Can Breast Implant Illness Be Cured?

Can breast implant illness be cured without explant surgery? Well, the short answer is no. If in fact the implant is a main driver of inflammation. I've talked about this on my show and other shows. And if we look at breast implant illness as a continuum of chronic inflammation, then a foreign body doesn't matter. If it's a hip, knee, breast, dental, cardiac, neurologic, doesn't matter what type of implant it is. If that's a source of stimulus to your immune system, then you can't completely resolve the symptoms of chronic inflammation without performing the explant surgery. And there's been a lot of discussion around should you perform a en bloc capsulectomy, partial capsulectomy, total capsulectomy, an incidence of one in a thousand of a lymphoma associated with a breast implant. So in that instance, the natural thing that we do is we don't want to actually create a new problem for a patient by either opening a pocket where there's lymphoma or in fact, do an incomplete excision in the setting of an infection or a cancer or anything of that nature. So we always carefully work around the capsule. Some capsules are thicker, some capsules are thinner. Sometimes the longevity of the device with the patient, the number of surgeries they may have had, some people will scar maybe a slightly significant amount more. And if it is, sometimes those are easier cases. Certainly above the muscle cases are easier than below the muscle cases. But I've done over 1600 explants at this point, so there's not a specific type of situation that bothers me both, you know, with my number of explants I've done and the number of oncologic procedures I've done over the course of my career in plastic surgery, the nature of these is just trying to get all the material out, make sure that there's not gonna be something else left that would stimulate an immune response. In my series of, like you said, over 1600 explants and over 943 with quantitative PCR testing in our study, that about 30% have a bacterial biofilm. The most common bacteria is cutie bacterium acnes. And this is found on our face, neck, our chest, our shoulders. It's just a bacteria in the skin. I can't tell you exactly how each of these cases became tainted with this biofilm. So it's more being cognizant of it's a foreign body and whether it's a hip, knee, breast, shoulder implant, cardiac implant, it doesn't really matter what type of implant is they all can get a biofilm and become chronically inflamed. This is nothing new. This has happened in surgery since devices have been used. So the fact of the matter is chronic inflammation in this setting will not be completely resolved if in fact the device is the main driver, so that would require its removal.