How Breast Implants Compromise Your Health and Make You Sick – Dr. Robert Whitfield MD : 1043

You're listening to the Human Upgrade with Dave Asprey, formerly Bulletproof Radio. 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 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? You must had a wake up call to figure out that this wasn't working. What was your wake up call?

All right. My background is mostly in an 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 the 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 in the United States is a breast implant, because. And it's a small number of women who actually get reconstruction. 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, I take all the scar out, and I. They 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, 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. Ah, 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 en bloc? And so for the audience, enblanc 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 it, 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, en bloc.

Versus total versus partial capsulectomy. 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. I think it was just kind of one of those things. Whereas I was like, I've always been intellectually curious, and I didn't make a big deal about her asking me that. I said, well, I take them out that way, basically. Anyway. So, yeah, it's fine if there's some nuances to it, but, yeah, of course.

Why did she want that? Was 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 centers. So I took her to the 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. 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 altogether. 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'd 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 antibiotic sensitivity profile for it. And I, as tradition, I follow 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 loss.

And she didn't call it that because this was 2016.

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 coming, calling. 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 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, you know, 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 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. 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 explain why I don't anymore. But got her clothes wrapped up. I open 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. 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 an occult infection.

So 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.

Right.

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 but 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 going to get to that. So because that's an Internet sensation thing. So I go out to the husband, I say, look, she's going to do that. I go out to the husband, I say, look, she's going to 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 going to find like some God awful bacteria right from the icu. Multi drug resistant, da da da da. Comes back normal. Now I'm just pissed.

But 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, MicroGen DX. 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. So 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 patients, physicians 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.

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

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 lot of doctors do listen to it. Thanks for being a listener. I didn't actually know this part. And yet 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 wavi, but okay, so you learned about EEG on the show.

So I sent an inquiry to WAWVI and Austin, who lives in Austin. He recognized my address because his family used to live right there. And he called me on 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 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 being a 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 aren't 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, like, 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 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 the 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 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 LPPA2, IL6, CRP, SED rates. 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. Sorry.

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. It's called the chronic inflammatory test. Nice. It's. 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.

Right. 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? What if there was something you could.

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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 map? So things of, and you know, as you know, if you can't absorb nutrients at all or you're limited, then your ability to recover is minimized. 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 scarring, 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 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 at 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 gonna have breasts that look the way you want them to look.

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

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

Absolutely.

That's part of my argument.

You got breast implants for a reason. So. And I obviously, after doing oncology work for so long, 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. With 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 and 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 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 the 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 everybody understands they come from different cell line. Breast cancer's 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 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, is a fat transfer?

Yeah, it's very Safe and individualized to the patient will have longevity. Of course, we talk about, you know, 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 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 still work when they're 60?

So as they go through metabolic changes, they'll gain and lose according to their habits, their lifestyle, their diet. So. 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. Right. 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 the mom who had kids and skin's in good shape, not stretch marks, not a lot of sag, and she's like, I just want more volume. 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 have 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 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 problem in patients who had large implants placed very, very tight skin envelope, meaning maybe they haven't had kids with is typical. And the rapid expansion creates too much stretch on those and that causes the, you know what you've described an absence of sensation or loss of sensation. And when I do their explant, I will find that nerve terminating into the capsule of the implant. Many times they may have nerve pain, they may have absence sensation as you've described. But I've seen all manner of nerves involved with the side of that implant as it runs from the armpit, from back through the armpit to the side. And those are very, you know, if you. I have people come in routinely and say, oh, you know, I have all this nipple pain. I have all this electrical type activity here. And that's what's the 12th nerve as it comes through that, that ear. I see it all the time. I try to take pictures of it too. So anytime I see it, I can show the client like, this is what was called palsy. This. It's like a traumatic neuroma, basically.

This is why I like talking with microsurgeons, because, you know, all that wiring stuff that I don't know, which is super cool. So. But the fat transfer, you're unlikely to have that because you can't. Okay, how many cup sizes can you go up with a fat transfer?

Yeah, typically it's one and a half cups. Okay. So, you know, and it varies, I think. And I always like anybody. I have examples in my mind where I feel like, yeah, this is a much better result than an augmented result. Because an augmented result rarely looks natural because there's too much upper pole fullness, typically. And over time, it won't change with the breast because if you put it behind the muscle, the breast implant stays behind the muscle, the breast comes and ages and goes off of that. So you get like a change that's obviously not stable aesthetically attractive.

