How Breast Implants Compromise Your Health and Make You Sick – Rob Whitfield, M.D. – #1043

You're listening to the Human Upgrade with Dave Asprey. Today's interview is an in person interview in Austin, Texas. Today we're going to talk about something that I think you need to know about because either you may have breast implants or people in your life do, and it's not really clear to understand why you're having some strange symptom and how it could possibly be connected to your breasts. So what I thought I'd do is I'd find a top expert in the country on breast implants and that we'd have a real serious conversation about it. So Dr. Rob Whitfield is here on the show and he's done a lot of breast implants. You've put them in.

Yes.

And you've taken probably more out than you've put in by far.

Yes.

All right. So most people who put breast implants into women will sort of tell you on swear of, on penalty of death, breast implants are harmless. But at some point you must have had a wake up call to figure out that this wasn't working.

What was your wake up call? Right. My background is mostly in oncology reconstruction. So my intent through training both in surgery, plastic surgery, and microsurgery was to provide patients with procedures that would salvage and protect them through a cancer journey. And so predominantly breast cancer is a very prevalent cancer. So we were involved with cancer reconstruction. And one of the tools you utilize in cancer reconstruction is a breast implant, obviously.

Right.

If you're doing a sarcoma reconstruction and they remove part of your tibia, you use a tibial implant. So whether it's a knee, a hip, a breast, a dental implant, a neural spinal implant, a defibrillator, I've helped every single provider take care of their implant problems. So there's not a implant that's devoid of a problem because it's a foreign body. And when you put it into somebody, your body immediately reacts to that and creates a capsule around a scar because it doesn't want that in your body.

Right.

So everybody has an immunologic response to it. And so I get asked a lot, like how many breast implants did I put in? Which is something you were alluding to. Well, for oncologic reconstruction, the dominant method of reconstruction, United States is a breast implant because. And it's, it's a small number of women who actually get reconstruction. The, the reason it's so prevalent is in any community, if the plastic surgeons in those communities are basically trained, they can provide that service for the client. My specific Niche was microsurgery. So I would do nerve and muscle sparing procedures to take skin and fat from the abdomen, inner thigh, even upper buttock tissue, and transport that to the chest and hook that up via microsurgery using the blood vessels that the cardiac surgeons use to revascularize the heart.

Okay. A little bit different than sticking some balloons in and filling with saline, right?

So for me, I didn't put in a large number of implants. I took a large number out. And when I look back at my experience, I was taking care of folks with this problem without knowing I was taking care of folks with this problem.

Okay.

Somebody would show up with a red chest, a tight band feeling across their chest, the capsular contracture, very firm implant. And I knew. I'm like, well, if I just take that out and I take all the scar out and I put their own tissue there, then it's autologous. It'll heal.

It'll work. All right.

So moving forward. In 2016, I had a breast cancer patient who relocated from Georgia to retire here in Austin on the lake. And she came to me and said, I want my Reconstruction taken down, Dr. Whitfield.

And I said, okay.

There was no specific reason. She just wanted to be flat. She was tired of having a reconstruction. She had had one for over 20 some years. She had no real physical findings on examination. Her history was otherwise consistent with a breast cancer survivor. Her laboratory analysis, which we'll talk about later, just revealed basically nothing.

Okay, so she was healthy.

Yeah. One complaint.

Bad fatigue. Oh, okay, so she wasn't healthy. People who are tired aren't healthy unless it's because they didn't sleep or they ate crap.

But the predominant thinking, Dave, is if you had cancer and you were treated with poison to cure your cancer, and you had bone marrow suppression, that explains your fatigue. And I was in that lane. That's what I saw.

That's what you believed.

So I took her to the operating room. There's one caveat. She asked me to do something I had never been asked before by a patient. She said, can you take out my implants? Enbloc. And so for the audience, enbloc is a term used in pathology. It's tumor extirpation, or removal is done en bloc. Say, for a sarcoma or any cancer, you want to be around it, not in it.

Okay. So she wanted you to take the tissue around the capsule, the scar capsule.

And the implant together. So when I talk about, I say it's like taking things out in an undisturbed manner, like not breaking the Easter egg.

