Transcript of The Breast Implant Illness Episode | Dr. Robert Whitfield

Can breast implants affect your ability to lose weight at all?

If someone has chronic inflammation, we'll just say they're in a cycle where they're going to retain fluid.

How many women do you think are walking around with breast implant illness that have no idea?

Annually, there's 2.2 million implants placed worldwide. If you just do that over 10 years, 30%, you're looking at 6 billion people.

Should people with breast implants be avoiding saunas? Yes. Do you think most men can tell if a woman has had Botox or not? No, men are stupid. Vindicated once again. I'm never wrong. If you or someone you love is struggling with anxiety, infertility, depression, joint pain, food allergies, hair loss, brain fog, autoimmunity, fatigue, or a myriad of other symptoms. And if every doctor you see tells you, I just have no idea what's causing it, maybe you're just under stress, and you have breast implants, you might be suffering from breast implant illness. This episode is for the women who love their breast implants and don't want to part with them, those that definitely do want to part with them but want to know the next steps, and for anyone struggling and trying to figure out if breast implant illness is what they have in the first place. Today, Dr. Robert Whitfield, also known as Breast Implant Illness Expert, is on the show. He's been a plastic surgeon for over 25 years, board-certified for over 16 years, and performed over 3,000 explants and counting. His practice is in Austin, Texas, where he specializes in breast implant illness, obviously, or BII, breast implant removal surgery, and advanced cosmetic procedures such as his no-cut facelift.

Dr. Rob's skills dovetail into a perfect balance of art and science, where he provides hope to scores of women looking to age gracefully or restore their health after breast implant illness. This podcast is a multi-camera, beautifully-shot show in 4K with the purpose of creating a superior podcast watching experience for those who prefer pulling it up on your smart TV. Watch by subscribing to Real Alex Clark on YouTube so you never miss an episode, and also follow @cultureapothecary on Instagram to be the for us to know about merch drops, how-tos, nontoxic swaps, and more content. This show is exclusively made possible with your financial support because you agree with our mission to heal a sick culture, physically, mentally, and spiritually. There's a tax deductible donation link in the show notes or leave a five-star review. That's an easy, free way to support the show. Please welcome Dr. Robert Whitfield to Culture Apothecary. I think we should set the record straight. Are you anti-breast implants?

So It's not a if you should have it or not, you should have it. I mean, I get asked all the time, would I let my daughter get breast implants or would I let my wife get breast implants? My daughter is a Leo like me, and you're not going to tell a Leo anything.

For women in your life that you care about, do you advise them to not get breast implants?

No, I think it's like Dr. Plodges is in front mind, you had a money show. I think for us on the provider side, your job is to help people make informed decisions. If you can't do that, you shouldn't be doing your first job. You're just not good enough at your job. When people come to me and say, I didn't know this, and I didn't know that. Well, that goes back to who talked to you at the time you were interested in whatever you got done. If it's a breast augmentation, did you learn about the other options for breast augmentation, including fat transfer? If someone says no, since fat transfers have been around for 100 years, I always question that in my head because, say, for instance, somebody just wants a cup size change. Well, that's not an implant augmentation. That's a fat transfer. I did 100 or 200 fat transfers a year for cancer patients. I always discussed that with the patients who came wanting cosmetic enhancement. If all you have is a hammer, the whole world's a nail, it may not just pound shit in all day long. That's all you do. That's all you know how to do.

Then that's all you're going to offer a patient. In cancer reconstruction, it's a problem solving game. Here's the problem. You have these fundamental concepts and training and ability, you solve it. If somebody just comes in who's 18 and says, I want a breast augmentation, and somebody's going to say, All right, well, saline, silicone, size, shape. What is your 18-year-old brain wired enough to do and make a decision about at that point?

What are you saying different compared to other plastic surgeons when somebody comes to you saying that? Are you still doing regular breast augmentations as well as explants?

No, I haven't placed an implant in about four years. I think the other answer to your question is, they just don't say no. If you came to me at 18 and said you wanted a breast augmentation, I told you, here are the options. I didn't really feel like you understood the options. I would just say no.

Do you think that that is a huge problem, is not enough plastic surgeons are willing to say no, not even just breast implants, but any surgery?

Yeah. If that's your occupation, it's coming from a cancer background, so it's the opposite for me. Most of the time, I couldn't say anything, but okay, I'll figure out how to take care of that problem. But if it's a cosmetic augmentation and someone's I get the autoimmune question all the time. Can I get an implant if I have this autoimmune problem? Well, that question answers itself. If those patients would have came to me and asked me for implant-based augmentation and/or breast reconstruction, I would have said, Hey, you already have this underlying problem. We don't know why that's raising its head. It doesn't come from your family. This is just happening. I've heard you talk about problems with your gums and your gut and anybody who has inflammation. The last thing they need is another thing to promote inflammation. Whether you put in a hip, knee, breast, dental implant, they all promote inflammation. They're foreign bodies.

