A conversational explainer (video) with Robert Whitfield MD describing the biological process of acute vs. chronic inflammation after surgery. The speaker contrasts normal acute inflammatory responses (immune cells, mediators, repair) with chronic inflammation sustained by persistent stimuli such as bacterial biofilm around breast implants; Whitfield reports his experience with explant surgeries and links biofilm (Cutibacterium acnes) to ongoing inflammatory reactions.
Questions this video answers
About 1,500 explants
About 35%
Cutibacterium acnes
Chapters
Can you explain exactly, like, from a very kindergarten level of why I was experiencing that inflammation? Like what? Like really get in there. Besides the four pathways, what was actually happening?
So acutely after surgery, there's acute inflammation, or if you sprained your anchor and your ankle swelled up, that's acute inflammation. And your body has inflammatory cells. Inflammatory cells can be our B lymphocytes, our T lymphocytes, our monocytes, mast cells. People have heard of mast cells or endothelial cells. These all secrete a product, if you will, that stimulates inflammation. And you want acute inflammation in certain instances, Correct? Right. Because it's going to drive repair and healing. But when that acute process is over, if you still have the stimulus for inflammation now, you are going to develop chronic inflammation because your body's going to keep sending the inflammatory cells out to get rid of the problem. And so in the case of a breast implant, wherein I've done about 1,500 explants at this point, about 35% have biofilm. So that's. Biofilm's produced by bacteria. So it's a contaminant biofilm around the implant when you take it out. Right. So the biofilm is found by DNA testing, but the bacteria is called cutie and bacterium acnes. And this bacteria produces almost like a little slime layer to protect itself from your immune system. Even though your immune system can't get rid of it, it's still stimulated to react to it and respond to it. So once again, you create more and more inflammation in a constant manner.