Okay, so the Easter egg, just for listeners, you have the silicone or whatever, the bag of fluid is made out of the implant, and then you have a scar capsule around it that your body made. And you could take out just the implant and leave the scar.

Correct.

Okay, good deal. And so en blanc meant removing the scar tissue and the balloon enblock versus.

Total versus partial cap selective. Okay. So, I mean, I had done cancer surgeries with my colleagues and on our own and reconstructed. And so this was not a big thing for me to do.

Yeah.

And so I did it that way.

But how dare you do what your patient wanted? I mean, aren't you the doctor?

Well, I think it was just kind of one of those things where I was like, I've always been intellectually curious and I didn't make a big deal about her asking me that. Yeah. I said, well, I take them out that way, basically, anyway. So, yeah, it's fine if it's. There's some nuances to it, but yeah, of course.

Why don't you want that?

Would she. She didn't allude to that at the time. She did not tell me anything. And I was like, okay. So I took her to the operating room. She had to be monitored overnight for a separate medical condition. So her case was done in the hospital, which predominantly. I don't use hospitals, I use surgery center. So I took her to operating room. And so each oncology takedown for reconstruction proceeds for me the same way. Of course, I'm trying to do everything and take it out intact. Because if you're going to have a cancer recurrence, it's usually at the scar in a breast cancer case or the tissue associated with the scar underneath it. So you excise the scar, you take it out all together. And so when it comes out and the pathologist looks at it, they can actually make sure that everything is in order. And also you take cultures of the area when you remove it, because as we all know, implants are foreign and they can become infected, frankly, infected or contaminated with biofilm.

Okay.

So I take everything out and on her one week follow up, I see her and she's doing very well. And we're going through the pathology. There's no evidence of recurrent cancer, which is obviously great. And then I look at her microbiology report, and she has an E. Coli infection. Not a smattering of E. Coli. A true.

A medical crapload infection.

And just so the audience knows, for a hospital to identify that there is greater than 10 to the fifth or 100,000 bacteria in that sample. And so I was pretty taken back by that. I had missed a breast implant infection. I hadn't missed a small amount of contamination. I had missed an entire occult infection. And so that really bothered me. And I. So I went back through all the notes and I talked to my team. I was like, I don't what is going on here. And because it was done in a hospital, as you know, they'll create an antibody antibiotic sensitivity profile for it. And I, as tradition, I followed that profile, put her on antibiotics, and what do you know, magically, her fatigue was all better in a month.

You mean chronic infections anywhere in the body make people feel tired and have all sorts of unpredicted things? When bacteria make bacterial toxins and circulate them around in your body.

Yeah, it was pretty shocking. So I think we're all basically collections of experiences. And this one shaped how I practiced moving forward.

So what made her want to get it taken out this way? She had to have some secret knowledge or she was psychic.

Well, she didn't really ever allude to this. But shortly thereafter, my office started getting calls from patients requiring explants. And they're like, you have all these people wanting this now. So she put me on some Facebook.

She was probably an early advocate for breast implant.

And she didn't call it that because this was2016. She. She was. And you know, people who do well, don't like wander back to see you. So she just kind of went about her way. And all of a sudden I just had people like come and call in. Not tons of initially, but because I would do it this way. And what's becoming the vernacular en bloc, which is it's not a term that's, you know, frequently going to be used, but that's what's posted on these message boards. And they identify surgeons. And then I started having people come, and as I left my group practice, went into solo practice, this became more and more the theme. I still did oncologic reconstruction. I would take care of breast implant problems, meaning that if you had a capsular contracture, if you had a poorly positioned breast reconstruction or a cosmetic one that had been revised multiple times because of all my experience using techniques for cancer patients, I would correct those, but just so that everybody listening understands those all will ultimately fail.

Wow.

It doesn't really matter how good I am. You can spend all day, pat yourself on the back, because eventually that device will, over its lifetime, there will be a problem with it. My wife came and asked me for breast implants, and I was like, no, first of all, it's not my aesthetic. I don't think big boobs are the thing. But second of all, if you can avoid foreign bodies of any nature, then I don't feel like that's a bad thing for your biome. I think as much as we can take care of ourselves through improvements, and whether it's our diet, supplements, sleep, many of the things you ascribe to, implants don't really fall into those as. As categories. So we just kept rolling along, doing these cases. And in Q4 of 18, I had an ICU nurse travel from Louisiana. Her sister lived in Austin. She wanted me to do her explant, and I did her explant. And it was the nastiest set of implants I had ever taken out. I take everything out. Hers went according to plan. No disruption in the capsule at all. Took it all out, put it on the back table, got everything. You know, at that point, I used to use drains, and we'll explain why. I don't anymore. But got her clothes wrapped up, I opened these things on the back table. And I think many providers confuse gel bleed for biofilm.