Okay.

With time, because it. You want something that will age with the patient. And, you know, we have lots of clever ways to treat the skin now so we can actually tighten the skin up over time in a non scarring fashion. But we'll talk about that.

So, guys, that was what in, in theater work we call foreshadowing, because there will be another episode because Rob's really a massive innovator in a couple different parts of this. The thing that most impressed me to have you on the show now is the fact that you're doing brain scans of people and. Okay, brain scans with breast implant illness. Oh, look, you are having changes. And then you're also doing the genetic testing. You're using the DNA company, which is also really, really cool. Because, guys, Dr. Mansource has been on, I think four or five times on the show because they're doing such cutting edge DNA work. And to find that here we have a top expert in breast implant illness who's going to the DNA company. And yes, guys, I should disclose I'm an investor and advisor in the company, but you're doing that. I had no idea you were doing that until I sat down in your office. I'm like, you're using who? So what are you finding on the DNA side with breast implants? Because, because I think this is interesting.

You know, that we talked a little bit about the urine marker and inflammation. So that was a big puzzle piece. But the biggest puzzle piece has been functional genomics from Dr. Mansour's group and so helpful to us. And I now have over 200 genetic reports on patients with breast implant illness.

That makes me so happy.

And I explained to everyone, you know, I can listen now. And I didn't have this training, obviously in medical school because we didn't have that information. But if you listen to and recognize the patterns of poor functioning genetic pathways coupled with environmental exposures, they can, the story just writes it right in front of you. So if you have, in my mind, I think of the, you know, the four pathways described in their reports of immunity. The vitamin D pathway, the methylation pathway, glutathione, essentially, and the antioxidant pathway.

Geez. It's almost like if you've listened to any of the shows before, you've heard about these pathways, even if you don't have breast implant illness, say those one more time.

Glutathione, glutathione methylation, vitamin D and antioxidants.

I love it.

So, and eventually I hope to write a paper where we just talk about the archetypes of what will lead to this. Because when you have. And my first client who had that was not a breast implant illness client.

No kidding.

So the first client I ever had, a male, came to me and we do hair transplants and we use exosomes and all this stuff. And he's like, Dr. Whitfield, I want you to do my hair transplant. And he start. I was like, well, you have a lot of strange things in your health history and your review system. So I don't understand why you have so much inflammation. And I don't operate on people with high amounts of inflammation until we can create a plan and get them on our heart protocol with supplements to just lower their inflammation. Right? Because you don't want to operate on somebody in a high inflammatory state because you're not going to, you're not going to cause that to be better. Because Rob's the number one promoter of inflammation, right? I cause cortisol release. I give people problems.

Well, that's what surgery is, surgery does.

So you're, you're, you know, do no harm. So I said, you need to do this genetic test. I have you. You'll get some insight from this. And this guy, he was the first all four knockout I've ever had, so. All four knockout. So he had a suboptimal vitamin D methylation, glutathione, and antioxidant. So I told this guy, too. I was like, man, if you had breast implants, you would be, like, so sick right now. And he's like, what are you talking about? I was like, look, okay, so when these things don't function as, you know, like, you're three out of four, I look at it with my clients, and I was like, okay, so if we have all four that don't function, they're acutely sensitive to this. They have difficulty with everything we try to implement. So we implement it super slow. We take our immune support bundle. We use, like, only liposomal formulations so that we're bypassing the gut. While that's trying to get healed and really trying to bring their poor enzymatic function up so that they can actually have a reasonable level over, you know, maybe one or two months prior to surgery. You're trying to get this built up so when they have surgery, you're not then really setting them back, because what you don't know will really cause trouble for patients.

I so appreciate that you're doing that, and that's such a high standard of care for people. What differences do you see when people go through your prep protocols in how quickly they heal and what they do?

So once we do the battery of tests that I feel helps you the most, and I would just say that I've spent the better part of six years curating this. So the food test, the GI map test, the hormone testing, our total toxicity testing, which identifies bisphenol stalates, herbicides, pesticides, heavy metals like arsenic and groundwater, which has gone from. And mycotoxins, which are what Dave refers to commonly about toxic mold exposures. Combine that with our functional genomic testing, our inflammatory marker testing, and I can give you a very well rounded picture of what I think from an individual standpoint you're facing and how we can help you. And then, you know, I'm kind of the air person, right? So I have air filters all over my office.

