Silicone surgery

I have just returned from lecturing and demonstrating dermatologic surgical techniques at hospitals and universities in Sumatra. While there, I read with great interest your lead article in the Sunday, May 6, 2001 paper on silicone.

I was privileged to be invited to do surgery on multiple ladies with impure silicone reactions while in Solo Tampil menarik tanpa silikon (Beauty without silicone). I was a keynote speaker on the subject "Complications of silicone injections" and "Beauty without complications of silicone" at a seminar in Jakarta.

The problems evolve not from properly administered pure medical grade silicone, but from the impure and adulterated products arriving from China, Taiwan and Thailand, your writers have determined. However, pure silicone products are used throughout the medical world by a variety of specialists, and it panics people to misinterpret this fact.

Artificial impact organs of a variety of types are used successfully, including breast, testes, chin, nose, ureter, etc. All are pure, placed in sterile fashion, and excellent for their respective intended uses. Recent use of a heavy liquid silicone for eye implant work has gone on successfully, and additional new products are on the horizon. But none of these are impure, adulterated or non-sterile, as found in Indonesia, and all are placed by physicians rather than lay operators.

A comment from a plastic surgeon, Dr. Yefta Moenadjat, quoted in your paper, is incorrect. Collagen injections do not stimulate "the formation of natural collagen after each injection". There is a minimal fibrotic reaction to the bovine (cow skin) product in some humans, but reliable and permanent collagen is not lain down after each injection.

Having personally participated in the original clinical studies on the product these many years ago, biopsy studies of injected sites failed to confirm Dr. Yefta's claim. Your reading public is advised to consult with knowledgeable dermatologists/dermatologic surgeons when any foreign materials are to be injected into or on their skin.

PROF. DR. LAWRENCE M. FIELD

Foster City, California

USA