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Women's Health Books
The Naked Truth About Breast Implants
From Harm to Healing
By Susan Kolb, M.D.
The Book's FORWARD reads...
This book is a testament to two important journeys of discovery
which merge in the person of Susan E. Kolb, M.D.
The first is the recognition and definition of an important,
modern, and environmentally caused new disease, which according to the
rules of naming medical disorders is best called siliconosis. Dr. Kolb
has made major contributions to this recognition and is one of a limited
number of physicians qualified to bring these matters to more general
attention. She prefers the equivalent term, silicone implant disease,
which conveys to the afflicted patient a more direct statement of cause
The second journey is even more remarkable: Dr. Susan Kolb
experienced the same adverse effects from her own silicone based mammary
implants that impacted literally hundreds of thousands of other women.
This book is timely. Against a great deal of research and
clinical evidence in the peer reviewed literature in many fields, some
dating to before 1950, the American Food and Drug Administration partially
reversed its incomplete moratorium on silicone gel content silicone mammary
implants in 2006. The ban, imposed by FDA Commissioner David A. Kessler,
M.D., J.D. in 1992, was based on such issues as prevalence of rupture
with release of silicone gel and oil to elsewhere in the body, fibrous
deformation of the chest wall, and a high risk for replacement far short
of stated claims of product longevity. What was not taken into proper
account was the immunogenicity of silicone. Had it been, so called saline
content devices would have fallen under the moratorium as well. It is
the contact of the outer surface of the silicone shell that stimulates
the immune and inflammatory response to which are later added the cogent
problems of infection, biofilm formation and scar contracture.
controversial at the time, and contested strongly by implant surgeons
and even more strongly by the manufacturers of these alien devices, the
partial ban of silicone implants had a remarkable counter effect. The
frequency of implantation of saline content silicone devices rose substantially
for the rest of the decade.
After consultation with basic scientists at the University
of Tennessee, in particular the then medical director of the Memphis Pathology
Laboratory, David L. Smalley, Ph.D., and my then clinical chairman (Obstetrics
and Genecology), Frank W. Ling, M.D., and others, I began a clinic to
explore the effects of implanted silicone devices of all kinds, not just
mammary prostheses, in February 1996. The timing was in response to the
evident lesions formed in the tissues surrounding the devices, the axillary
and other lymph nodes and a complex matrix of systemic signs and symptoms
new in the health experience of hundreds of women. What was unexpected
at the time was the rapidly increasing number of women coming to clinic
with adverse effects from their saline content silicone devices.
It was immediately obvious that most of them did not understand
that the phrase “saline implants” was a deliberate simplification
by the manufacturers, the spinmeisters and some surgeons, to bypass the
uncomfortable and inconvenient truth they were basically silicone devices
which happened to contain saline rather than other, more liquid silicones.
Dr. Kolb describes this accurately and effectively later in this book.
Now that many aspects of the restrictive conditions of the
partial moratorium have been removed, we are on the verge of a new epidemic
wave of anterior thoracic scarring, chest and axillary deformations, device
rupture and migration of small amounts and lighter weight silicones throughout
the body, all with their attendant and often vigorous immunological and
This book, written with clarity from her experience, both
as patient and as surgeon and with the wisdom gained from her hundreds
of patients, is a cautionary tale for the near and distant future. What
comes to the fore are the dysfunctional reviews of science practiced at
the FDA these past ten years or so and the innate conservatism of many
physicians to reject what is new, no matter how strong the evidence.
Medicine as practiced is a disconnected receptor system
for information in which those with vested financial interests have the
power to force the conversation away from basic truths, even to attempt
to discredit those physicians and researchers with abundant data and no
personal axe to grind, to use the common metaphor of a past generation.
Dr. Kolb’s record, as both an implanting and an explanting surgeon,
shows her to be a clinical researcher of the finest type, and as a woman
afflicted by siliconosis, is unassailable by those forces and interests.
Her abilities as a surgeon and a caring physician were the
two reasons, during my active clinic years, 1996-2002, I referred more
patients to her than to any other explant surgeon. This book, which so
well displays the double journey she has undergone, now with a deep understanding
of the nature of the disease and how best to help her patients enter the
healing process, justifies completely the confidence I had in the late
1990s. She touches on the problems of silicone disease as one of many
now emerging environmental threats to human health, some of which, like
siliconosis, are due to alien chemicals in the human body.
This book is neither an exposé nor a diatribe. It
is a call to allow the self correcting scientific method and process,
based on data, not opinion, to be applied to those now emerging disorders
of the modern world. The same must be said of the now re-emerging problems
of siliconosis. It is the diary of a pilgrim bearing the professional
burden of deep knowledge and the agony of her personal experience.
D. Radford Shanklin, M.D., F.R.S.M.
Emeritus Professor of Pathology,
Laboratory Medicine, and Obstetrics and
Gynecology, University of Tennessee, Memphis
For more information, or to order this book,
contact Dr. Kolb at (770) 457-4677 and mention this website.