You saw the ones around here, too. I walked into your office. It doesn't smell like formaldehyde in here.

No, we have the cleanest air in town in my office, you know, but your water. So I gave you a hydrogen water bottle when you visited us. So there's a Lot of things we can. Steps we can take, just like you highlighted in your video. And then, you know, I use all of the programming prior to surgery to get you in the best possible position for surgery at the time of surgery. It's very specific to how I run our. We call it an eras. Enhanced recovery after surgery. I have a certain amount of medication that I use on a limited basis around the time of surgery. You said you don't do well with propofol. I heard you talk about before. I do the explant surgery under dental anesthesia. And the night before, you take a medicine to reduce nausea, reduce inflammation, and prepare your nervous system. Because.

What's the medicine?

So we use some gabapentin.

Okay.

And Zofran and Celebrex. And so that's a common ERAS protocol around the United States. It's been published. We use one dose of IV antibiotics 30 minutes prior to incision to reduce skin site infections. And that's the standard of care. I don't put anybody on antibiotics after surgery.

So you take it orally beforehand, they.

Give it to you IV. Oh, IV 30 minutes prior to incision.

And if it's IV, it's less likely to affect your gut bacteria. Right.

Typically, it's the big misnomer is that if someone gives you oral antibiotics after surgery, they're somehow going to protect you from an infection.

Right.

That's nonsense. Wow. Okay, so we do our case. I have a very programmatic way to do the case every single time. Our goal is always taking everything out intact every single time. Whether we execute other steps, like I said, a lift or fat transfer, that's case dependent. And, you know, once we get the material out of the pocket, we use a lower PH solution for the pocket. So your audience understands. I have so much data regarding what's in a pocket. I would never use an antibiotic rinse to try to control what's in a pocket.

So you're just using something that's more acidic?

Correct.

You mean like vinegar?

Well, any unicellular or multicellular organism, as you know, cannot tolerate PH change.

Yeah.

So as soon as you do that, what's in the pocket is done.

And you don't use anything like ozone or silver or other things like that that are like, really old.

But I have ozone in the office, as you know. But I don't have it in the or. Okay, we close. I don't use drains anymore. I drain it internally, especially when I'm doing fat transfers. I interconnect the abdomen and breast pocket to Drain it internally. People who have tubes are more likely to get infection. I know that's heresy. But in general, if you have something sticking out of you, bacteria travels in, not out. So once that part of the procedure is done, I go and I do, you know, a take a series of pictures of the implants and capsules and do a couple videos because patients want to know in real time what I found. And I just do a brief video for them and we make longer ones. And then I open everything on the back table, examine it. And so you can't really see what I'm describing from results we get from quantitative pcr. And it's hard, hard. Even if there was a small cancer, you send that to the experts to look at under a microscope. So I take a small biopsy, I send it to the lab in Lubbock, MicroGen DX. They do all of my quantitative PCR sampling, and that comes back in a couple business weeks normally. And then the pathology is sent to a lab here in Austin. That's usually, you know, three to five business days turned around and we'll wash off implants, return it to the client, provided they're not ruptured. And I wrap everybody up. I know this is gonna another heresy thing, but I put ice packs on everybody before they wake up.

Okay.

Because the best anti inflammatory, the cheapest one that's most effective is ice. And the three medicines I described before, ice packs, just changing them 30 minutes on, 30 minutes off while you're awake, even more frequently if you want, will control your pain. Oh, I guess I didn't mention this. So I do an intercostal nerve block with a medicine that lasts about five to seven days. It's a liposomal bupivacaine.

Okay.

And it's called Exparel.

It's like lidocaine, but stronger.

Yeah. And it's diffusing into the tissue so it just sits there.

Oh, that's really smart.

Yeah.

And any of the canes, as I understand it, even procaine, they reduce inflammation of nerves. Right. Then reducing nerve inflammation seems to make everything better.

So when I see that nerve, I told you, I directly inject by it, so they never have that pain.

How common is it that doctors do that? I mean, are you just doing an unusual procedure?