Is basically the only thing you're doing at this point, breast explant surgeries, or are you doing other surgeries as well?

We do fat transfers, but I have so many people now coming from Asia and Europe and in the United States that there's not really time to do much else.

Right. Yeah. It's become your entire thing. Was that on purpose? I mean, were you interested in BII from day one as a plastic surgeon, or were you just doing regular breast augmentation and then started noticing a pattern of women having problems?

Most of my background is in oncology. I did microsurgery for almost 20 years. So microsurgery is like sewing together the coffee stirrer you get at Starbucks with a piece of hair that you can't see under a microscope.

And what does that do?

So that connects the blood vessels. So think of the coffee stirrer, one's an artery, one's a vein. And when you do a transplant of tissue, you have to have an artery to take the blood flow in and a vein to bring it out. Otherwise, it fails. And so the last surgeon to win a Nobel Prize was Joseph Murray. He showed that you could transplant a kidney in a Symese twin. So that works because your immune system is identical in those two people. Then out of that, everything afterwards requires some level of immunosuppression. A lot of people get implant-based breast reconstruction in the United States. It's the most common form, and people are like, Why? Well, this is a country that is massive, if everybody hasn't noticed. This is not Belgium, this is not Finland. Our country, just the state of Texas alone, takes 12 hours to drive across. Outside of big medical centers, community-based hospitals have to be able to provide a service. If you go see a surgeon, unfortunately, you're diagnosed with breast cancer, you can get a lumpectomy and radiation therapy because that's consistent with the five-year survival of a mastectomy. If you're getting a mastectomy, you would hope the patient wants a reconstruction, but that's not always the case.

Maybe they just want a flat closure. That's fine, too. It's just what the patient wants. You have to be able to explain the menu properly to the patient. These are the risks and benefits of having an implant. These are the risks and benefits of not having an implant. These are the risks and benefits of a tissue-based reconstruction, like something that's called a DIEP free flap. The tummy tissue that gets discarded in a tummy tuck, if left connected to the blood vessels that run in the six-pack muscles, the rectus, are hooked up properly, which I did 95% of the time, then that becomes a tissue transplant that preserves the shape, size, volume of the breast that you can give them, and you add to that with fat over time. What I used to do in the reverse engineered world is I would get a patient who had a painful breast reconstruction, or maybe they had got an infection, maybe they had got radiation therapy, and over time, the tissues had become fibrotic or thick and or firm, or basically, they were extruding an implant because the tissue can just fail over time over the implant. I would convert all those people into that DIEP reflap that I could, and if they had any reactivity to the implant or an infection or anything, all that would go away because you're using your own tissue.

Remember, it's like. It's your genetic material. It can't be rejected. As long as we hook up everything properly, like I mentioned, it's going to survive just like the organ transplant I mentioned previously. Everything after that requires immunosuppression. If someone puts in a device and starts having a reaction, now I get all these patients, sent to me, Alex, who have immune problems.

Okay.

What are doctors doing for them? They're getting drugs like prednazone, which is a steroid. They're getting drugs like methotrexate. They're getting plaquenil. All of these different drugs are just to modulate what? It's what your body's doing in response to having something for it. It's reacting. If someone came to me already with gut trouble, Shogren's syndrome, lupus, history of autoimmune disorders, because autoimmune disorders predated implants. I mean, autoimmune disorder has been around It was the late 1800s. First implant was placed in 1962 in Houston by Konan and Jura. So these things are not new. But setting up somebody for absolute abject failure is not great. So I would not do that.

And so did you start noticing a pattern of women all saying they have the same set of symptoms after breast implants?

A cancer patient I took care of in 2016, the patient came in and said, I don't want to have a breast reconstruction anymore. I'm retired now. I don't want it. And that's totally fine. I did her diagnostic work. I reviewed all of her records. Her examination was totally normal. I believe she had to be monitored overnight in the hospital for a pre-existing condition based on her primary care doctor's recommendations. I did her case in the hospital. As of everybody listening, when I would take you down a breast reconstruction, you got to think of it like the Easter egg. You don't want to find the candy inside. You want to do that after the fact. You want to send everything out. If it's infected, you want to keep that inside the scar tissue around the implant itself. If it's got recurrent cancer, you got to send all these things off to make sure that's not the case for the patients, of course. At a week, she didn't have any recurrent cancer on her screening for that, which is the pathology report. But on the report to look for an infection, she did. She had a Necola infection.

