Link Between Breast Implants and Mast Cell Activation with Dr. Kelly McCann & Dr. Robert Whitfield

Mast cell activation and breast implant illness. Today we have Dr. Kelly McCann. She's really going to dig into mast cell activation syndrome and possible links with breast implant illness.

There is a paper that came out of Australia last year, now that it's 25 about the link between breast implant illness and mast cell activation. And it's really very impressive. When patients who thought that they had breast implant illness got their implants out within two weeks, their symptoms declined by like 75%. And at nine months it was almost 85%. And even in the group that had their explants done who did not believe that they had breast implant illness, they actually had a 70% reduction in their symptoms as well. So what does that tell us? It tells us that silicone breast implants are causing mast cell activation most likely in a lot of people, even if they're not aware of it. It's upregulating the immune system and causing issues.

Yeah, let's talk about that because I told you before we were together at a different meeting that I had people come to me self referred with breast implants who had been clinically diagnosed with mast cell activation syndrome, which to me was relatively. Obviously I knew what mast cells were, but I, I was not really keen on what mast cell activation syndrome was. So maybe just for the audience, how do you, after working for a decade in this space, how do you come to the conclusion that someone has that, what, what do you, what tools do you have to, to tell them that they have that problem?

So it's a, it's a syndrome that has a lot of components to it. Both basically you have symptoms in many different systems of the body that are allergic, inflammatory or kind of growth related. So it can present in a wide variety of different ways. Some people will get fatigued, they'll get allergy symptoms, skin symptoms, gastrointestinal issues, they may have cardiovascular symptoms, pots, they can have neurological symptoms, psychiatric symptoms, kind of like. And then of course a lot of symptoms around the breast. You can have lots of inflammation and pain, but you don't have to. The challenge with mast cell activation is that we all have mast cells. Mast cells are part of the immune system and their job is to identify and fight foreign invaders. They're born in the bone marrow, they move to the periphery. They live in the areas of interface between ourselves and the outside world. So like our nose, respiratory tract, GI tract, they live around, around our nerves.

That's really important because the triggers can be just a host of things. And maybe that's, that's the thing that to me, when these patients came in, they were telling me, potentially triggers. And so like, anything could be a trigger. So obviously we operate on patients, a medication, a something that may contact the surface of their skin can trigger them. Because obviously we know about things like latex allergies, there'll be drug allergies. But like, these are diverse triggers, right?

Absolutely. Because the purpose of the mast cells is to constantly look for foreign invaders, what they perceive to be foreign invaders. So this could be a misperception, right? That's the whole idea, is that people who have normal mast cells and not mast cell activation syndrome, their mast cells are looking for infections, they're looking for toxins, they're looking for ways to protect the body. But in a certain percentage of the population, probably roughly 20% of the population, they have mast cells that are more hypervigilant. Right. They're more sensitive. And when they see a foreign invader, they're going to get triggered. The triggering event then causes a release of these mediators that are in the mast cells. Those mediators are often inflammatory. So you've heard about the cytokine storm with COVID that's a mast cell event that's dumping all these inflammatory mediators to help the body fight the foreign invader. Right. And when we put an implant in, that's a foreign object in the body. And for those people who have these mast cells that have a tendency to be hyperreactive, they're going to react all the time, and then you start to have this cross reactivity with other things. So the food that you eat, the medications that you take, the supplements that you take, the air that you breathe, you know, the perfumes that you wear, all the personal care products, the things that you put on your skin, people start to develop more and more and more sensitivities. And unfortunately, if the primary trigger is the breast implants, they can remove them and reduce their symptoms a great deal.

So when was the first documented case, the max cell mast cell activation syndrome?

The first paper came out in 2007.

So let's, let's just start there. So I, I get this a fair amount, and this is a, that everybody's super clear about this. Autoimmune disorders, mast cell activation syndrome, all these typical kind of things that are associated with, but not exclusive of patients who have breast implants all started before or after breast implants. So autoimmune disorders like Sjogren's syndrome, lupus, et cetera, found out in the late 1800s, things like Dr. McCand is discussing muscle activation syndrome. She's talking about 2007.