Oh. So they're saying that the gel is coming out of the thing, but it's not. It's actually growing on it.

So you know what biofilm is? It's basically a polysaccharide, and it's gooey. And when people, like, feel it, and I see them on YouTube or IG going like, this is bio or this is gel bleed. I'm like, no, that's biofilm.

So it's basically a bacterial slime.

Yes.

Like, kind of snotty, right?

Yes.

Yep.

And, you know, and your audience should know, when you do the traditional culture swab technique on biofilm, you will not find out what is there. The bacteria has purposefully created that biofilm to avoid detection by your body. And by the techniques we use, you.

Know what it's like. Some people have thought about the lining of the gut, right? And if you think about it, you have the gut and you have a layer of mucus, Right. And the mucus is put there by your body so that you don't digest your own gut, basically. And so you need to have that slimy layer that's there, and the bacteria is behind that layer. Right, Right. Okay.

So this is the second thing that changed our practice. So, one, I never assumed anybody with an implant didn't have a occult infection.

So you just.

Everyone has them I was when I got that symptom pattern which as we talked about earlier, like doctors are trained, they're trained to recognize patterns. And one of the problems with breast implant illness is it does not fit a pattern of recognition for the doctor.

It's a lot like toxic mold because the symptoms are, there's so many. And you might have, you know, eight out of 50 possible symptoms. Those are the things it seems like modern medicine is designed to fail at.

Yeah. And because they commonly happen at the same time in the same patient, it's even more confusing.

Well, that means it's hypochondria because if you have eight symptoms all at the same time, I mean, they teach you that in medical school, do they not?

Well, yeah. And this gal like, so this is an ICU nurse. When I used to get a medical provider coming to me, like this lady worked in the ICU for years, I'm like, God knows what kind of biofilm she has. She's colonized with everything, right? Everything. Every antibiotic resistant bacteria you can think of. This person would have. So had I used what tech I use now, I would have really had some insight. But back then I was using clia based lab testing, which is taking a swab like a Q tip, wiping it in the pocket, sending it to the lab in a container, they incubate it, which has been done for 100 years, basically hasn't changed. And you'll get a report kickback if in fact there's something to kick back.

If there's something that will grow on the media that they're using it with and what that means for testing. Imagine that if you lived on steak and they wanted to see if you existed and they gave you impossible burgers, you wouldn't exist because you couldn't eat impossible burgers because they're not food. So it's one of those things, you have to have the right food for the right bacteria. So one of the things, even if you swab something that's unusual, it may not grow in the lab test. Right. So you're saying that universally you're seeing bacteria, but what about yeast and fungus? Are those major players too, growing on implants?

Oh, we're gonna get to that. So because that's an Internet sensation thing, so I go out to the husband, I say, look, she's gonna do better. These are clearly infected and I just need to wait for the results to come back. And you know, so I'm going back to my 2016 experience. I'm gonn some God awful bacteria from the ICU, multi drug resistant, da da da da da. Comes back normal. Now I'm just pissed that she was really sick. Yeah. And so if someone's infected, just so the audience understands this, back when I used to drain people, which I don't do now, the drain tube in this patient was putting out over 200cc's of pure fluid a day per side.

That's a lot of flu going through.

This, which means it's an infection.

Wow.

So I did, and I didn't do anything back then other than use antibiotic solution to cleanse a pocket and put a drain tube in, because that was my teaching, my learning from oncology reconstruction.

So.

