The Dr. Robert Whitfield Show

In our previous episodes, we mentioned a variety of reasons why patients decide to undergo breast implant removal. Regardless of the reason, it's crucial to have a comprehensive understanding of the potential risks or complications associated with this breast explant surgery.

That’s why today’s episode is another important one. Knowledge of the potential risks allows individuals to make informed decisions about whether to proceed with the procedure and enables them to prepare and prioritize their health and safety.

One of the complications after a breast surgery, although quite rare, is pneumothorax, which is an incidence of injury in the chest cavity. I’ve personally performed almost 1,200 explants. Such an incident of injury has happened to me 5 out of 1,200 explant cases, which is a very low incidence.

As with any surgical procedure, there is a risk of bleeding and infection. One of the more concerning complications involving bleeding is hematoma. And fortunately, I haven’t encountered one of those in several years. I also haven’t had an infection case due to drains in over a couple of years.

As with any surgical procedure, scarring is a common risk. The visibility of the scars depends on various factors such as the surgical technique used, the patient's healing process, and more. However, it's important to note that while scarring can happen, there are measures and techniques available to help reduce the visibility of scars and promote optimal healing.

Personally, I think fat transfer helps with some of these aesthetic issues, which is why I usually do it and recommend it to my patients. Additionally, I work very hard with diet supplements and other testing to optimize patients and lower their inflammation.

As much as we can, we really ensure that we get to optimize the patient’s hormone levels and enhance recovery any way we can. With regard to BMI, I think patients with low BMI and big implants are the most difficult patients. They are more prone to breasts sagging or drooping in the long run but they can have a delayed fat transfer.

To minimize any risks or complications, we do all of the testing through our Holistic Accelerated Recovery Program (HARP), alongside optimization with supplements, proper diet, treatments, and lymphatic massages because we always want to provide our patients with the best care possible.

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The frequent concern that I get from patients is whether or not they will have scars after they have their breast implants removed, known as explant surgery. This is understandable because scarring is a common concern for those undergoing any type of surgical procedure.

Women who have had prior surgeries or procedures may have already dealt with scarring and are aware of possible negative surgery effects, so they tend to inquire about potential scarring to understand how it might differ or compare to their previous experiences.

Today, I’m here to answer that question to help you learn more about the aftermath of breast explant surgery, particularly regarding scars.

The first thing to know is that when we perform explant surgical operations, we do them through the fold, with a vertical periareolar approach.

Factors like breast size and shape are also taken into consideration since the size and shape of a patient's natural breasts play a role in determining the outcome after implant removal.

If you have wide breasts that extend into your armpits, you're going to want that narrowed. Otherwise, when you remove the device itself, it may be more flattened and boxy at the bottom.

The usual approach when it comes to these instances is the vertical technique, which is basically like looking at the scar pattern as a lollipop.

When we use the vertical technique, we are able to take and lift the tissue below the nipple complex as we close it. As a result, we get an increased or elevated nipple position without removing the nipple.

For people who have already gone through lifting procedures, I revise the incision by carefully tangentially excising the skin around the areola for it to fit smaller breasts. When we speak of tangential excision, we’re not removing the nipple complex, but rather removing the tissue below in a way that allows us to close and lift at the end.

When we’re done with the vertical excision, we now have a wide-open appearance, allowing us to view and even go through the tissues. The implant scar capsule is then exposed to us, which we take out circumferentially in an intact manner.

On the other hand, we need a slightly bigger incision if we’re going underneath the breast to get everything out. In such a procedure, it becomes a bit more challenging because the tissue around it makes it difficult to get everything that we need out. In fact, we need a 6 to 7 cm incision to get that out, all hidden in the fold.

In doing a periareolar lift, we can diminish the stretched-out areola if that’s what you want to do – to downsize the areolas to match smaller breasts. That’s just going to leave you with one scar pattern around the outside of the areola.

We’ve compared the vertical technique to a lollipop, as mentioned above. That technique leaves you with a lollipop-type of scar but allows you to take out excess skin and fatty tissue.

As much as possible, we want to minimize scarring whenever we can. That is why we really do a careful assessment when it comes to these procedures. These are just some of the things that we discuss and evaluate to see what will work best for individual clients.

In some cases, the patients consider additional procedures such as breast lift or fat transfer to improve breast shape after implant removal. These options can help restore a more youthful appearance or achieve the desired breast size.