Obviously it was there a long time ago. Right. So in the 50s, 40s and 50s, people talked about multiple chemical sensitivity. And there was a doctor out of Dallas, Dr. Bill Ray, who had an entire clinic devoted to environmental medicine. Right. And so doctors who have been practicing environmental medicine for, for decades and decades are familiar with multiple chemical sensitivity. And Then recently a PhD named Claudia Miller worked with Dr. Larry Afrin and Tanya Dempsey, who are leaders in the field of mast cell activation. And they wrote a co A paper together and, and really solidified the idea that these two conditions, whether it's mast cell activation or multiple chemical sensitivity, they're very, very similar. Now you can have mast cell and not chemical sensitivity, but not often.

But don't they. And maybe. Cause I'm not familiar with that paper or if in that paper they discuss genetic predisposition to problems with detoxification. So if you can't detoxify, well, using the antioxidant glutathione, you're going to be very sensitive to chemicals, perfumes, environmental toxins in general because they're going to accumulate and you can't cope with it. You're going to exceed capacity very, very quickly and then you'll become what we see as someone who's got symptoms of chronic inflammation.

Right.

And that's, that's what we see.

So as I mentioned, roughly 20%, 17 to 20% of the population has mast cell activation. And those studies in the genetics came out of Germany. And the thought is that I think it's really multifactorial and what happens is that we have a predisposition. Like I'm an allergic kid, my mom's an allergic person. She's got celiac disease. So. Right. It's. Yeah, I have mast cell activation because of mold. And what happens is that people who have this genetic predispos predisposition get repetitive hits. So it could be a mold exposure, it could be Lyme disease, it could be EMF exposure, it could be a specific toxicant exposure. Like you have. You lived on a farm right Next to a bunch of farmers who used a lot of pesticides or something like that. You live next to a golf course and they're spraying pesticides on everything. So these hit, what I'm calling hits, exposures then kind of ramp up the reactivity of the mast cells over time and, and then you put it in a foreign body like a breast implant. And now the mast cells are going crazy cuz they, they never get a break. They keep seeing that implant as a foreign invader and are caught continuing to have this inflammatory response.

Right. I mean, that's what we talk about routinely. And I. I joke about it, but you can't pick your parents, and you can't outrun a bad diet. Where you grow up, you grow up. And Dr. McCann is. Is saying it, but not saying it out loud. Like, the specific chemical spread on golf courses that got outlawed In, I think, 2004 maybe was atrazine. And then the chemical in Roundup is glyphosate, which is basically, I have clients who grew up in the Central Valley of California who ran under crop dust, doctors that were spraying the fields as kids. And so they have tremendous amounts of that. That toxin in their system, which is. And Dr. McCann can elaborate on it. But any of those things can be neurologic disruptors. They can be endocrine disruptors. Anything that's doing those has those manifestations in our body certainly is going to ramp up our immune system and cause more problems with mast cell activation, which she hasn't even got to why all the bad things happen when a mast cell gets upset, but she's going to tell us exactly why that happens and why people get so unwell after that.

Do you want me to talk about that next? Okay. So the mast cells are pretty little cells. They are filled with all these granules of chemicals. And these chemicals may be things like histamine, serotonin. They're enzymes, they're cytokines, chemokines. They are also growth factors. And we have different combinations of mediators in different cell, different organs in the body. And each person's combination of mediators is different also. So the mast cells and the composition of the inflammatory mediators that are in my muscles in my skin are different than the ones that Dr. Rob has and that are in his skin. So that's one of the reasons why mast cell activation looks like everything. And it's so complicated. And each person looks very, very different. But what those mast cells are doing is trying to protect you. Right? Because as I said, their job is to fight foreign invaders. And when they release their mediators when they perceive a threat, what they're doing is they're calling other components of the immune system in to help deal with that threat. And unfortunately, we're the innocent bystanders of our immune systems trying their best to help us. So.