Concordantly with this, I was in the leadership position in the Aesthetic Society's Research Education foundation. And ALCL had come to four, which is anaplastic large cell lymphoma. It's closely associated with textured breast implants. So I had never used textured breast implants in cosmetics at all. I had used them in reconstruction because the intent for them in a reconstructive case was to prevent malposition and rotation. So descent up or down, medial, lateral, or by degrees of change, because you're using shaped implants typically in a reconstructive case. And so this happened. The reports came out, I discontinued use right away as a early adopter of that practice, not knowing what was actually going on with textured implants and breast implant associated large cell lymphoma. And so, you know, there were reports with that early on about a particular bacteria, rickettsia. And I knew the company had that had done those with quantitative pcr. So I got in touch with that company, who happens to be in Lubbock, Texas, microgendx. And I said, I want to negotiate a rate to send all of my samples to you.

So you found a new way of doing testing.

Right. So they do quantitative pcr. So for everybody listening, quantitative PCR is a research tool that's now become commercially available to take a DNA fragment and amplify it. So if there's one copy, it's cool.

Because with PCR testing, if you just amplify it enough times, you can find anything you want, right? No.

Has to be there. Has to be there. So they run it. The table they run for me specifically is 150 bacteria, fungus and mycobacteria.

Ah, so you're going, oh, and mycobacteria. Can you say what a mycobacteria is for listeners? It's something that a lot of people don't know about. And you can say, dave, I don't care. Trust me, you care.

So mycobacterium in plastic surgery is a very bad actor.

Yeah. And in dental health. Right.

Yeah. So think of it and we'll talk about how I do fat transfers later. But every year, somewhere where sterilization techniques are not meeting standards, there's a mycobacterium outbreak. And it may happen in a few patients and before it's caught, but it is definitely a bad actor in plastic surgery, in immunosuppressed patients. If everybody remembers from the AIDS crisis, Mycobacterium avium was a big problem in patients with aids. But mycobacterium in a plastic surgery patient means to me they're significantly immunosuppressed or it's transplanted there through contaminate.

So the immunosuppression can happen because of what's in the breast implant illness itself. Right. Like the things that are in there or toxic mold in your environment is immunosuppressive. I used to have suppressed immunity and yeah, all sorts of stuff will grow during that. And then this stuff takes advantage of it.

Yeah, it's an opportunistic infection. You have to have suppression in order to have this be a problem. And so I wanted to make sure that all of my samples, my client samples, were being looked at completely, both for cancer and through a microbiology lens. Because you cannot have something that affects someone's long term health by doing what I did in 2016, which Ms. An occult infection and I certainly don't ever want to miss a cancer. So that is, technically, I do the operation the same way all the time in terms of I'm trying to take it out like an undisturbed Easter egg. We send this off to pathology, we send this off for quantitative PCR analysis so we know exactly what's going on with each of our clients. They have that peace of mind that I'm going to make sure and do it the right way every single time and get them this information. So there is no question at a month, three months, three years, did I do this and is it gone? So that spurned me doing this. And so From Valentine's Day 2019 to present, that's how everything is done when I treat a patient.

Wow. So you really test for all these things. The reason that I wanted to have you on the show today is when I sat down and talked with you a couple months ago, I was just impressed, number one, that you listened to your patients in a way that a lot of positions don't many people. When I go to see the doctor, many doctors would say, you know, kind of, I don't believe you because you can't have all this stuff going on. So your ability to listen was really strong. But also just over the last five or so years, it seems like you've unpacked the problem in a way that's. That's really changed how a lot of people think about it. So I would consider you to be one of our top experts in the illness around what's happening in the breast implants, what's going on in the body. And you do some things that are pretty unusual from what I've seen. For instance, you'll do an EEG, the same kind of stuff I do. At 40 years in, like, a brainwave test of people with breast implants. That is so abnormal for a surgeon that I would just call you Dr. Abnormal. But I'm pretty sure that's already been said, right?

Yeah, I've been called a lot of things. That's not even that new, honestly.

Right. So, EEG for breast implant illness, what do you find in the brains of women with breast implant illness?

So. So, like, I was upset when I would hear people be critical of the patients by saying, what. What the hell was brain fog?

It's so real.

And I was like. When someone from the client side said this to me for the first time, I said, okay, so I just need to understand exactly what that means to you. What. What is that? What are you describing to me? And I said, well, I have trouble remembering my kid's name.

Yeah, God, I remember that.

And then he said, I can't find my keys sometimes. I'm like, well, okay, that's short term memory loss. So if you just convey to the. To me, as a provider, if you say short term memory loss, I understand that.