Oh, I've been using Exparel. That medicine, doctors, surgeons use it quite frequently. Yeah, I've been using it since 2004.

Okay, so it's. It's not new news. No. All right. And for a lot of people, this is maybe like this is a surgical thing. But here's the deal. If you're going to go get a surgery, you might want to do a little bit of homework and just find out whether the person you're working with thinks like Rob or thinks like kind of a cookie cutter approach. Because if you aren't prepared for surgery, your outcomes are going to be worse. And if you have this weird inflammatory stuff that doesn't make any sense, maybe it's your breast, maybe it's a root canal. Is another common source of this of kind. Kind of a thing.

Oh, yeah, yeah. At one time we found Provotella.

Oh, wow. That's a.

Not very. It's in your mouth.

And if you look at some of the stuff that Naveen is talking about with Viome and guys, Naveen Jain, CEO of Viome. I'm also an investor advisor there. He's finding more and more mouth bacteria relations to what's in the gut and what's going on throughout the body. So I think our oral microbiome and our gut microbiome, there's a lot more science coming out about that.

And it.

It's one of those things where I don't think I'll be able to stop doing a gut bacteria episode at least once every two months for the rest of my life at this point.

Well, I mean, since you mentioned that. So, you know, I get asked all the time, like, when can I stop taking all these supplements and my diet and da, da, da. And I always ask, like, are you feeling better? If you're feeling better, what would Dave tell you to do? He'd try to make you feel even better.

As soon as you feel a little bit better, you should definitely drink a six pack of Bud and eat a box of Twinkies, because now you can. I mean, it's obvious.

Well, you know, I. I'm. I just. I just stopped there and I was like, well, you know, I think I want you to feel even better.

Oh, you mean you can keep upgrading over. Oh, geez. I. I guess. Okay. It's a big leap. Glad you thought of that. The. How many pills a day do you take?

About 40.

You say 40 supplements a day. Is it working?

Absolutely.

Do you feel pretty good?

I do. All right. I do. So by full disclosure, there's not anything I give a patient that I haven't taken, so. It was one of your shows, and you made me think about. You've made me think about toxic mold a lot.

Thank God.

And so with all the genetics from Kasha's company, you know, I'M just like, I hear the story and I ask them, like, if you go into a place where there's a lot of smoke, or if you. If you have a strong chemical smell, does it bother you or do you know you lived in a place that had mold?

Yeah.

And that's the entire state of Texas.

Well, it's the entire world. I mean, it's such a massive problem.

And so this is my hack. I give them oral liposomal glutathione in my office, and if it doesn't taste like it's supposed to, which you know how it's supposed to taste, they'll be like, hey, this tastes like sulfur. Like, yeah, your liver doesn't work very well.

So if people take oral glutathione and it tastes really bad, they need it even more. Yeah.

Because, you know, you can't outrun your diet. You can't pick your parents, but we can level you up. So if you just slowly start taking oral loop oral liposomal glutathione, you can bypass a problem with your gut for. Until that's better. But you can build up your enzymatic activity so that you're, you know, it's. It's what you say, it's hacking, right. You're. You're adapting to what your functional genetics are. You know, there's your genotype and your phenotype. So we have this genotype, and we're trying to use these supplements to give us a slightly different phenotypic expression of what's going on. And it is uniformly accurate. In my office, when these people do this, I know they have mold exposure or phthalate exposure or something on their tox report, because that's where all of that goes is to your liver. And if your ability to. So everybody needs to understand. So as Dave's alluded to on his show, many, many times, toxins that go to your liver have to be dealt with in the glutathione pathway. And if you can't, your liver burden is just. It becomes super abnormal.

I do want to make sure if you're listening to this and someone in your life has breast implants, you are@breastimplantilnessexpert.com yeah.

So let's. We've leveled this up too, because people have asked, can I figure this out? You know, on the front end? So we have a quiz you can take to identify signs, symptoms, many things we've discussed.

Okay.