Yeah, just like you said, like, you go back to the foreign invader aspect, which is, you know, I. I always try to enlighten folks when they either on my show or I have a chance to talk to them about surgery in general. And so surgery has a unique position in that it demonstrated tolerance. So the, the surgeon who won the Nobel Prize, Dr. Joseph Murray, transplanted a kidney from one Siamese twin to another because they had the exact same immune composition, because that's the only way you can do that operation and not have rejection, which is what Dr. McCann is really ultimately talking about, tolerance. So when you put something in that's not your own. So we often hear. And whether it's a famous influencer. Oh, my God, let's take. What influencer do we want to talk about? Whether it's Gary Brock or anybody's talking about peptides or exa. Exosomes, which recently was talked about by Brigham Bealer on Joe's podcast. Like peptides right now. And that's not the. Probably the best example, but peptides are amino acids. And in this setting, they're going to be. Those are in synthetic. So we. Those. And even with those, you can get little skin reactions. So if you're a mast cell activation syndrome patient and you think you're gonna get put on compounded tirzepatite or. Or compounded BPC157 with whatever. Because the recent warnings of the FDA about peptides. So there's autologous, which is your own, basically, and there's something that's allogeneic, and then there's something, you know, like we're discussing now, which is a completely foreign substance you're putting into somebody. So whether it's a, A. I always use the knee, hip, breast, dental, cardiac, neurologic. I, I think for everybody listening who doesn't know anything about my career, I did six years of general surgery, two years of plastic surgery, a year of oncologic reconstructive surgery. And I helped every surgeon who operates, who puts in a foreign body at one time or another in my career, help take care of a problem created by. Or an extrusion of a foreign body. And that's just the nature of doing that kind of work. And mostly the work that I did was with respect to cancer reconstruction. But all those things have reactivity. And looking back throughout my career, why patients would have different intervals of. We'll just say recovery. We were not taught in school about functional genomics. In fact, the genome project wasn't even complete when I was in medical school. It was more of a, like a, A big idea, so to speak.

Pipe dream at that point.

Yeah. With computing. So everybody listening should Understand, like, the reason we have what we know about genetics is because computers got better. Without computers, we're still just sitting around, drawn little charts and family trees, trying to figure out what's going on with. So with computers and the advent of computing, there was a documentary produced about the BRCA mutation. So it's called Decoding. Annie Parker but ultimately your genetics, not to get too tangential on this, they set up playbook and then your exposures, and this is a, a very specific exposure that we're talking about with the addition of a breast implant. Whether it's for cancer or cosmetic purposes, that is irrelevant in this situation. So once you introduce that into the person, your immune system forever is trying to get rid of it, right? A hundred percent of the time, all day long, every day, 365 days a year.

Exactly.

Trying to get it out of your body.

And for those people whose immune systems are already revved up from genetic predisposition or other exposures, it is going to send you into a spiral that, that we call breast implant illness or implant illness or where you're not tolerating that thing anymore. One of the things that I wanted to say was there's a, there's a, a theory, a way of talking about environmental toxicant load from an environmental medicine perspective that we call total load, right? So everybody's body is a sink. Some people are born with ginormous sinks and huge drains. That's your ability to detox. And you can stuff all sorts of things in that huge bucket, right? These are the people that party like rock stars and drink and smoke and die peacefully in their late 90s instead because they were able to deal with all the toxic exposures that they had. And then there are people who have really shallow sinks and very narrow drains. These are the people who get mast cell activation. They get a mold exposure, environmental toxin exposure. I mean, the truth is, like, we're bathing in chemicals all the time, every day. And, and if we have a larger exposure or a genetic incapacity to manage that, we're going to get symptoms. Usually the first symptoms that show up are immunologic symptoms, and that can be autoimmune or hypersensitivity. So you've got like two sides of the same coin. The, the autoimmune is going to be where your immune system attacks your cell, right? Where your immune system has that mistaken signal. Or you could get a hypersensitivity reaction that might be an allergic reaction or a sensitivity, and mast cell is on the spectrum. And then as you Accumulate more toxins. I was always taught that then you start to get neurological issues and then endocrine issues when we're talking about environmental, toxic, and exposure. So bisphenols, bpa, phthalates, some of the pesticides, some of the mold toxins, the mycotoxins actually are endocrine disruptors or a ton of endocrine disruptors out there, and those are adding to the bucket and causing problems. Certainly an ability to detox is also part of the equation too. But most of the time at this point, we can't just take glutathione or sit in a sauna. For some of us, that's not sufficient. Right, Right.

I'm glad you brought that up. So everybody listening knows I have some strong feelings about sauna, especially with implants in place. So the. I get asked this, like, literally I was asked this at this meeting I was at. Can I do the sauna Rob, or can I do this Rob? And so extreme temperature elevations will certainly cause probably mast cell activation or enhance it. So you don't want to do that. And if you have implants in place, I've had patients have significant Herxenheimer type reactions from sauna sessions. And the, the, the whole point being is, like, nobody did a trial with breast implants and stuck you in a sauna, randomized you to see if you would do okay if you were in the sauna versus somebody who wasn't in the sauna. And it wouldn't matter anyway, because in the beginning, why would it matter? Like something that's brand new if we just say that it's brand new? Unless you had a, the lemon law, like a, a, a completely defective device from the jump, you wouldn't have a problem. Like when people ask me, like, when does this start? Or Dr. McCann, when can muscle activation start? Well, I, I always say kind of the same things. Like I just said, you can't pick your parents. So we don't know. Iod, toxify. I've looked at genetic sequences on my patients. I have a very strong profile of who gets the problem given a certain set of circumstances. But then the air you breathe, the fluid you drink, food you eat, the products you use on your skin, your stress levels, your. Your sleep pattern. Oh, my gosh, we ain't even talking about the sleep. So my favorite thing is to figure out how to hack my sleep better. So all of those things are contributing to your bucket that you were talking about and how you can manage it. And no, you can't take glutathione and solve all these problems, and you can't get in the sauna and take a binder and solve that problem. What else, what else do I get asked about?