Right.

I don't know what the hell brain fog is. I do now because I see it all the. I understand it from the client side now, but back then I was like, oh, so it's just short term.

Short term memory loss, plus a lack of energy, like, you have to summon the effort to think of something that should just come automatically is also part of it. And short term memory loss, at least that's how I would have described it. Right.

It was actually you who convinced me to do EEGs.

Was it really? That's amazing.

All right, so I was listening to a show, and you described Wavi Medical.

Yeah, they've been on the show. Guys, if you're new to the show, a. A Lot of doctors do listen to it. Thanks for being a listener. I didn't actually know this part. And yeah, Wahvi, we did an interview a while ago about brain speeds. And if you read my new book, Smarter, Not Harder, I talk about one of the measures that they take as kind of proof that there's an operating system in your body. So that's a little side note about Wabi, but. Okay, so you learned about EEG on the show.

So I sent an inquiry to Wavi. And you know, Austin, who lives in Austin, he recognized my address because his family used to live right there. And he called me on like Sunday in the office, and we talked and I explained to him what I was interested in by acquiring Wavi to look at my patients who have brain fog.

Yeah. And Wavi is an EEG system designed to basically do a basic brain health setup or checkup. Yeah.

And so Wabi has a wonderful program. They have an irb, an institutional review board approved study. So my clients who are willing to participate sign the study consent form and we're able to include them. So we try to do a EEG pre op, a week, post op, a month, and three months. And their scientists are, are looking at the data and they have identified changes in latency. I think for us, like, I want to provide as much data in science that we can apply to this problem. So it's not viewed as it's in someone's head. It's not viewed as hypochondriac or anything of that nature. So I feel like whatever we can do to help the women who have this issue, I feel like that's, you know, and I don't charge anybody to do this. I have this as part of my program.

And so do they have brain fog? Like, what do you see is there?

So we're doing it across the board. And there are changes in, as you would imagine, voltage, There's a little decrease, and we don't have enough accrued yet to make strong claims. But the scientist is comfortable with what we're giving them and they're reviewing.

Okay, got it. So the results are in 10. And guys, brain voltage. Like what? Yeah, your brain has electricity in it. That's what EEG is based on. And it's one of the things that when you do the 40 years of Zen training in Seattle on the last couple days, we actually train you to increase voltage in your brain. But you can only do that if you have the right minerals, you have the right building blocks, and you have enough energy production in the brain. So if all of the things are lined up to allow you to do it, then you need the brain to want to do it. And when you set all that up, you can actually improve your own voltage. If that's a tuning of your brain, that's the right one for your performance. So most people, when you say brain voltage, it's like, what you mean, I could have a different battery pack in my Tesla or something, but kind of, yeah, you can have a faster, hotter spark in the brain. And you're finding that people with breast implant illness have just lower levels of changes.

Yeah, they have changes. And as you would imagine, as you've alluded to on your show, many, many times, having toxic mold exposures. When you deal with the folks who have mold and breast implant illness, poor people, they have a lot of neural inflammation. And when you look at their genetics or their food sensitivities or their hormones or their GI map or their toxicity report, which we'll get to shortly, it paints a really good picture of why they have so much chronic inflammation and why the doctors who are trying to care for them have zero understanding of what is going on. One, because the. The actual tools, and you've mentioned on the show, the CRP and SED rate are the traditional tools used to look at inflammation in my patients, because I've looked at LPA, 2, IL 6, CRP, SED rate, they do not show that.

We're going to pause for a second there. He's looked at all the inflammatory markers that you would expect, and they didn't work. So I keep going.

Exactly. So these are the traditional markers that have been mentioned both by Dave on his show and we've looked at, and they do not track with this patient population.

Okay, so what that means is that when you have breast implant illness, the markers don't change to show inflammation.

No.

So then people say, well, on a lab test, you don't have inflammation, therefore you're making it up, therefore you're crazy.

Right. So last year, a company was brought to me at a meeting at the Mindshare Collaborative who has a novel biomarker for inflammation.

Okay. This is JJ Virgin's group. JJ's been on the show. She's a close friend. Okay. See how this works? There's almost a community of biohackers working all over the world to make things better.