And we've put together a consumer's guide to explant surgery to highlight things that we've talked about things like our recovery program, things that you would need to continue to heal after surgery. Surgery's not the. I think if you've been listening to this, you understand that I don't focus on just the surgery. Surgery is one aspect of this problem. It's really your genomics, your diet, your absorptive capabilities, your hormone balance, your toxicity level that dictate much of this. And we can now follow it and assess it. And then in my office, we see you at a week, a month, three month intervals after that. Because I have so many people travel from into Austin, out of state. I do things virtually, of course, I have an entire team. I have a detox specialist, I have a nutritionist, I have a patient advocate. I have NPs and PAs that are. Very many of them have had explants, as I might I can add. So they're uniquely aware of the problem. You're not going to call my office and get shined. No shade will be thrown at you for calling my office. So everybody understands the issue, and we want this to really elevate the understanding of the issue.

My read on this is that you are moving your field forward. And there are a few people who have been really, really brave about talking about breast implants, like Danica Patrick, who is a friend who's been on the show. She's been very public about it and just saying, hey, I feel so much better. I'm rebuilding my health after this. And so I believe that the real value that you provided in this episode is, look, if someone wants bigger breasts, that's okay. That's biohacking. You can have bigger or smaller breasts. You can also have two arms or one arm. I mean, you can remove an arm if you want. Like, it's your body. You get to do whatever you want with it. But you should know what happens when you do that. Your proposal saying, look, if you want to do it, you can do a fat transfer, which is safe, or at least safer than the other alternatives. But it's not as safe as having no procedures at all, because all procedures carry a risk. Right? But that's a path forward. So if that's your thing, you can do it. Number one, that would solve a lot of problems. And then number two, just acknowledging people who've had a procedure with implants, what does it look like? So thanks for doing that. And just, guys, that URL was breastimplantilnessexpert.com and I want you to go there, and there's all kinds of Resources. I mean, there's. You explant the documentary. Is that something that you did or is that something that you just used?

No, it's something that's been sent to us. I mean, there's more and more in this movement. I think our biggest contributions will be publishing our EEG study, our biofilm study, our genetic study. Those will be. I'm going to try to add as much scientific data as we can.

This is something that I know is real. I have too many friends, including doctors, in fact, many of them who've had their implants removed and just feel so much better. Some very close friends. And this is a real thing, just like mold. No one believes it's real. And it can take traditionally 20, 30 years for something like even mold to become more real. But when you have an industry manufacturing devices that make a lot of money, they're going to suppress that kind of information as much as they can, and they'll do it because of profit. And it's like there's an evil overlord saying, we will do this. They just make little decisions to highlight how good their stuff is and to ignore all the data and the opposite. But it's guys like you who are saying, no, this is reality. And I genuinely appreciate that because that's how we move our whole species forward. So, thanks.

And at Dave's encouragement, we've started a program to help train practices, other, thank God, medical providers to learn about this. And then I've started an explant surgeon program to help. You know, I think this is not taught really, in training in a manner that is how I would do it. So just being able to provide some resources and opportunities for observation of surgery and learning the ins and outs, you're.

Teaching surgeons how to do it, right? Because you don't get that in medical school. It takes a long time working with the surgeon and you have to have someone who maybe knows how to do.

It.

Which is amazing. And if you want to change the field, that's what you have to do. And it's just. It's an enormous amount of work. And I can see you did the work to do. The discovery, the journey you described of noticing one patient saying, this doesn't make sense, and just having that unrelenting mindset, like, I'm going to figure out what this is and doing EEG and doing PCR and all. And so that has changed God knows how many women's lives that this kind of quiet hope, hopelessness that comes when your brain doesn't work and you're exhausted and you're trying to, you know, do your job and your family and all.

That to the women you know, we want to support you and to your listeners if you have a friend, a colleague, your spouse, a sibling, a daughter, if they have these types of issues. And so we can highlight kind of basic things if someone's suffering from anxiety and or depression, shortness of breath, tightness in the chest, heart palpitations, really lots of problems with their digestive tract, from constipation to diarrhea to bloating, swelling, muscle and joint pain, restless legs, and they have this in accompanying having breast implants. It would be useful to send them to breast implant illnessexpert.com have them take a quiz and see if they can learn something and help them do that.

And share this episode. The whole point of the show here is that if something's really useful, then you send it to someone who could use it. And all the resources are linked on daveasbury.com on the page for the podcast. Thank you for listening, Rob. Thanks for amazing work in the field.

Yours for having me.

You're listening to the Human Upgrade with Dave Asprey.

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