Colonics, coffee enemas. I mean, not to say that they don't have their place. I don't know how we talk about those things.

But it's interesting that the folks who have the most, the mold exposure patients, like people who've been exposed to mold, as you have tons of trouble and including, but not limited to extreme fatigue in certain instances that I, I don't know if I could ever fathom not feeling like I could get up and get out of bed. Like, they describe it as they just don't have the will or the energy or the motivation to get up and get out of bed. Now that's, that's awful. And I've had people just tell them, yeah, I've had people just tell me that if they didn't have that combination of whether it's a clonic or coffee enema, which I, I, I was like, okay. I mean, obviously, like, any drug delivery can go through a mucosal surface. So of course, there's rectal medications and yeah, you would get a huge jolt of caffeine that way. Yeah, that'll help your mind.

It's more, it's more than just the caffeine, though. I mean, colon hydrotherapy. Colonics have been used in environmental medicine for a long time. And it's not about the poop. It's, it's really about the stimulation. Whether it's the coffee or the stretching of the colon wall with the water in the colon. Hydrotherapy is stimulating the gallbladder to dump bile. Bile is where a lot of our environmental chemicals hang out and mold, and you can even get it filled with infection. So if you dump a lot of bile into your gastrointestinal tract by using these methods, it actually is enhancing the excretion of these toxins into the toilet. And you're overwhelming your environment, your enterohepatic recirculation, which pulls them back in. Because when we eat and we get a bile dump when we eat, the body is really efficient and wants to pull that, pull that bile back into the body. Right. So that's the enterohepatic recirculation. Because it's expensive for us to make bile, so we want to hold onto as much of it as we can. But then we're pulling back in the mycotoxins, we're pulling back in all of the chemicals, all the toxins that are in the, in the bile because remember they're. Many of them are fat soluble. So the coffee enemas and the colonics help get. Get more out than you can possibly reabsorb. And so that's one of the reasons why they're suggested in environmental medicine. But they're not really that much fun to do. Although they can be incredibly helpful for people.

Yeah, let's summarize that so that everybody gets. That's a lot to say. And unpacked very quickly. But so you're cheating the normal time to eliminate waste by stimulating it. And just like if we gave somebody cholera cystokinin and got em to dump bile. So the bile salts are what get reabsorbed in the enterhepatic circulation and that's where the mycotoxins are typically bound. So if you can the cheat if you will, is get it out before it can get reabsorbed as so to speak. And that's why those patients are. Are doing better. And even if they're. I always worry about. They're just constantly getting re exposed either through the error that they're in or the. Maybe the home or it has a leak or something or at work. People work lots of places that or they have to go from place to place. I have all sorts of folks in construction and real estate who just constantly get exposed to things because of the nature of their work. So I think those, those are great points in terms of how to cope. Eliminate. Right. I mean that's basically you're. You're eliminating fast so then you're allowing your body to reabsorb the bile salts and that way you can eliminate more mycotoxins. So I mean that all makes perfect if you wanna think of like biologic sense. And then you get the, you get the benefits. I never discount the help of caffeine though. I, I'm a big believer in caffeine.

Oh well, if I didn't have my one A two or one A one double homozygous snips and could tolerate caffeine and sleep.

You get tumor out of caffeine.

Oh yeah. Caffeine will. If I have, if I have caffeine at 7 in the morning I won't sleep very well at night. So sad to say.

No more caffeine active CYP A1D.

Yeah. Yep. That's.

I don't have that.

You're clearly. You don't have that.

No, no. But what you said was very important too about since we were on the gut. So if you have a big problem with mast cell activation and vis a vis, you're gonna have more and more histamine release. You're gonna get lots of problems with gut leaky gut syndrome, probably dysbiosis.

