Explant 101: Dr. Whitfield explains explant Prep, Detox, Diet, Supplements and the SHARP Method

All right, welcome to this episode of the drive. I'm Dr. Whitfield, board certified plastic surgeon in Austin, Texas. My practice has to do with explant surgery, surgical recovery, lowering inflammation. We do that a variety of ways. You can actually read the book we wrote about it called Sharp that actually describes our methodology. Two, you can take an inflammation test. You can navigate off of this to my website, drrobertwinfield.com and secure a test to go ahead and better just introduce you into the concept of inflammation. That's a urine test. Three, you can sign up for a webinar about detox without retox using the SIRT method by myself, Dr. Whitfield. After that, we do have all of our supplements that are based on genetic reports that also work to lower inflammation, but do a special way. They're liquid based, so they're easy to absorb because I don't know your absorption and neither do you actually, for that fact. And then obviously, if you're a professional, if you work for a practice, or if you own a practice that deals with cases of chronic inflammation, you want to learn more about our methods, you want to include those in your practices, then we have a link to sign up for training. If you're a surgeon who desires explant training, we have a link for that. So you can sign up for that as well. So let's get into it in terms of explant for breast implant illness, you know, what is it basically, explant 101, what does it entail? You want to know the length of time of surgery, length of time of recovery, how much time you'll be here in Austin. And so basically I have patients come to me a variety of ways. They may have seen and worked with a number of specialists in endocrinology, rheumatology, gastroenterology, cardiology, pulmonology, any specialist you can come up with for OBGYNs. And typically they don't feel well, but their blood work says it's okay, it's fine. And patients get dissatisfied with that, they get disenfranchised with that, they get disenchanted with that, they're uncomfortable with that because they don't feel well. So then they'll typically seek out care from a number of providers, nutritionists, acupuncturists, chiropractors, naturopaths. And I think every person that they encounter in that situation where they want to utilize either functional medicine or some kind of integrative approach is very willing to help. But it's a poorly understood problem. So let's give the latest information about this problem. So symptomatic patients recently were studied, their blood was sampled. And patients with increasing symptoms of breast implant illness, like brain fog, like fatigue, like dry eyes, shortness of breath, tightness in the chest, extremity pain, nerve pain, GI problems, or gut issues. Those patients were more likely to have an elevated blood marker called oxylipin tinho. That was shown in a paper published by Dr. Methun Sina. It's a very relatable paper because then they used that information to go ahead and do a study to show that it was reproducible. All those studies I've done videos about and they're in my YouTube channel. Then another study was published actually by us regarding the bacterial amount on implants. And so now we have a paper that shows the substances in the blood, and then we have our paper showing the amount of bacteria and types of bacteria found on implants. So in our study of almost 729% had a bacterial element. So if you had looked at that over time, that's roughly about a third of the patients will have this problem where they have bacterial contamination. So what is it in the other 2/3? Patients experience symptoms for a variety of reasons. Genetically, we don't detoxify certain substances well. So think for instance, if you were working and got exposed to chemicals, maybe in the military or at your job, at a factory or in your home, there could be a water leak, a roof leak, a refrigerator that had a water line that leaked, a sink that leaked, a wall that cracked, exterior wall that cracked and leaked around the window frame, and a lot of water to get in. There's all sorts of ways to get exposed to mold. Mold can also come through a variety of grain sources like cereal or coffee. Fruit can have mold as well. And then environmental toxins that we take for granted are things that are found in plastic, like plastic casings or plastic water bottles. They're called phthalates. The products, if heated, can leach out of the plastic into your system by exposure through skin or drinking the fluid in a water bottle. Say there can also be leaching of chemicals out of different products that contain metals. Or you can also get exposed to heavy metals in a variety of other. An exposure that's common with elevated levels of arsenic is just your water gets contaminated. So we always want you to drink filtered water, not out of plastic, out of like a stainless steel or a glass container. And then for food sources, we want wild caught fish, grass fed grass, finished beef, non hormone fed, free range poultry, and then for air quality, we recommend Jasper air filters. CEOs a flood and disaster expert familiar with mold. It helps reduce the sport counts. Where we sleep or where we live or where we work. Those are in my show notes with codes to help offset some of the costs. The symptomology, as you can imagine is wide and varied and they're just symptoms of chronic inflammation. So acute inflammation is akin to if we tripped and fell and twisted our ankle and the ankle swelled up, the body creates a signal. Different cells will react to these signals for healing, it'll swell up. Then as it begins to heal and you begin to recover, the swelling goes down and those signals, those cells that are helping contribute to the signal of inflammation, will go away. In chronic inflammation, that signal doesn't go away. There's an implant in place that creates a chronic inflammatory response. You develop a scar capsule. The scar capsule is not going to block your breast tissue from interacting with the implant. We know that it's more of a woven substance. Your body makes it. Sometimes it's thicker, thin, and just think of like something that's see through or wet toilet paper. It's really thin. It can interact with your tissue so you're not protected. If there's a rupture, somehow, a leak, somehow contaminant, that all can interact with your tissue and create these symptoms. So what's the process look like? Anybody can do my sharp method remotely. So if someone has not got the ability to come to Austin and visit, they can run the program remotely. That gets started through supplementation and testing. Testing looks at genetics toxicity, which is a urine test, stool test or poop test to check your gut microbiome health. There's this blood spot test to look for different, Really just ways to gauge your inflammation and give you an inflammation score that's more accurate. There's a food test and then we look at hormones as well. Those are