The BB extraction went well. But it was a lot trickier than I thought it would be.
I thought my first BB extraction, right around a year ago, was tricky; it was located in the patient's scalp, not far from his temporal artery. So there was the scalp vascularity to consider. Plus shaving the hair around the site, then dissecting into the scalp and around the encapsulation took some time. But I got it out of there, with no complications.
Today's procedure was a lot trickier. The BB was located in his right little finger, so although the site wasn't nearly as vascular as my other patient's scalp had been, I was dealing with ligaments and tendons. Tricky...
I numbed him up, grasped the BB under the skin with a curved hemostat, and made a small incision in order to kind of pop or squeeze the BB out. No luck. As with the other patient, the body had created an encapsulation around the BB to keep it from interacting physio-chemically with the body. Dissecting the encapsulation took a lot longer than I thought it would, but I eventually got to the BB, grasped it again with the curved hemostat, and popped it out of there. It had been in there for 10 years. The patient was glad to have it gone.
I sutured the site up, asking the patient to flex and extend his finger a few times before tying off each suture.
Whew! Tough one!
But I did it. Happy patient! 
= new reply since forum marked as read
So. This explains your PM earlier today.
It went well, though; thanks for your support!... 
I so miss assisting with cases. That sounds so interesting. I was once a phenomenon with steri-strips and skin tears. That is my scope of practice. 
But the encapsulation required me to make a larger incision, and to dissect around it. So I had to close with sutures. 
...to put forth the effort to learn what it takes to provide good medical care for the rest of us. You have chosen to take on a great deal of responsibility, and I know the workload can be extremely demanding.
You're worth everything you earn and then some.
A 'make it yourself' CO2 plastic soda syphon bottle exploded in my hand.
Peeled back a deep 1" flap of skin on my palm.
He used 9 or 10 stitches to close it.
Almost no scar 5 years later.
A year after it happened I showed him what a great job he had done and took him out to lunch.
but my expertise is limited to bicycle bottom brackets. 
Aren't BB's copper clad steel spheres and couldn't those incredibly strong neodymium magnets be employed in extracting them?
I can't imagine ever leaving a BB, (or pellet) in there. Usually they are pretty superficial wounds that are dealt with, with bravado and beer, but I'll defer to your expertise. 
