We don’t know what we don’t know, till we know it.
One of my greatest peeves about silicone breast implants is that women can end up with migrated silicone and most often weren’t aware this is possible. We all got the ‘silicone is safe’ spiel without this possible complication being mentioned. Silicone in lymph nodes, surrounding tissue and even vital organs is all too common. When this happens we’ve unfortunately and unwittingly joined the ‘permanently harmed club’. Once you’re in the club you land in a medical abyss (but, that’s another blog post).
Silicone granulomas form because our body is trying to protect us from silicone that’s escaped the implants. They can form anywhere that silicone has migrated, including lungs, liver and other equally unfortunate places.
As is common in life often we don’t know what we don’t know until we’ve learned it through experiencing difficult circumstances first-hand. And even then, we often don’t come to fully understand what we didn’t know till long ‘after the fact’. We often don’t know the questions we should ask because we’re not even aware of certain possibilities.
My explant surgical report noted there was silicone still against my lungs, but made no mention of the large mass and silicone granulomas that were removed. Nor did it mention the acute inflammation, necrotized tissue, extreme calcification, biofilms and other serious issues. Those were all generically lumped into my explant surgeon saying repeatedly when she came to see me in ‘recovery’ that ‘it was really bad in there’ and “your implants really needed to come out.” She didn’t volunteer how close I’d been to death. It was only when I confided to her that I’d worried if my implants hadn’t been removed that day I wouldn’t have made it to another surgery date that she acknowledged how close I was to the precipice. Her response to me was, “that was probably a very accurate intuition.”
Fortunately my implants were sent for private analysis so I had the benefit of learning things I’d otherwise never have known. It highlighted how my lack of awareness of ‘things possible’ had limited my ability to request details from my surgeon that would have offered accurate insight into what my implants had done, and the degree of harm.
Post-explant its important to be aware of specific questions to ask the surgeon beyond if they got all of the scar capsules. If I’d asked my surgeon I’m certain she would have been totally honest and I don’t mean to imply that in not having volunteered everything she found within my chest wall that she’d been dishonest. It’s common for information pertaining to our health to end up whitewashed. We have to know what to ask.
Knowledge is power. Knowing the truth of my implants gave me a sense of understanding and closure. We all deserve to have that.
IDEAS for questions to ask your surgeon:
Based on my personal experience I encourage women to ask their surgeon what it was like within their breasts and chest wall. Was there migrated silicone? Were there reactive and/or silicone filled lymph nodes? Was there infection? Was there fluid? Was there acute inflammation? Was there necrotized tissue? Was there calcification? Was there a mass? Did you test for BIA-ALCL and all other implant related cancers? Was there anything else suspicious, not mentioned already in my questions? I also encourage women that had ruptured silicone implants to have a follow-up ultrasound scan about a year post explant to check for residual silicone and other implant/silicone related issues.
The reason I encourage having an ultrasound post explant with ruptured silicone implants is that my surgeon told me she’d gotten all but a few granules of silicone that was against my lung, however that turned out not to be the case. I think she believed that to be true at the time, but I’ve seen in other instances also where over time silicone not seen by the surgeon presents itself.
** Its a good idea to give your ps a heads-up that these are things you’ll want to know about post-explant. Its especially important regarding testing for BIA-ALCL and other implant related cancers to have that conversation with your ps prior to explant.**