Robert Whitfield MD explains how implants trigger an immune response that forms scar tissue around them, causing tightness and fatigue. He describes autologous reconstruction using a patient's own skin and fat from the abdomen or thigh, and shares a 2016 case of a cancer survivor who chose explantation and went flat.
So there's not a implant that's devoid.
Of a problem because it's a foreign body. And when you put it into somebody, your body immediately reacts to that and creates a capsule around a scar because it doesn't want that in your body.
Right.
So everybody has an immunologic response to it.
So I would do nerve and muscle sparing procedures to take skin and fat from the abdomen, inner thigh, even upper buttock tissue, and transport that to the.
Chest and hook that up via microsurgery using the blood vessels that the cardiac surgeons use to revascularize the heart.
Okay. A little bit different than sticking some balloons in and filling with saline.
Right?
So for me, I didn't put in.
A large number of implants.
I took a large number out. And when I look back at my.
Experience, I was taking care of folks.
With this problem without knowing I was taking care of folks with this problem.
Okay.
Somebody would show up with a red.
Chest, a tight band feeling across their chest. The capsular contracts are very firm. Implant.
And I knew.
I'm like, well, if I just take that out, I take all the scar.
Out and I put their own tissue there, then it's autologous.
It'll heal.
It'll work.
So Moving forward, in 2016, I had a breast cancer patient who relocated from Georgia to retire here in Austin on the lake.
And she came to me and said.
I want my Reconstruction taken down, Dr. Whitfield. And I said, okay.
There was no specific reason. She just wanted to be flat. She was tired of having a reconstruction. She had had one for over 20 some years.
She had no real physical findings on examination.
Her history was otherwise consistent with a breast cancer survivor. Her laboratory analysis, which we'll talk about later, just revealed basically nothing.
Okay, so she was healthy.
Yeah, one complaint. Bad fatigue.
So she wasn't healthy.
People who are tired aren't healthy unless it's because they didn't sleep or they ate crap. But the predominant thinking, Dave, is if you had cancer and you were treated with poison to cure your cancer, and you had bone marrow suppression, that explains your fatigue. And I was.
In that lane. That's what I thought.
That's what you believed.
So I took her to the operating room.
She was one caveat. She asked me to do something I'd.
Never been asked before by a patient. She said, can you take out my implants? Enbloc.
And so for the audience, en blanc is a term used in pathology. It's tumor extirpation, or removal is done en bloc, say, for a sarcoma or any cancer.
You want to be around it, not in it.
So she wanted you to take the.
Tissue around the capsule. The scar capsule and the implant together.
So when I talk about it, I.
Say it's like taking things out in an undisturbed manner, like not breaking the Easter egg.