What I emphasize in my other episodes is to make sure to consult with a qualified plastic surgeon or provider who has a vast understanding of these things to ensure your overall health is taken into consideration and who will monitor your progress not just before and during the procedure, but also during your healing journey afterwards.

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The reasons why patients have breast implants or breast explant surgery vary. However, most people still don’t know the risks of having breast implants which is why there are those who undergo breast explant surgery as they suffer from various symptoms like capsular contracture or nerve pain and sometimes, even breast implant illness.

That is why it’s important to find a qualified plastic surgeon who you’re going to be comfortable with. And in today’s episode, we’ll be talking about the process of having breast explant surgery.

Some people think it’s difficult to find a plastic surgeon who would be a good fit for them and that’s understandable considering that we really have to be careful in choosing one.

Some plastic surgeons show examples or a gallery of samples that will help you in deciding what you want. They must have other documents or proof that would show their credibility as plastic surgeons.

Maybe they have a podcast or channel like I do where you can hear them speak before you meet them. That will help you develop a level of comfort with them based on how they discuss breast implant illness and their process for identification, treatment, and planning for surgery.

It’s important that we go through an extensive testing process to really trace the root causes of pain or inflammation and to provide clear and concise answers to the patients should they have any questions regarding their case.

For my patients, coming to see me in Austin is part of getting them ready for surgery. Prior to the breast explant surgery, we coordinate with our patients to make some changes regarding their overall diet and lifestyle. We also take into consideration what supplements and other medicines they are taking that might interfere with the surgery.

We have a Holistic Accelerated Recovery Program (HARP) that gets people on the right track, especially for the breast explant process. We lower the inflammation, if any, and prepare and optimize them for any procedures that they may undergo through.

We'll give you the tips and tricks postoperatively that will help you from a physical standpoint to further empower you not just mentally and physically but emotionally as well in your journey of recovery. We want everything to really go as smoothly and efficiently as possible.

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Besides choosing a qualified plastic surgeon, there are those who also take into consideration the costs of breast explant surgery. In fact, one of the questions we frequently get is whether breast explant surgery is covered by insurance.

Insurance coverage influences the decision-making process. Knowing whether or not such a surgery is covered by insurance helps individuals evaluate the costs and benefits before deciding if they are willing to proceed with the operation. In today’s episode, we’ll be talking about such insurance coverage and financial preparation.

At present, it’s hard to get breast implant illness or breast explant surgery covered by insurance since there is still no International Classification of Disease 10th Revision (ICD-10) coding for such a procedure.

As an alternative, what we use for the ICD-10 Code is breast pain considering that it is still indicative of breast implant illness. Many patients suffering from breast implant illness have experienced breast pain, which is why we tend to associate breast pain with breast implant illness. In line with this, patients also suffer from capsular contracture or pain associated with the implant, which may be nerve pain or breast pain in general.

Everything is very costly! The patient has to pay for the facilities to be used and also for the surgeon, which is why many patients ask if these can be covered by insurance. The answer is yes; however, breast explant surgery can only be covered by insurance upon showing medical necessity.

We used to provide basic letters of medical necessity. However, it became sort of a problem for us because insurers would come back to us to really inquire about many things, which really complicated everything. That is why we gradually shifted to implementing a purely cash-based practice. And although it is rare, I had people who had self- administered plans able to get reimbursement from insurance.

We have pointed out how costly it is for patients to get breast implants and to undergo breast explant surgery. Surely, some of you may have started wondering how to prepare for the expenses.

We use PatientFi and Ally routinely, which are great companies that work with our patients to provide options for financing. We can also work and consult with your tax strategist and advisors if it is possible to have these written off of your taxes as medical expenses. Another recommendation is to get support and counselling from a financial advisor or other patient groups advocating for explants.

You can also check out our Holistic Accelerated Recovery Program (HARP) to get started. We offer supplements and services that would help you to learn more about breast implant illness and help prepare you for financial investments.

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There are many reasons why women undergo breast explant surgery. Although some women do breast explant because they don’t want them anymore, some opt for breast explant surgery due to health issues or complications such as capsular contracture (scar tissue tightening around the implant), rupture, infection, or chronic pain.

Knowing the expected recovery time gives people reasonable expectations regarding their healing process. It prepares them for the temporary limits and pain they may encounter during this period, which can help lessen worries. In today’s episode, we’ll be talking about how long breast explant surgery and recovery take.

When you undergo an operation, whether breast explant surgery, breast implant, breast reconstruction, or others, you have to ensure that your immune system is in its optimum state.