Sibo.

What does that look like?

Yeah, sibo. So sometimes it's difficult to tease out, right, because people who are mold exposed have all these symptoms. People who have mast cell have very overlap symptoms. You get leaky gut, the peristalsis slows down. People have bloating, gas, heartburn, diarrhea, constipation, alternating, they get labeled with irritable bowel syndrome, which is a useless term because it doesn't tell us how to get you better. But so, so many of my patients with mold and mast cell also have small intestinal bacterial overgrowth. We're supposed to have bacteria in our colons, not in our small intestines. And when the peristalsis is not appropriate, things get backed up. Bacteria decide to set up housekeeping in the small intestine and cause a lot of grief, because as you eat, they're gonna ferment your food and create gas and all these symptoms. And so with a mast cell patient who is mold exposed and has SIBO and maybe breast implants, trying to figure out, like, what's the order, how do you get things better is really tricky. And you have to work with a functional doctor who understands and sees all the potential problems and addresses them in the right order. So for some of my patients, it is absolutely we gotta get out of the mold first. Right? Nothing's gonna work unless you're out of the mold. And then for a lot of people, we have to treat the sibo. And additionally, when people are in mold, not only can they get sibo, they can get small intestinal fungal overgrowth or just fungal or mold colonization in general. So maybe you got a breast implant and now you're colonized with mold 2. That doesn't have to be in the breast implant. That can be in your sinuses. It can be in your GI tract. And so figuring out and treating the mold and or fungus that's there is also an issue.

Yeah, let's just talk about mold, because I. I get a lot of messages and. Or there's a lot of misinformation about mold and breast implants. And so we published a paper last year looking at six, over 600 consecutive explanted specimens, and the predominant species was bacteria. In our series, it was Cutibacterium acus followed by staph epidermidis and in the first thousand cases I did, there was only a handful, like five that had fungus. So don't. For everybody listening, I don't want you to feel like mold is coming from your implant. If you got a test that said you were mycotoxin positive either on blood or urine or muscle, whatever the, the modality of error, it is not coming from your implant. If that provider is telling you that, that is almost uniformly not accurate advice because that one, they can't tell you. And two, I published a big paper just to prove the fact that that's not the issue because it was getting talked about. It's very, it's lovely TMZ material to show what they consider to be a moldy implant. People go on and talk about it and it's just a bunch of bullshit. That's not the issue at all. It's bacteria. And it's the bacteria most commonly found on your chest, shoulders, face and neck. Cutibacterium acnes. And then in general a common bacteria found all over the body, Staph epidermidis, that readily produce biofilm. So the biofilm allows protection really for the bacteria and difficulty for your immune system to surveil it and take care of it, which probably further upsets the mast cell situation. And for us, you know, the, I, I would hope at some point the, there's science that's shown that the interaction between the bacterial biofilm on the device so up against your scar tissue and the breast tissue, specifically a fatty acid in the breast tissue called oleic acid becomes oxidized. Now for everybody listening, if you have too much oxidation, that's a problem. You want to have more reduction. So if you have too many oxidative type situations in your body, you get too many what we call free radicals. It's hard for your body to deal with and that creates more stress and we refer to it at a cellular level as oxidative stress. So I think of like you're working out hard, hard, hard. And if you don't methylate well from a genetic standpoint, you stay sore for a longer period of time. So we know that this interaction happens and produces a molecule called oxylipin Tinho. There's no test for this yet. I mean, I know this cuz we know the scientists who perform the studies and I've talked about it on my shows, I've interviewed the scientists, the work's published. I mean there's no confusion to me anymore about the cause and effect. Now that's only in those patients who happen to have, we'll just say those bacteria and it's causing that interaction. Now does that explain everything? Of course not. But just in general, that gives you roughly a third of the patients that I take care of and explant with that issue. So what's going on in the other 71%? Well, as you can imagine, it's a combination of all the things we've been discussing on the show. It's your genetics, it's your diet, it's your environment, it's all the things that you get exposed to on a day to day and it's a lot to cope with. I'm sure Dr. Kelly can commiserate with me. It's a lot when your patients have and start listing all the different symptoms. And now it's just whether it's a particular set of symptoms in a system like your nervous system or your, your musculoskeletal system like the, the list is long and it's quite diverse and it confuses a lot of, of providers. And I don't envy anybody trying to take care of a patient with mast cell activation syndrome syndrome or chronic inflammation in general. And, or I will highlight that people don't ask a lot if their patients have breast implants. I hope that's changing because you need to know as a provider who may be listening to this, whether or not a patient has an implant of any type anywhere in the body so that you can better understand the potential interaction.

