Capsulectomy art 3

Everybody, we're getting loaded up here. I just want to check and make sure everything is fine. Uh, We are, I believe, online now. Definitely live in the community. I need to know, um, if you guys can chime in on the different channels. Can you hear me okay? I don't have a mic on right now. Let me just make sure everything's turned up. Let me know if the sound is a problem. All right, I don't, I don't think Instagram is working, otherwise I would see it. So, all right, I actually can see it on Instagram. Okay, okay, good deal. We'll let everybody hop in. Everybody get loaded, locked and loaded. Start saying hello. This is part 3 of the capsulectomy series, so let me know. Feel like the streaming is a problem. Gonna let everybody hop on. Something wrong with streaming. That's better. Dentabro DDS. Dentists don't annoy me. I work with them closely, especially OralMax, a lot of facial surgery when we were doing head and neck instructions so they don't annoy me. Sherilyn, unmute the auto in, uh, uh, audio inside the community. That could be a problem. Are you having trouble hearing me? Is anybody having trouble hearing me? I can change mics real quick. Let me just do that. I'll adjust the mic real quick. Hold on, let everybody filter in. Let's give it a minute. Just started streaming this, so Let's give it a minute. We'll change the mics out. It's not a big deal. Make it better. Yeah, everybody inside Dr. Rob's circle has to unmute to hear the audio. I'm just going to double-check the mic here. Yep, it should be good now. Testing 1, 2, 3. Testing 1, 2, 3. All right, we'll get rolling in just a second. Perfect. Testing, 1, 2, 3. That should be better. I had forgot my remote mic. So I have a comment on YouTube that somebody explanted that they don't feel better. So that's part of the reason I wrote the book, The Sharp Method. So, um, I, I get concerned when people have explants and have no program built around, um, how to recover. So preparation and recovery are key in our programs, and, um, we'll talk about that a little bit, but I'm gonna, I'm gonna tidy up part 3 of the capsulectomy series, and I'll Wow, my stream has got like definitely a problem here. All right, I'm sorry if you're having trouble seeing me. My internet should be fine. I have no idea why that's a problem. And somehow the stream key in Rumble is a problem. I don't know why that's a problem. Said there's an error. Looks like I'm not streaming in Rumble. Sorry about that. Everybody should see me on Instagram, TikTok, Facebook, YouTube, X, and LinkedIn. And I'm sorry about Rumble. You have to update the stream keys all the time. So, so this is part 3 of my capsulectomy series. Part 1, we talked about some basic things as it pertains to capsule formation. And some of the basic things we, we get taught in terms of capsular contracture. Part 2, we talked a bit more about bacterial contamination and biofilm. Now Part 3, and the way I like to explain it as it pertains to capsules, capsular contractures, is I think of those things as combos of a more complicated immune response. I look dark on here. I'm just gonna turn another light on. Sorry. Oh, that's a bit better. Not as dark. So, if you have a more complex immune response, you can have quite a few more symptoms. And if you combine that with some limitations in detoxification, either genetically, or you've exceeded your threshold for exposures to toxins. Say, for instance, where you worked, where you grew up, maybe where you played sports. Places we've lived over time can contribute. I had a very, very interesting case of a golfer this week, and I think we should do a whole show, honestly, with her. She has a great story. And a really complex, uh, tox, uh, tox test, honestly. So, you know, we're a combination of all these things, and I get a little frustrated with the capsulectomy debate because I don't really think it's a debate. 29% have bacterial contamination. And then a new paper that I'm going to talk about was study, uh, was published out of Denmark, and I read it last year. It was published in, I believe, the summer, but I didn't read it until more in the fall when I was— I just came across it. I was doing research for a talk I was giving, and it was extremely, you know, interesting to me because the way I think about and how I used to do surgery for breast reconstruction was to perform— and I'll— bear with me, I'm gonna try to make it as simple as possible. So if you do a reconstruction with someone's own tissue, what I used to do is called a DIEP free flap breast reconstruction. So a lot of words and everything. So flaps are layers of tissue. This one was just skin and fat associated with the blood vessels that provided the blood supply to that area. Think of like a triangular shape of tissue from the abdomen. And you could use the entire lower abdomen that would be discarded in a tummy tuck to reconstruct both breasts for a patient who was having mastectomies. But one of my first instances of care for a patient where, if I think back, they were having more of an immune response, was a patient who kept getting a red chest and had tightness and capsular contracture. She would intermittently get treated with antibiotics for this redness, and they would just call it red breast syndrome after breast reconstruction with implants. She would get treated with antibiotics, and it would eventually go away. So the thought was it was some potentially infectious problem. This went on for a long period of time, but she was really uncomfortable with the reconstruction. So my thought at that point, and that was 2005, Um, was to take all the scar tissue out, take the implant material out, and use her own tissue to reconstruct the area. Because if you're having an immune response, if you put your own tissue there, think of it like your own transplanted tissue. Think of like the very first organ transplant was done between genetically identical or Siamese twins. Was done by Joseph Murray, Dr. Joseph Murray, who happened to be a plastic surgeon. And that ushered in a whole— the specialty of transplantation, basically. And at that point, they didn't have drugs. They knew if they did it from a Siamese twin that it would work because they had already tested it with the skin, which is highly antigenic. So Going back to that case from 19— or I'm sorry, not, uh, from 2005. If I were to transport that tissue, hook up the blood vessels and everything, heal properly, um, that would heal that area because it has brought new tissue. You reestablish blood flow. All of that would be able to heal. And this has been documented for a long period of time in plastic surgery with the advent of flap surgery throughout the history, um, it's very rich history in plastic surgery. So your own tissue always works better than anything because it's your own tissue, it's genetically identical. So the next step in organ transplantation was to do a non-identical twin, which