My sister, who recently passed away after a long bout with breast cancer and recurrences and things, I would have been supremely pissed off if someone had missed that on my sister. I went back through all of my records and notes, no indication of this. This goes to the limitation of this. If someone has an implant that actually has bacteria around it, we have no way of knowing that.

Really? So there's no scans or anything that can detect?

No. If it's not frankly infected, like you don't show up and you have red skin or swelling or something that tip us off that will show up on a diagnostic study, there's no way to really alert you that there's underlying chronic infection. We recently submitted a paper for a publication of, I think it's almost 700 of my cases, I have several thousand now, of PCR-tested samples. Everybody remembers from the pandemic, you could go to the antigen test, you could get the PCR test. It's now the lingo. A PCR test is the most definitive way for us to see any bacteria, fungi, or mycobacterium inside the pocket. I don't care about the shell of the implant. That's not what's important. I want to know what's up inside that against your scar tissue. So really what's hugged and stuck inside. Because that sends a signal to your body. When your body reacts to that signal, your immune system gets activated.

Do you notice more problems with the different material that the breast implant is made with? Are there problems with silicone versus saline, et cetera?

Breast implant cancers are a problem. It's a really low incidence. It's mainly in the textured implant. I have one instance of this in my practice where it's not a T-cell lymphoma, but it's a B-cell I'm fun with it. I have seen it. It's really unfortunate. I would like to say that I know for sure who has texture and who has saline is going to have these different outcomes, but I don't because I see so people. Saline smooth implants were used predominantly in our country from 1996 until 2013, when a new silicone implant was brought back to market. Then the other implants were brought back to market as well. I've seen all of them.

Yeah, all of them have caused problems. People get breast implant illness no matter what implant.

Yeah, there's not an easy to indict situation here. It's a foreign body, whether it's your dental implant or your cardiac implant. I used to help all the orthopedic surgeons. Anybody can get an infection from any implant place, but many times they're used for really functional purposes, like reconstructing someone's jaw for cancer or replacing a knee joint for osteoarthritis or cancer. I mean, there are all sorts of things that have to be done in the name of keeping someone mobile or able to eat.

I guess we should probably define what is breast implant illness?

Chronic inflammation exists with or without implants. Most of my patients show up with a laundry list of chronic inflammatory symptoms from head to toe. Neurologically, they can have brain fog, they can have headache, they can have light sensitivity, sound sensitivity. In the whole ear, nose, and throat system, dry eyes, cough, sinusitis, chronic stuff that has no answers, heart palpitations, chest pain, shortness of breath, nerve pain in their extremities, tremors, and then the gut is just wildly abnormal, everything.

That's interesting that you say the gut. I don't think I would have ever thought that gut problems could be caused by breast implants.

When I look at this, I think it's chronic inflammation, and the breast implant is playing a component. When I look at testing for it, I look at your functional genetics. We're very big on understanding how you detoxify. Everybody has a set of jeans for mom and dad, and those genes dictate how you detoxify. Now, if someone has heard of all the fancy people on podcast who talk about the MTHFR gene and how wildly expensive. They've made testing for this, which is a joke. I'll let you know. We have a company we use that tests for over 250 genes for like, $900. But some people are charging $600 for five genes, including MTHFR, which is just ridiculous. Ridiculous. That's part of your methylation path.

If you have the MTHFR gene, are you more susceptible to breast implant illness, you think?

We're in a room right now with everybody doing this show. There's five people. Half of us will have that gene. That is one player. Then how we metabolize vitamin D and absorb it and transport it. Everybody may or may not have heard of something called glutathione, which is an antioxidant. They use it for beauty a lot. They're like, Oh, get your glutathione, push IV at the place. We use liposomal glutathione as part of our inflammation support bundle. But the point is that substance is incredibly important to bind up and detoxify things in your liver. When you have limitations in vitamin D metabolism, methylation, how you metabolize glutathione, and then your antioxidant pathway. Everybody remembers antioxidants like vitamin D All right. If we have limitations genetically in the antioxidant pathways in our cells, we'll have a buildup of products that makes us more and more fatigued. You can just imagine, somebody might My client is that person who has three or four of those problems. Plus, in general, many of my patients have trouble with estrogen toxicity or just difficulty with estrogen metabolism. Many people listening, I will go on to problems with PCOS and endometriosis, a lot of which is a genetic predisposition.