all on top of the basic inflammation test that you can get today. So once that's crafted, you get a detox plan, a supplement plan, you get set for surgery. Surgery could be an explant or explant left. Typically we won't talk about a fat transfer in this discussion. And then you come to Austin the day before surgery. We'll see you in the clinic, go over everything in detail with my team and get you all set up for the day of surgery and after surgery. Preoperatively we have medications and we discuss those that are meant to lower the person's any nausea we want to help avoid. We have an Anti inflammatory have things for nerve pain. We provide those, we prescribe those and pick those up at the pharmacy. We also have a small amount of narcotic in case that's needed. So that's the day before surgery. Typically my patients go have dinner either at the well or they prepare their dinner and then they come to the surgery center the following day, which is where I'm driving right now. The following day, we start usually at 6am first case arrives at 5, and then we get started. I get everybody marked pre op. If there needs to be markings for a lift, for just doing an explant, we'll just indicate that. Then the anesthesia providers do a special serratus anterior nerve block in the pre op area. So that helps after giving you medicine to make you sleepy, it helps get pain medicine already circulating before you ever go back, which we feel is a big improvement in getting ahead of any kind of discomfort you can have. Then we go back, we do the xplex, done. If it's above the muscle, we use the incision typically previously placed by the surgeon below the crease or an old lift incision. We'll go down, identify the anterior or the top of the capsule that's looking at us. That's your scar tissue. And then just like you're clearing off the surface of one of those plastic Easter eggs, I'm going to try to see just the very top of it, not leave a lot of tissue on there. There's a nice plane or a way to separate it that we usually find. And then we take off all the top surfaces away from the breast tissue and the muscle. The muscle we'll talk about can be very different in each patient. And then typically we'll find the junction of the big pec muscle, pec major, and the small muscle on the chest wall, pec minor. We'll separate that because typically there's scar tissue there and it forms almost a triangular shape. And then we'll remove that scar tissue away from all the muscles. And if it's behind the muscle, it has to be removed away from the rib surfaces. And then finally we'll take that out. We try to take every single capsule out totally intact. If they're thicker, it's easier. If they're thinner, it's a little bit more difficult. And then we'll go ahead and clean out the pocket. We use different solutions to rinse out the pocket. We don't use antibiotics. And then once that's complete, I created a communication between the breast bucket and the tissues of the abdomen. Like the fatty tissue so the fluid can drain down. Because we don't place plastic tubes to drain the fluid out. It's very much like if we do tummy liposuction, many times we do it from just additionally beneath the breast. So we just can connect the tissues of the tummy with the breast pocket. It'll drain out. Normally you don't need a drain tube. And just for everybody's interest, if you're concerned about drain tubes because someone's told you you need them, you should look up something called the drainless tummy tuck. It's part of every surgeon's or should be part of every surgeon's options for with a tummy tuck surgery. So once that's all done, we get the wounds closed. We use only absorbable sutures. There's nothing sticking out of the patients, there's nothing to be removed in the office. We then use a layer of skin glue. Typically we let that dry and put a clear bandage called a tegaderm over the top of it. And then we simply apply a soft dressing, wrap it up with an ace wrap. And then I like to put an ice pack at the top because we want the old breast pocket to close. So if we allow the fluid to drain out of the bott and we keep the top compressed. So think of it as the opposite of a push up bra. We're trying to close down the top of the pocket, then that allows everything to heal up. You'll come to the office the following day for scheduled hyperbaric treatment and or what's called Flopresso, which is a special lymphatic device we have out of New Zealand. It's great for helping really stimulate lymphatic drainage. We feel that's key to getting this process made more efficient for you. We have red light therapy. Of course we want you to walk. Walking is great exercise. We don't want you to lift weights or do anything else. We'll release you to do that. Special things for considerations with the muscle. If it's behind the muscle and we can connect the muscle to its insertion point, which was what was released by the initial augmentation surgeon. We do that. We discussed that with the patients. If the muscle is too thin or it's not able to be repaired that way it is allowed to heal in position. Patients can go back to. Just think of it this way. I've had people return to the military and do their physical training test at one year and have an absolutely normal test score, normal bench press score. So all those things Just take time for healing. At a week, we'll see you back in the office, we'll assess everything. Typically people are traveling back by car or plane and then all the appointments after that are virtual at a month, three months, six months, nine months, 12 months. If you can come in person, we always like to see you in person for any of those appointments. Then the detox program that was set up initially is ongoing during all the surgical follow up process. It's also important that you maintain supplements with our inflammation support bundle because we're trying to get you the nutrients that you need to recover and boost your immunity to help the healing process. In terms of your diet, that whole time you're on a higher protein diet with both very, very good sources of animal or plant protein. It doesn't matter to me. To really improve how much protein you're getting, we have a plant based protein that we offer as pure pea protein. And of course amino acids can be taken. We have those and supply those through a powder. You can also have other sources if that's easier for you to take pills and then prioritizing your sleep. Getting seven to nine hours of sleep using a wearable like an ultra human ring, we have options for that in the show notes. So ultra human ring to me is more accurate than a oura ring. A whoop strap is also a good option. Eight Sleep, which can go on the mattress cover is a good option to help monitor and measure sleep. Using air filtration with Jasper, using better water quality and then of course improving your food quality. Don't eat anything processed, no refined sugars, healthy fats, only grass fed butter is a good one. So that is explant 101. Let me know what you think.