Breast Explant FAQ @robertwhitfieldmd

Hey, it's Dr. Whitfield. We're going to do some FAQs about breast implant illness. So I get asked frequently, are there any studies regarding breast implant illness? And there actually are quite a few coming out in the literature now. And we just are about to submit our experience with PCR testing on over 600 samples. And since 2019 I've been doing PCR testing on the capsule material. And then and the capsule is the scar capsule, it's not the actual implant capsule. And that's to help us better understand what kind of bacteria are on the surface of the capsule. And about 30% of the time we find bacteria on the capsule. Along those lines. So biofilm are groups of those bacterias that can give off signals. And recently there was a paper by Thuntuna and this paper talks about something called 10 Home Oxylipin 10 Home. And it really is interesting in that this substance, if it's raised, it can actually contribute to fatigue. A lot of my patients experience fatigue. So the research is getting better and better. And I know I get asked routinely about, you know, is this going to be covered by insurance? Currently that's not the case. I've had a couple clients successfully get reimbursement on self administered plans. It's always everybody's responsibility is certainly to collect their information, file their claims. We give them all that information as well. All right, next question. Question is in terms of getting an explant, a lift and a fat transfer, do surgical plans change? And typically so when we make a surgical plan, so we're going to do an explant procedure, typically we're doing those and we're using the, say the incision can be under the breast, it can be down the front. When we do like a lollipop lift, which is a vertical live and a periareolar approach can be taken with smaller implants. So those are the three access incisions. And if we're going to do an explant, all of that's obviously determined beforehand. Now when we're taking fat, we're usually taking fat from specific areas and it's inner outer thigh, the love handle or the lower back area. You can also do mid back. And I recently had a patient request to do their upper back. So those are all fine. And in the front or when you're lying on your back, you can do a patient's abdomen. Just my patients are obviously typically maybe have had children experience weight loss, they may have skin issues, may have stretch marks, what have you. So you just have to Be more judicious with those cases with not over removal of fat because you don't want to make the skin looser. So we provide skin tightening. And I particularly prefer to use the product Body Tight. It's bipolar radio frequency, has a great deal of control. It's really safe and effective, gives about 30% greater skin contraction. So I prefer that product. When we're doing skin tightening, anybody 35 and over, I recommend doing that. And then in terms of placement of fat, back fat goes beneath the skin but above the breast tissue. So everybody has a layer of fat beneath their skin. And some layers are deeper, some layers are more superficial, depending on where you are on the body. But on the breast, basically beneath the skin, above the breast tissue, you don't want to be in the breast tissue and you don't want to put it in the pocket where the implant was removed. So typically those are our planning. I frequently now I'm getting asked about my sharp process or methodology. Our strategic holistic Accelerated recovery program is very effective in lowering inflammation. So we use it obviously in our breast implant illness patients because they have a lot of inflammation to begin with. I've discussed this on every show I've appeared on, including Dave Asprey's show and Lauren Bostick's Skinny Confidential. So chronic inflammation with the medical device like a breast implant can be very, very difficult for patients. And so we want to start lowering their inflammation right away. So we put them on supplementation, we do testing and then develop a detox plan for them as well. So we have supplementation for the year. We typically use liposomal supplements because many of my patients with breast implant illness have a lot of difficulty with absorption. So we use liposomal formulations. So those are liquid, they're easily absorbed. They're once a day to begin with. It's very simple. And then we do testing with functional genetic testing. We do toxicity testing, which is a urine test. We do gut microbiome testing. We do food sensitivity testing. We also look at blood work. And then we build out a detox plan. We have a separate team running detox for me now because we have so many patients. Those patients stay with the detox team for approximately a year as well. And then obviously, the surgical plan depends on what the patient's preference are and our ability to do that for them. So more and more people are doing sharp, they can do that remotely. And that program continues to grow. Now I get asked why patients who have blood work problems aren't changing after explant. And specifically we'll Relate liver issues and kidney issues. So our liver and kidney are main detoxification organs, liver more so than kidney. So if your liver number is AST, ALT, ALK, PHOs, total bilirubin, if those are abnormal, which I don't see routinely in my patients, then there may be underlying issues that has to do with non alcoholic liver fat deposition and alfd and that's probably more common. Some of that if you get into the nitty gritty is due to diet. So numbers like liver numbers that are abnormal probably will be a little bit more complicated to get resolved. And then if someone has an elevated creatinine, which is a measure of kidney function, that is typically not going to be resolved as part of an explant procedure. So although we can lower inflammation through our program, those are more representative potentially of other issues. And everybody asks about pain. So we have a really specific program to help control discomfort. Basically we start by lowering inflammation pre op with our sharp process. And then the night before surgery we have patients taking anti inflammatory, something to help with nerve pain, something to help with nausea. And then the morning of they'll typically at the surgery center, depending on their timing of the surgery, do another dose of that at the surgery center. And then the anesthesia providers that we work with are great at performing nerve blocks so they do nerve blocks for us. And then in the operating room we add additional medication to block nerves as well. And that is really, you know, all being done prior to anybody waking up. Our wake ups are very smooth. Our patients go usually between 30 minutes and an hour after surgery. They typically stay in a hotel or an Airbnb around our location in Austin. And they're here for about seven to 10 days to take advantage of all the things we have in our office. So the day after they'd come in and get hyperbaric oxygen therapy, red light therapy. We have a lymphatic massage device that we currently are really happy with called a flopresso which helps you get into more parasympathetic state. Really good for flushing out the toxins and fluids and then obviously having a gluten free, dairy free diet high in protein. We recommend eating at the well in Austin. Here there's two locations, one downtown and one in Westlake by us. They're gluten free, dairy free, seed oil free restaurant and you just got to stack good days on top of good days. Our patients typically have a very, very low discomfort level even with explants, lifts and fat transfers.