If you metabolize estrogen a certain way instead of making, we'll just call it good estradiol, you may make a lot more estrone, and that's responsible for problems with your cycle and pain and endometriosis and PCOS. The person that I see you as the most trouble would be the person who has estrogen, toxicity, and has all those limitations genetically, and then it gets worse.

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If somebody were to get breast plants, it should be a prerequisite. They should all get their hormones tested before going through with this because then you would see, Hey, I have crazy, whacked out estrogen and things which is likely to lead to problems.

Oh, it gets more complicated. Everybody who has that detoxification ability now has to look at their exposures. We used to go to the doctor and get a blood count and see if we're anemic. Now I'm the plastic surgeon who checks your toxin levels for mold toxins or heavy metals or environmental toxins. So don't use parabens. Make sure your products go through the environmental working group. I know you all know this, but I'm going to reiterate that because you get too many chemicals through products for women that cause and wreak havoc on your hormones, basically. So that combined with we look at stool testing because a lot of gut health issues are intimately associated with this. Food sensitivities. I look at all those tests, plus we have some new things coming that look at metabolomics. Metabolomics is probably the thing that will help us get beyond the testing that so many people come to me and say, Oh, Dr. Woodfield, all my blood work's normal. I hear this all the time, and they just come with reams of paper or bloodwork. Those tests, Alex, haven't changed since I've been alive, and I'll be 55 next week.

It's not one of those things, where as especially, we're actually helping. When we look at metabolomics and these new things that are coming, like more genetic testing, now you can start to pull back the curtain, if you will, to understand what's going on at a cellular level, looking at how glutathione levels are in the body, palmidic acid, sperm Gaba, all these things will become important in establishing your inflammation or when someone comes to see me like, Okay, what is their real inflammatory level or score?

When a woman is coming to you and she's saying, I don't feel well, I mean, Are you usually the last stop? Has she been going everywhere and everybody thinks she's crazy and it's making her feel insane? I don't know. I'm testing for everything. You look completely normal to me. You're completely healthy. I don't know. What is the typical patient like? What is she going through by the time she gets to your office?

Nobody wants to have a surgery. Nobody comes in begging me, Hey, Dr. Rob, I want to have surgery again.

They're probably coming to you hoping you're going to say, You don't have this. Yeah.

Or I would tell you what most of them resided themselves, too, because they've consumed as much information as possible about it, because I am the very last person they want to come see. Because when you come to see me for everybody listening, that means you've resided yourself to spending about a week in Austin and having surgery. People ask, I help tell people what to do about surgery. I don't tell anybody what to do about surgery. Everybody who comes to see me has already decided they want to have an explain. I'm not convincing anybody of anything anymore.

I mean, somebody's just saying, I don't feel well. How do you determine that breast implant illness is what a woman has?

We created a methodology called SHARP, and it's really just to look at all that testing, plus create a detoxification program for them. It can be used for any type of surgery because anybody is exposed to multiple things, daily, monthly, throughout their life. They're going to build up a certain amount of toxicity. Your body is going to be able to handle a It's a certain amount of it. But the joke is, when the bucket's full, the bucket runs over, and that's how my patients are now. It could be anything. They could get exposed to mold. They could have a traumatic event in the family. Somebody passes away.

You have a list that you run through before the surgery to basically eliminate any possibility that it's not breast implant illness. You're checking for mold. Is that what you're saying this detoxification happens before the surgery?

Yeah, the tox test is actually it looks at mold toxins. Mold is a big problem. Huge. It's not easy. If you don't know what's going on and you continually get exposed, it's going to have a significant impact on your health.

Are most people with breast implant illness, are they diagnosed with an autoimmune disease before and then chose to get breast implants anyway, or are the autoimmune diseases popping up after the breast implants?

Yeah, it's the latter. They're told they're developing some autoimmune disease. I do see some people that did get implants who had an autoimmune disorder, like showgrins or something, which I think just sets them up for more problems.

Can breast implants affect your ability to lose weight at all?

Oh, yeah, sure.

Explain that.

If someone has chronic inflammation, we'll just say they're in a cycle where they're going to retain fluid, and whether that's from more cortisol production or just having a chronic inflammatory process ongoing in the body and getting signaling, like we said before, from the interaction between the implant and your tissues. There's a new paper out that describes something called Oxylypin/Tinhome. Where there's this interaction between your body and the biofilm, and it creates more fatigue. But these are just now coming to the light. We don't know all the different things that are going on, but I see people who will gain 10, 20, 30 pounds, not because of an adjustment in diet, but they're just retaining mostly fluid. When you see them in person, examine them, they're very puffy, very swollen. Everybody should understand when I explain to somebody It's all rainbows and unicorns. We have a great program that helps really limit discomfort and get you back on your feet quickly with hyperbaric oxygen therapy, red light therapy, lymphatic massage, all the things. But I tell them, you're going to lose 10 to 30 pounds over this period of time. It depends. If people put in a ton of work up front through integrative care, functional medicine, acupuncture, nutrition, functional nutrition, all the things, they've already tried really, really hard.

