What is your opinion on women wanting their breast implants removed due to illness? Why don't doctors mention this procedure to women wanting their saline breast implants out? I have women contacting me on a daily basis asking who they should see to have their saline breast implants removed since they have the same exact symptoms as I had prior to having mine out. Most doctors don't even mention getting the en-bloc and leave the capsule in. I find the women who don't get them out en-bloc only get sicker while the one's like myself who do get this extra procedure gain most of their health back. What is your opinion on this?
Removing Breast Implants Due to Illness
Doctor Answers 12
Explantation due to illness in saline implants
Removing Breast Implants Due to Illness
Thank you for the question.
As you know, there are patients who present to plastic surgeons for breast implant removal surgery hoping that removal of breast implants will alleviate a variety of medical conditions that they may be experiencing. Given that there is no science associating the presence of breast implants with these illnesses, I cannot promise the patient's relief or improvement; on the other hand, out of respect for the patient (and with enough medical experience to know that patients are often right about their own bodies), I do remove the breast implants (en bloc). This involves removing the breast implants and the surrounding thickened capsule "in one piece". Given the concerns, implants and tissues are sent to microbiology and pathology.
I think that as time goes on, as our experience increases further, we will learn more about any possible association between breast implants and "illnesses". I think that it is important, as physicians, to keep an open mind.
In the meantime, I hope the plastic surgeons will individualize patients care based on good ethics and not "scare" as many patients as possible to remove breast implants and capsules, exposing patients unnecessarily, in many cases, to unnecessary risk (morbidity) and expenses.
Thank you again for the thought-provoking question.
Implant removal and health
There have been many studies that have shown no association of collagen vascular disorders with breast implants. This is what originally kept silicone implants off the market for about 15 years.
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I have removed implants in a few women who wanted them out for these kinds of reasons. I did tell them that afterward things might not change with the illness about which they were concerned. This has usually been the case. With this being said, I feel it is the patient's body and I will do what she requests as long as it does not seem to be harmful.
John Di Saia MD
Implant Capsule Problems
Usually the plastic surgeon who placed the implants can also remove the implants for cosmetic, psychological, or medical purposes. Saline implants usually have no significant shell since they do not have any silicone gel present, but a thick capsule around a saline implant may be removed if it is present. When implants are placed we do a medical history review. If there are no prior medical issues or illnesses it has been accepted that implants will not cause any illnesses. Why are patients contacting you specifically? Are you a web host site for breast implant questions?
What exactly is your question?
What exactly is your question? You seem to making some generalizations and it is unclear what your issue is. If you are asking about the association between implants and illness, there is no scientific evidence to support that claim. However, many women do choose to have their implants taken out if they have coincidental autoimmune or other concerns. When the implants are taken out, in most cases the capsule is left in place. However, if the patient wants that capsule out and it is surgically possible, then there is no problem taking out the capsule. However, if the patient has very thin skin, then sometimes it is dangerous to take out the capsule. Also, there is a higher risk of bleeding when the capsule is taken out. These are all issues that should be discussed with your surgeon ahead of time. If you are having some issue with your surgeon or a communication breakdown, then I suggest that you seek a second opinion from another surgeon. Good luck.
Not sure what you are asking
Breast implants are now among the most thoroughly researched medical devices in history- there is abundant evidence of their safety and no reason to any longer believe they might be implicated in any systemic illness. It is possible, as my colleague points out below, that the saline may become contaminated with bacteria, causing the patient to feel ill, but this is a rare occurrence.
Whether or not to remove the implant capsule at the time of implant removal is something that should be discussed between the patient and surgeon in preparation for the procedure, and would be affected by the circumstances leading the patient to seek removal of her implants.
Doesn't make sense
There is no scientific evidence to date that implants of any kind cause any illness in women. The past silicone implant episode, in the early 1990's, prompted several studies that demonstrtaed no relationship between silicone implants and illness. Saline devices have been used all along and were never implicated as causing any illnesses. The FDA would never allow this to occur as you have seen by the silicone episode. It took over 10 years to get gel devices back into use in the U.S. after the science and trials proved their safety.
Removing saline devices and leaving their capsules should not make any patient "symptoms" worse. This does not make sense. These women should be evaluated by their physicians to make sure they receive the appropriate diagnosis and treatment.
Question not clear
You do not mention what illness you are referring to nor what affect to your health you believe your implants are causing. Also, it is not clear what the capsule has to do with your question. In general, saline implants are not known to cause specific diseases or illness themselves although there are very rare anecdotes about contamination of the saline with various unusual organisms both bacterial and fungal. Explantation of the implants can be contemplated under a number of scenarios and the ramification of both the explantation and the failure to explant should be discussed between the surgeon and patient. However a cause and effect link between saline implants and a specific disease process must be clear before a recommendation for explantation can be made. Of course, just as a patient electively chooses to undergo augmentation, she has the right to voluntarily undergo explantation but should be informed of the consequences of such action including breast deformities, scars required to restore form and shape, and possible emotional depression due to body image issues.