Very Good point, Rob. Dr. Rob I did want to circle back to like the biofilms from these organisms and, and in the mold world we get a lot of issues potentially with biofilms. So for example, I have had a bunch of patients who've been mold exposed. We do some nasal swabs looking for or even urine testing if they have urinary symptoms. And what we're looking for is bacteria and, or fungus by next generation sequencing, which is the creme de la creme way to look for bacteria and fungus. And we're finding a lot of different kinds of staph, different kinds of propion bacterium, acnes and, and fungus in nasal passages of people who have been mold exposed. And then they're creating these biofilms in the nose, they're creating biofilms in the bladder, they're creating biofilms around the breast implants. And in order to help support the immune system, we're treating with biofilm busters, different kinds of proteolytic and fibrinolytic enzymes to break those up. And that's really helping the immune system then clean up what's in the nose. And remember those mast cells, they're constantly surveilling for foreign invaders, and that those foreign invaders include not just things like toxins and implants, but they're also looking for bacterial infections and biofilms. And so there does seem to be this relationship between mast cell activation, biofilms, mold, et cetera. I had one woman, we've been treating her with for mast cell activation. We did the mold thing, we did sibo, we did Lyme, Bartonella, et cetera. And she was still having a lot of rashes. And when we started going after the bacteria in a biofilm in her bladder, all of her symptoms got so much better. So I, I do think.

So that was on a NGS of the urine that you found that it was in bladder?

Yes, yes. And you can find it in a lot of different people too. That next generation sequencing is not something that most providers do or are, are cognizant of. The gold standard of urine culture. It's like, I don't know, a century old. That's crazy. In the world of AI and quantum computing, that that is our gold standard. We should really be doing next generation sequencing on everything. It's my, my personal bias. And then these biofilms in genetically susceptible people who are also hypercoagulable, that becomes reinforced. So on the bacteria side, the bacteria making biofilms, on the, the human side, people who have a tendency to make clots are reinforcing that biofilm, making that biofilm even more resilient and resistant. And what I'm finding in, in many, many, many of my mast cell patients is that they are also hypercoagulable. Maybe not Factor V Leiden, but there's another gene variant called plasminogen activator inhibitor 1. I'd say, Gosh, I don't know. 90 plus percent of my patients who have mast cell also have this hypopoagula and it seems to be associated with cardiovascular family history. So if people have a family history of stroke or heart disease, they will often have this hypercoagulability, which reinforces the biofilm, which makes everything harder. And then there's more stuff to inflame those mast cells.

Well, I agree with you going back to NGS. So for everybody listening, in 2019, we switched to next gen sequencing for all of our sampling of explant specimens. So we have the largest experience with NGS in the world on that, and that's what we published. So. And when we have a problem with a refractory urinary tract infection, or if there's a question, I don't default to what Dr. McCann knows is very antiquated, which is a swab culture. We will always either do NGS preferentially or we'll send both, because with ngs, you don't get a antibiotic sensitivity pattern, which in some cases is necessary, obviously, for treatment. And you'll send a regular culture just to try to get some information regarding that. In terms of genetic mutations that contribute to hypercoagulability, certainly having an MTHFR, which about 40% of the population does, contributes to hypercoagulability. In fact, I would not do microsurgery on anybody who has a. I stopped doing that in 2000, maybe 17, 18, anybody who had MTHFR mutations. I would not offer microsurgery, too, because of the increased risk of microvascular complication. So I. I agree with you, like the. I mean, the devil's in the details always. And I. I hold a really, really strong conviction that if you understand your genetics better, it becomes much easier for both you and your provider, obviously, to take care of you. But then. Then you can navigate a pretty complex world a bit better if you understand those things. So, man, it's been a great chat with you today, and I want to make sure Everybody can find Dr. McCann. So I'm going to let her tell you her social media handles her platforms that you can follow her on to learn more and maybe visit her.

Thank you, Dr. Rob. I am in Southern California. I have a brick and mortar practice. You can find me@thespringcenter.com you can also find me on social at DrKelly McCann. So I look forward to seeing what happens with all of this. I mean, I think that mast cell activation and breast implant illness, there's such an overlap and such a need to understand this. So thank you, Dr. Rob, for having me, and it was a pleasure speaking with you.

Thanks for hopping on.