All right, keep going. Well, had I not went to that a couple years ago, I wouldn't be where I am now, because the. The group. The collaboration in that group is strong. And when people Know what I do? They find other people to help me do a better job. So they brought this company to me, which I had knew, no, had no idea existed. And basically they had been treating their clients that had Covid with this. Not treating the client, checking inflammation on patients with COVID because they were trying to find a way to follow the inflammation that exists after Covid, which, you know, as you've explained on your show many times, a big cytokine release, poor genetics, will give you a lot of problems with COVID So basically it's a urine study that looks at metabolism on thromboxane A2. So I was like, okay, sure. You know, send it to us. And so we started doing it. And I have the tiniest gal in my practice who's wonderful, eats like a great diet, takes best supplements, has out of control blood pressure, breast implants, all the symptoms. And so I had to put her on blood pressure medicine because her doctors couldn't get her blood pressure down. And so traditional medicines in diuretics or ACE inhibitors, sometimes newer, doesn't mean better. So I put her on something old, centrally acting clonidine and lowered her blood pressure and did her surgery. Her brain fog is lifted. She feels kind of like herself again. She still has problems with hypertension, but she had the highest chronic inflammatory test before surgery I've ever had. It's called the chronic inflammatory test.

Nice.

I mean, I've got a lot of companies who, they're wonderful, but their names are.

Got it. So there's all kinds of.

So this test now we use routinely to follow. And I know it works because if you put someone on my program before surgery.

Okay.

It drops before surgery.

Wow.

So you're, you. You can level. You know, we always talk about leveling up in business, but you can decrease your inflammation and level up prior to surgery.

Got it. And so when you say put them on your program, what is the program?

So as everybody listening, this is. This is six years of work of figuring out, like, you know, what mistakes I've made, what have I missed? What can I do to help this group of women? And so on your show, you've elaborated on gut health. I don't know how many episodes you've done just about the gut.

I always think I'm done. And then they find something new like, damn, another show on gut health.

But okay, so we link your food sensitivity testing to your GI map. So we take what is going to cause you more inflammation from your diet and link it to, basically, I think of it as, like, what you're absorbing what you're not getting. And then do you have leaky gut? Is your secretory IGA super high on your GI maps? So things of. And you know, as you know, if you, if you can't absorb nutrients at all or you're limited, then your ability to recover is minimized. You're gonna, you're gonna stay swollen longer, you're gonna have fatigue longer. All things that nobody who's coming to my office wants. They want me to. You know, how little can downtime be because they have a family and work. No scoring, painless. These are just a few things that are asked of me on a daily basis. So food sensitivity, GI map. I really pay attention to the hormones now, and I think it's a really underserved area in this group because women, perimenopausal, postmenopausal women, you know, their, their hormones are changing. And in particular, the hormone that we look at specifically for me is their testosterone. Estrogen will change and go down. Progesterone changing, going down. But as those go down, testosterone just plummets. And if your testosterone is super low, especially the bioavailable testosterone, your ability to recover and get from catabolism to anabolism and healing phase is severely limited. This has been shown in all sorts of studies over time in surgery. And as I cared for burn patients in training, this was hammered into us about the use of oxandrolone, and we did a study on that in pediatric burn patients for wound healing. So I think I focus on that to make sure once again, that we're enhancing the ability of the patient to recover. But as we talked about a little bit too, I have a large number of patients who fly from around the country to get fat transfers the same time. Because when you take implants out, you're affecting the aesthetics, and you may be able to do a lift. But revolumization provides less of a visual change and more of an enhancement to offset that change.

Okay, so basically, when you get the artificial stuff taken out, you can get fat from somewhere else in the body. Put it in there, and you're still going to have breasts that look the way you want them to look.

We're trying to make it as close as possible because it is a big psychological issue.

It's okay to want to look the way you want to look.

