Dr. Robert Whitfield MD explains risks of breast explant surgery, including pneumothorax, hematoma, infection, and scarring. He says complications are generally low with an experienced surgeon and describes aesthetic options like fat transfer and lifts to address tissue changes after explant.
Questions this video answers
Nearly 1,200 explant surgeries ("over almost 1200 explants").
Five pneumothorax cases in almost 1,200 explants (anecdotally reported).
Patients as young as in their 20s and as late as in their 80s.
Chapters
It's Dr. Whitfield, and welcome to my breast implant illness podcast. Today's question that we're going to look into deeper is, are there any risks or complications associated with breast explant surgery? So breast explant surgery is performed for a variety of reasons. Most commonly in my practice for breast implant illness, it can be obviously performed for somebody who's tired of having their reconstruction, just wants it taken down, wants to go back to a natural result or a breast cancer patient who's flat. I've had a experience in all of those, relatively large experience, obviously in breast implant illness. Risk and complications associated with explants are basically the same with implants, with a couple caveats. There is an incidence of entering the chest cavity, which is called a pneumothorax, in augmentations. It's low. Personally, I've done over almost 1200 explants at this point. And that instance where you get a pneumothorax has happened to me in five cases in, you know, almost 1200, you know, explants. So super low incidence. And I haven't had a hematoma, which is the next thing that I would actually be more concerned about, which is bleeding. And I haven't had one of those in, you know, several years actually. So you. All those things should be low and, you know, a skin infection, super low. I don't drain people anymore. I haven't had an infection due to drains and over a couple of years, obviously. And I've had one person get an infection when I haven't used drain in an explant only case and had one other infection. So that's super low as well, given how many I do and how high volume practice I have. So it's always bleeding, infection, scarring. All right, so, you know, scarring going to happen because you're reopening an old scar or you're revising a lift scar or you're making a lift scar. So scarring is part of your, you know, genetics. But typically when you're taking things out, there's less scarring after because there's less pressure, because the implant's gone. So there's weight, there's less expansion of tissue. Tension is one thing that really promotes scarring. All right, is there asymmetry that can happen? Sure. I mean, I mean, everybody in the world has asymmetry. 95% of the breast folds are not symmetric. They're not at the same level. They're about a centimeter apart. Most people don't have the same size breast and certainly that's why they got breast implants sometimes because they're not the same size. They went more symmetry, you know, they wanted enhancement. So obviously taking this out doesn't satisfy that in terms of a aesthetic. So when it's like that, I'm, I'm, I'm always trying to look for answers for these, you know, issues. And I feel fat transfer helps with some of these aesthetic issues. So that's something I do commonly. And then can you have poor wound healing? I mean, that's really subject to how we optimize patients. So I don't really see that in my practice. I work very hard with diets, supplements, other testing to optimize and lower inflammation, optimize hormone levels, enhance recovery anywhere we can. In terms of other factors that can be problematic, I think low BMI patients who have big implants are the most difficult patients. They have more breast sagging, or drooping, you know, long term, I feel like those patients would be optimized if they could be with a fat transfer because they're low bmi. It's really hard to find enough fat. But even my, my clients are low bmi. We get them optimized. They can have a delayed fat transfer, awake in the office, under local anesthesia, which sometimes is better for them. So I feel like that's an option that is utilized and becoming more and more utilized. Big, big implant in a, a, a patient that it doesn't fit their frame, so you're doing a lift. Maybe they can't, you know, have a transfer, so they've got that body image change that they've got to work through. And we try to provide as much support as possible for that. The kind of baseline medical issues. I've dealt with lots of problems with lots of different issues. Cardiac issues, you know, pulmonary issues, which obviously for us are concerning in surgery. But we've worked through those and got patients to a point where they can undergo their procedure safely and recover comfortably, even if they're coming from out of state. They'll stay here for about a week in Austin. And I've operated on a range of clients, you know, as young as in their 20s and as late as in their, you know, 80s, really. And so that wide range of health and overall age has become independent in terms of us taking care of patients to minimize any risks or complications. We do all of the testing through my heart program, optimization with supplements, diet treatments, lymphatic massages if indicated, peptide therapy if indicated, you know, IV therapy, whatever we can do to support the patient. We do because it is a large decision undergo explant surgery, want to provide the best possible setting for them. So we always want patients to pick their explant surgeon carefully. If they can't come visit us in Austin or have a virtual we know we can't take care of everybody. I'm limited by how many I can care for at one time, but we have a large network to help and provide support. We want everybody just to get the best care possible. So always seek out a qualified surgeon, make sure they're doing explants routinely and they understand the ramifications as I've discussed them on my shows and wish you all the best on your healing journey.
