review: is saline the solution?
Guthrie and Doug Podolsky, Wiley, p. 208, £ 9. 95/ $16.
The 95 pbk dispute over the safety of breast implants has been expanding and has become a major source of medical litigation.
The debate raised significant ethical issues for both patients and doctors.
As a result, the release schedule of this book is not much better, and I read this \"women\'s guide who have or are considering breast implants\" with great interest.
Randolph Gresley, a plastic surgeon who, along with medical journalist Doug Podolski, aims to shed light on the fact that this prosthesis enables readers to make a fully informed decision
The side effects of silicone implants caused a stir in the United States after a woman brought up a well-known court case that she suffered from a rare, debilitating organization
The jury found that her illness was caused by the implantation of silicone breastimplants for cosmetic purposes.
There is no scientific basis or a priori hypothesis to explain how surgery causes the disease.
Nevertheless, the association of these events raises questions about the safety of silicone gelimplants, a case that highlights a huge lack of data for laboratory testing or long-term and largely successful, clinical application of breast implants in millions of women around the world.
Most implants are made of silicone gel, which are mostly used to increase breast size for purely cosmetic reasons.
They offer a way to rebuild the breast after breast cancer mastectomy, although fortunately most breast cancer patients can now be treated successfully through the breast
Retain surgical techniques.
In the early days of the book, instead of a rational, balanced description of the facts, the authors made it clear that their belief that silicone gel implants are unsafe and should be abandoned.
They like to implant with a solid silicone shell, but fill it with salt water and think that they are not only safer, but also have better cosmetic effects.
While this may eventually prove to be the case, the evidence published so far does not support this argument.
This book begins with a brief history of breast implants.
Early types are often strongly promoted by \"doctors/promoters\" who sometimes generate economic benefits.
However, these early types were abandoned after failing to achieve a safe, lasting and good cosmetic effect.
Early salt water
The filledimplants are usually deflated shortly after insertion due to a gas valve leak, and the issue is still not fully resolved.
Silicone gel is a very inert substance that sometimes leaks through the shell of the prosthesis, a phenomenon called silicone bleeding.
But breast surgeons have been aware of this for some time and we are still not sure about the importance of this.
As the author points out, all breast implants are associated with early complications such as bleeding, bruising, mild discomfort and infection, although this complication is rare.
But most people don\'t have a long time.
The term problem, although over time, due to the formation of scar tissue around it, many prosthesis has hardened and the result is poor.
This is largely a special response of the body to a small number of patients, which occurs in all implant types and is subject to intense clinical research.
Using texture instead of smoothness can reduce complications
The surface prosthesis inserted under the breast tissue, or, especially in patients undergoing breast reconstruction, the prosthesis inserted under the muscles of the chest wall.
Guthrie summed up other options for breast reconstruction, but thought that all bar one was too risky or did not achieve a lasting and good cosmetic effect.
This is disappointing, as the author has previously summarized some of the relevant questions for future patients to ask their surgeon before performing breast augmentation or reconstruction surgery.
A crucial fact is that no surgical procedure is ideal for every patient.
In order to achieve the best results, reconstruction must be able to provide a range of surgical techniques and then be tailored to the needs and wishes of the patient.
While some of the more complex tissue transplants mentioned by guthrie are at risk, they may produce the best results in the hands of experts.
Patients should rely on published results (good and bad)
And make informed decisions about which reconstruction procedures, if any, are best suited to them.
While this procedure is not important when used for breast augmentation purposes, breast reconstruction can have a huge impact on mental function and quality of life of patients after breast cancer treatment.
Although some people hold reservations, there is no Oncology reason why such surgery should not be performed during mastectomy.
The whole Silicon economics emphasizes the lack of available evidence about its possible and proven side effects.
Now, all women who have this type of surgery are officially registered so that they can get information about possible side effects on their hands, at the same time, it also provides a crucial database for the final results of such prosthetic limbs.
The truth of the implant is that a \"water gate incident\" occurred\"like’ cover-
The Food and Drug Administration and doctors are responsible.
Although there is a lack of research, the relevant personnel have responded to potential serious problems by examining the available evidence, conducting laboratory and clinical studies.
So is Guthrie. a long time.
The time opponent of the silicone prosthesis, successfully demonstrated the \"real\" facts about the implant, allowing women to perform surgeryinformedchoice?
Some topics, such as preoperative counseling, are well covered.
But I think the lead author already has an answer, not waiting for the results of the study.
He saw the salt water.
Filling silicon implants is the perfect solution in all cases.
Gersley is right to challenge the wisdom we have received before.
But we have to keep an open mind, especially when there is such a complex need to balance costs and benefits, some people may perform better.
Nigel Sachs is a breast cancer specialist at St George\'s Hospital in London.