You got breast implants for a reason. So. And I, obviously, after doing oncology work for so long, I. I'm uniquely sensitive to what those problems are with image and trying to get the Best possible results. I've done fat transfers since, you know, the 98, essentially. And people will typically say that, you know, they can't execute them. They don't work as well. Okay, just so for everybody in the audience, I'll explain what a fat transfer is. You take which a fat transfer has been done for over 100 years. You take fat from one location of the body, whether it's the love handle, the tummy, inner, outer thigh, and you transfer it to another place. So whether we're doing a breast enhancement or a buttock enhancement, fat goes where fat belongs. And that's in the subcutaneous layer beneath the skin. It's not in the muscle in the butt transfers, and it's not in the breast in a, in a transfer to the breast. So if you put fat inside of a breast, you will get cyst formation, radiographic, radiographic abnormalities. If you put it in the subcutaneous layer, which is underneath the skin, you will not have radiographic abnormalities, provided it all lives. And it will not confuse a radiologist trying to look for breast cancer and micro calcifications, which is often written about and is a misnomer. It's not going to be misconstrued for that. So the, the cancer screening doesn't change. I've been doing it in cancer patients since 2002, for goodness sake. Of course, we would never do anything that would affect the surveillance of a cancer patient.

So you're saying that if you inject fat in the skin around the breast.

Correct.

That you're not going to have problems with diagnosis later. But if you inject it directly into the tissues of the breast, like I.

Guess the glands in the breast, parenchyma.

In the gland itself, then you would have radiographic problems. Okay. That means that people.

Which is common sense, it means you.

Can'T see that if a person has breast cancer or not because it's going to look like breast cancer, but it's just fat. Right.

And fat transfers cannot cause breast cancer.

Right. But it just looks like it might be. So they freak out. Right.

So the. So everybody understands they come from different cell lines. Breast cancer is an epithelial. The fat is mesenchymal. Fat can only transform into a sarcoma. Basically, a phyllodes tumor is. A Breast tumor is super rare. So basically we're talking about things that. That don't happen.

Okay. So the fat transfer is safe because you're not going to get an immune reaction. You might get an infection, but not like a breast implant. Just because if the procedure was done wrong, you'd get an infection, but once it's healed, you'd be fine.

Correct. And super low complication rate. Super low.

But I've had fat taken out twice for stem cells and I did not enjoy the liposuction and what they did both times I had it done with Dr. Harry Adelson. I mean, it's not like suction to pull fat out like for cosmetics. It's about a coffee cup's worth of fat. They took it from my love handles, but it wasn't particularly comfortable to have it harvested. So probably the ease of slice a little bit open in the breast, stuff a balloon in and fill it up or whatever. I have no idea how it works. But you're doing the. Putting a breast implant in is much easier than pulling fat out via some mechanism from somewhere that hurts and then putting the fat and purifying the fat and putting it back in. But that procedure, even though it's more work, is safe. So if someone wanted breast enhancement, that's what you'd recommend as a fat transplant?

Yeah, it's very safe and individualized to the patient will have longevity. Of course, we talk about maintenance of diet. We use higher protein diets, higher fat diets, in fact, healthy fats, of course, heaven forbid.

Higher, healthier fat diet. How dare, dare they?

Okay, right. Especially me. I'm always causing a little trouble, but I think balancing that in conjunction with their hormones sets them up for success. So if I were to do a breast dog on a, you know, somebody in their 20s with that technique, a fat transfer, would it work? Well, yeah.

And will it, will it be still work when they're 60?

So as they go through metabolic changes, they'll gain and lose according to their habits or lifestyle, their diet. But it's yours, right? It's autologous, it's not foreign. So you're not going to attack it.

Assuming they don't go through rapid weight gain or weight loss. You have a healthy 24 year old says I want bigger breasts, you do a fat transfer and then if she maintains her within 10 or 20 pounds, her breasts are going to hold up over time.

Yeah, biologically it just makes sense. So when I have, you know, the mom who had kids and skins in good shape, not stretch marks, not a lot of sag, and she's like, I just want more volume. Yeah, well that's what you do. And of course it's going to have longevity provided they're taking care of themselves.

So this seems like a safer alternative for women. Who want breast enhancement. But does it affect sensation? Because I know women with breast implants who've lost sensation or they lost sensation in their nipples after they had them taken out. So if you do a fat transfer, are you going to have sensation problems?

It should not create a sensation issue because think of like the nerve supply. There's nerves that terminate around the nipple complex, and the superficial layer of the epidermis is epidermis and dermis. The 12th nerve comes in from the side. So when you place a device and rapidly expand and stretch it, you affect those nerves, particularly the 12th nerve. That is a common part.