they did, and they had a, a way to immunosuppress that patient. And then the third and final step would be cadaver transplantation, taking a kidney from a non-related donor and transplanting that into another patient, the recipient. And so there's steps and everything, but that would require medication like steroids and azathioprine, cyclosporine, things like this to block the patient's immune response. And when we place a device in someone, we always get an immune response. With breast implants, a lot has been made about breast implant-associated anaplastic large cell lymphoma, BIA-ALCL, which is more of a T-cell mediated lymphoma. So T-cell response has always been studied, but the thing I wanted to highlight in the paper from Denmark, they showed that there was more extensive immune response with different cell types, not just T-cells, but B-cells, plasma cells, other macrophages. And so That is a more elaborate response, and the whole premise of the paper was to suggest that the patients who were having these firmer, thicker, more contracted capsules were having a more elaborate immune response, like they were rejecting an organ. I found that fascinating. It's the first time I'd ever read anything like that, but it makes total sense to me if you follow the logic I used to explain the organ transplant, because everything that's not your own or not genetically identical will be rejected. How much, how long does it take, varies in the patients. So I think we have a ton to learn about, uh, not just the capsule formation but capsule contracture. And I haven't mentioned things like ruptured implants, which I took out of somebody today. Ruptured silicone gel implant with a grade 4 capsular contracture. So I feel like we're only scratching the surface of our understanding of this, but I think the combination of bacterial contamination, the definitely enhanced immune response in some patients, especially those they identified with capsular contractures, demands, you know, more study. And when I read the paper, I was very excited. I reached out to the scientists I've interviewed on my show who's done the work with Oxylight and Tandem Home I've talked about. And he said they had submitted a grant about this 'cause it's such exciting news. So, excuse me, my voice is not doing good. Take a little swig. Some electrolytes. Um, so those are the things, right? Capsules form around devices— hip, knee, breast, cardiac, neurologic— all these devices. There's thickness and thinness of capsules that varies. We know that they can become contaminated. We know the contamination, especially in breast implants, with Staphylococcus aureus and can lead to oxidation of fatty acids in the breast, shown by Dr. Bethune-Sina's work. And that oxylipin-10 home, that increased oxidative compound, can be found in higher concentrations in patients with symptoms. So you take it a step further and you see that these capsular contracture patients, or patients that have firmer, thicker capsules, however we want to graded out in the systems have a more elaborate immune response when you look at them at the cellular level. So I really wish we had a commercially available test where I could do this. A PCR will not do this. This is more looking at, uh, RNA sequencing, which is, to my knowledge, not commercially available. But if anybody's listening who has this capability, I'm happy to learn more and But this is definitely, you know, demands more, uh, research for sure because this is— I, I found these to be fascinating findings. So to me, I think we're learning more and more about it. I think capsular contracture is still a very, very big problem. It doesn't matter the type of implant. I've taken them all out, including the newest ones that don't, uh, quote unquote, have more problems with capture contracture because it's not so much the fault of a device to me versus it's a patient's genetics and their exposures, uh, both, you know, environmentally and through other avenues, and then how they detoxify, um, their gut health and sensitivities. And then certainly the reaction people have can be definitely stronger and different. I think that makes sense. We're all biologically very different. And so when I read this YouTube comment that says, I have Hashimoto's and had an explant last August and have been suffering pain in my arms, legs, and knees. I thought if I had an explant, I would feel better. However, I feel terrible. Now that's an extremely disappointing thing to read. I've devoted so much time and effort to explaining this problem, and being, uh, that I'm on tonight and this person is— has talked about this, I'm going to say the reason I'm so passionate about this is that particular comment on YouTube. You can go to my YouTube channel and read this comment. It's very disturbing to me because it's not just about taking implants out of patients. About evaluating patients and looking at them and helping them understand, you know, genetically how they detoxify, looking at their tox burden, looking at their gut health, looking at sensitivities they have, especially things in their diet, looking at their hormonal balance. It's not just a blood biomarker thing. Looking at their travel history, trying to understand if they have been exposed to parasites. I think that's a really underappreciated problem. So, um, this is AnnPro1. Why don't you message my office? Because you're the person who should be running my SHARP method. Basically, the reason I wrote the book and put it out there is so patients can find it and understand it. And my, my team can help run groups for people who have explanted or having these problems, or get them prepared for explant. Even if you're not explaining with us, that's totally fine. Not everybody can get to Austin, Texas, where I am, but you should understand the current information. Okay, I'm going to end the live, um, on all the other platforms. We're going to go into Dr. Rob's Circle where you can ask me whatever you want to ask me. Um, happy to, to take questions. I know it's been a long week probably for everybody, and tomorrow's Good Friday, so drrobcircle.com. I'll put it in the chats. Um, man, my, my voice is not great tonight. Sorry. All right. All right, I'm gonna turn this TikTok off, but I always have trouble with, uh, TikTok. Thank you all for hopping on TikTok. Please go to drrobscircle.com and join it. It's free. Happy to answer any questions. I don't know if I can write a comment on here. I have no idea. I don't think I can. No. Okay, I'm going to start shutting off the stream and just continue in my community. Everybody in Dr. Rob's circle, go ahead and chime in. Let's make sure everything's working there. We seem to be having an interesting livestream problem and I guess Rumble didn't work. What's going on with that? And turn off YouTube. All right, go to drrobcircle.com, join for free. You can ask me anything you would like. We'll continue the conversation there.