To optimize your immune pathways, we do genetic testing and saliva tests which normally take a couple of months to get the results. We also conduct urine tests to identify toxicities and inflammation.

Another thing that should be taken into consideration is the environment, as it also affects one’s immune system and recovery after a breast explant surgery. If you’re in an environment with molds, you have to be careful as these affect the air quality, which can also negatively impact your health.

Having a healthy lifestyle boosts the immune system. Diet obviously plays a key role in all of these because if you can't eat and absorb nutrients, you can't recover easily.

You have to stay on track with your diet as it limits fluid accumulation by changing your oncotic pressure, which is the protein content in your blood so that you go from a leaky phase or catabolic phase after surgery to an anabolic phase or a non-leaky phase. This helps your swelling to lessen quicker.

Optimizing your diet includes an examination of food sensitivities and assessing your body’s food and nutrient absorption. We also have to check if you have bacterial, fungal, or parasitic overgrowth or leaky gut. It’s also important to ensure proper blood work and hormone balance for recovery since women have high levels of cortisol and sometimes estrogen as well, which can prolong recovery.

Generally, it takes one to two weeks of recovery if you’ve had an explant and it’s above the muscle and a couple of weeks - depending on how hard it is to get it out from behind the muscle. However, the recovery period still depends on many factors like your genetics, diet, lifestyle, environment, and hormone balance.

If we carefully optimize these, we’ll be able to give you the possible results and decrease the time for recovery. We're also introducing new things to enhance recovery like peptide therapy because we want you to recover as efficiently as possible.

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Behind the fascination with augmented breasts is a complex truth that involves a number of experiences such as trauma and the necessity for explants or breast implant removal. While breast implants have provided benefits for many women, they have also been connected with major complications and traumatic experiences.

In today’s episode, we are joined by Candice Barley, a breast implant illness patient advocate, and by Dr. Amanda Savage Brown, the author of Busting Free: How to Liberate Yourself from the Quest for Better Breasts Before, During, and Long After Explant.

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Not every breast explant journey looks the same, but when you hear these stories over and over again, the similarities are remarkable. Today, Candice Barley shares her breast implant illness journey with Dr. Rob. Candice's story is one of hope and ultimately a return to health. If you are struggling with Breast Implant Illness, there is hope for you as well.

In our previous episodes, we’ve talked about how inflammation worsens the illness. That’s why we have to figure out whether or not there’s inflammation in the breast implants. So what we do is we work up all the factors that contribute to inflammation by testing through our Holistic Accelerated Recovery Program (HARP) to really prepare the patients and optimize them for surgery.

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Breast augmentation or breast implant surgery has become a more popular surgical procedure throughout the years for various reasons. While it has many benefits, it also comes with potential risks such as capsular contracture, infection, breast implant illness, and more.

These risks are some of the reasons why many women opt to undergo breast explant surgery. That’s why it’s important to have a qualified plastic surgeon when considering surgery and to carefully assess both the risks and benefits of having breast implant surgery and other procedures.

My main take from the thousands of operations I’ve done is that we don't want to leave biofilm of any quantity in somebody. So what we do is remove all of what’s intact, if possible.

Women seek breast explant surgery for many reasons. There are those who want to lessen the pain from symptoms associated with breast implant illness like brain fog, sound and light sensitivity, shortness of breath, heart palpitations or chest tightness, neurologic symptoms in the arms, nerve pain, muscle pain, and joint pain, while some even experience gastrointestinal symptoms.

Whereas some are just tired and unhappy with their implants, some undergo breast explant surgery for breast reconstruction because they have issues with the appearance of their breasts. Maybe they’re uncomfortable with the size or maybe there are gaps or capsular contracture.

It’s important to carefully consider having breast explant surgery and to have a qualified plastic surgeon whom you can trust. It also helps to have a great support system around you throughout the process.

In our Holistic Accelerated Recovery Program, we have staff in place to provide more emotional support. I have several staff members who've had explant surgery, including our patient advocate and leader of our heart program. If they want to discuss this, we have discovery sessions you can participate in as well.

In our previous episodes, we’ve talked about how inflammation worsens the illness. That’s why we have to figure out whether or not there’s inflammation in the breast implants. So what we do is we work up all the factors that contribute to inflammation by testing through our Holistic Accelerated Recovery Program (HARP) to really prepare the patients and optimize them for surgery.

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Breast explant surgery or breast implant removal is a surgical procedure commonly done for various reasons such as implant issues, breast reconstruction, implant rupture, dissatisfaction with the appearance of the implants, or other cosmetic purposes.

