever had a then If you have ever had an injection, then you have silicon inside of you. Simply being alive and eating commercially processed food exposes us to silicone. This product is very common.
Individuals who obsess over silicone related problems are far more likely to start having symptoms and problems related to silicone. The idea that silicone causes illness becomes a self fulfilling prophecy.
There are inherent risks with having cosmetic surgery. Nobody has to have breast augmentation surgery.
Best,
Mats Hagstrom MD