In breast explant surgery, the implants alone may be removed or the surrounding scar tissue may also be included. In some circumstances, a breast lift may be done with the explant procedure to enhance the look of the breasts.

In today’s episode, we’re going to discuss what breast explant surgery is and why people want to undergo such surgery.

When we’re talking about breast explant surgery, we’re referring to the removal of breast implants and any scar tissue formed around the implants. Nowadays, many plastic surgeons do explants for various reasons.

My approach to explant surgery is to everything out in its entirety, which is why many people seek me out for that very reason. Typically, my clients are those who had a placement of a device either for cancer reconstruction or other cosmetic purposes and are experiencing symptoms associated with breast implant illness.

The most common symptoms experienced by my patients are anxiety, depression, brain fog, dry eyes, headache, light sensitivity, sound sensitivity, shortness of breath, heart palpitations, nerve pain down their arms or legs, joint pain, and other gastrointestinal issues.

Oftentimes, patients find me through what I offer in terms of holistic rejuvenation with fat transfer. In fact, I’ve been doing fat transfer since the 2000s for cancer reconstruction and other cosmetic purposes. I'm very comfortable with doing these operations and I have already refined my process, having done over 1,500 fat transfers.

When it comes to breast lifts, we have different kinds of techniques such as vertical, crescent, peri-areolar, and anchor breast lifts. The patients may have a preferred kind but it actually depends on the necessity.

If the patient had a peri-areolar placement, then we try to use that scar and remove the implant intact through it. The average length of a surgery is about two and a half hours. If we add a lifting procedure, it's a little over three hours.

Besides providing or enhancing the breast volume, it also helps offset some visual changes that the patient's not happy with. This is why as much as I can, I try to help patients learn about fat transfers and make them understand from my perspective.

Doing these operations can be draining, especially mentally, so it’s best for patients to have a great support system that shows up to help them and provide much-needed support.

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Although undergoing breast implant surgery has benefits, it also involves short-term and long-term risks like any other surgical procedure. There could be bleeding, infection, and scarring as short-term risks while for long-term risks, there are cases involving capsular contracture.

Reasons as to why women get breast implants vary but more than that and the benefits of having implants, they should also be informed by their provider about the risks of breast implant surgery. That’s why I’m here to discuss breast implant surgery and the risks that come with it.

We all know that as we age, we experience many physical changes. Some people lose weight and some gain weight. However, your implants will remain the same. But it is the breast appearance that we’re more concerned about as they may start to sag off of the implants.

When that happens, you’re more likely to need additional surgery. In case the tissue is aging off, you can recommend to your patient to undergo a lift surgery. This may be the case for women who were pregnant or had children and experienced expansion of the tissues with milk production and contraction after discontinuing breastfeeding. There may be stretch marks or other physical changes to the breast aesthetics.

In relation to the changes caused by various factors, we mentioned having a breast lift surgery otherwise known as mastopexy augmentation. Its purpose is to lift, reshape, and tighten the breasts for the improvement of their appearance.

If you're considering having procedures involving the skin, however, keep in mind there will likely be more complications related to skin infections. Obviously, there's more scarring when you're doing something like that because it's a visual scar that is going to be down the front of the breast and around the areola complex, unlike that in a primary augmentation, where it's probably under the fold around the nipple or in the axilla.

Like I always say, it’s important for you to choose a reputable board-certified plastic surgeon for these types of procedures. They have undergone a certification process demonstrating their knowledge and skill to have them qualified to perform breast implant surgery.

As a professional who did oncologic reconstruction for a long time, I was faced with many challenges with people who have pre-existing medical conditions. These cases trained us to be careful at every step of the process.

That’s why if a young woman came in for a consultation for a breast augmentation and upon collecting her information, I discovered she has a family history of lupus, rheumatoid arthritis, or other autoimmune disorder, I would not recommend that she get a breast implant for augmentation.

Your surgeon should make sure that they’re doing their best to monitor your situation before, during, and even after your surgery to avoid any complications. Before surgery, a plastic surgeon should conduct a thorough evaluation of the patient's health history and family history, including any medical conditions, medications, and allergies.

During the surgery, your plastic surgeon must take all the precautions in ensuring a safe and successful procedure. And after surgery, it's important for your surgeon to closely monitor your recovery and your overall healing process. Follow-up appointments and consultations are also crucial to address any concerns should there be any.

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