They're usually in a better situation, and it's harder for them to lose that 10 pounds. But it will happen. But if we're the first people to talk to them about cutting out gluten, Dairy, cutting out dairy, cutting out seed oils. Yes, I said that. Drinking more filtered water, but worrying a lot about your air quality. Like mold, once it's in a house and the spores are whipping around the house, they're just breathing in and out all the time. Using the air filters that filter out mold like a Jasper, those things are not second nature, like supplementation. People get a lot of supplement fatigue. I had to rework my whole supplement line. Now my inflammation support bundle that we start from the time we meet with somebody is basically liposomal, so that the liquids allow the absorption in the oral caviar in the mouth when you spray them, so I know you're getting them. Because I don't want to hear like, I can't take anymore pills, Dr. Whitfield. I get people all the time to say they're taking like 30 supplements a day, and I'm like, Oh, God.

Oh, you would just die if you saw my whole counter is taken over.

Well, the thing is, you don't know what you absorb. For the period of time that I have somebody, so the time we start working with them, we'll get them in the testing program, we'll get their supplements started. I know their inflammation will drop. I have lots of examples of that, especially when you can make impact through diet and fluid quality and air quality. It'll get better. From the time you talk to me and we line up a testing program for you and we get you on supplementation, I give you this series of steps to follow. Cut out gluten, though. Really cut out gluten. Reduce, if not, eliminate dairy, because I find a lot of clients like to eat cheese. Not helpful in this situation. I do talk about eliminating seed oils. Just think about what you're doing. For anybody who likes potato chips, I have a lot of women in my life who like chips. Chips have a lot of seed oils in them.

I know. That's why I tell my audience, Have you tried masa chips yet? Oh, my gosh. To die for, right?

Yeah. We have Ciete in Austin, and then one of my clients actually sent me a box of masa and said, These are better than Ciete.

So much better. I'm telling you, I can't even eat the Ciete anymore.

I can't say that. I live in Austin, man.

I'm getting shocked. I mean, they're great. Great company, and you can get it in any grocery store. But yeah, we love masa here. So yeah, you're saying eliminate the seed oils and then the sleep.

My patients are like, I don't get any sleep. I'm like, Well, all right, how long do you stay asleep? They don't even know. So the minimum, if you just look at data, is like six and a half hours. If you can't get six and a half hours of straight sleep, it's going to be super hard for you to recover. I start with that. It's like, All right, we need at least this length. They're like, Well, I got to go to the bathroom the whole night.

Yeah, but that's a sign that something's off, too. If you're getting up to pee in the middle of the night, isn't it?

It can be, but then I asked them, Well, when do you stop drinking I'm like, I don't know. I just drink stuff till I go to bed. I'm like, Well, okay. I mean, many times people are taking liquids in that will help them sleep. Maybe they're mixing magnesium or they're doing sleepy time tea or something. Okay, those are different things. I'm talking about the people sipping their grape juice, if you know what I'm talking about, before they go to bed because they're trying to unwind. They're taking something that basically is going to make them in the middle of the night. The way to hack this, if you will, is use a three, two, one rule. Stop eating three hours before you go to bed. Stop drinking two hours before you go to bed. Get off your screens an hour before bed, and then you get your room cooler. If you need background noise, there's all sorts of apps and everything. Then you have to cut out ambient light. If you're in a room that's brighter, there's no chance you're going to sleep right away. So a sleep mask, maybe Alex has one, she can I recommend.

But you have to have these things in order to actually even remotely get a stretch of sleep.

I'm blackout curtains, no big lights after a certain time, only beeswax candles or red lights. Switching your night table lamps to be red light bulbs, too.

These are all just basic things, and people who have problems with digestion are never going to sleep well. If you eat late, there's no chance you're going to sleep. It's not going to If you can stay asleep, all the fancy things that help you recover will happen. All of your hormones will get secreted. Your growth hormone will get secreted. You'll get this thing. It's like a lymphatic massage for your brain. You're glymphatic system will actually work. Then when you wake up, you'll feel like you're rested. Now, they'll be like, All right, Dr. Whittler, you say all this stuff. You can actually back it up. There's several wearables. I wear a Whoopstrap. I have an ultra human ring. I've worn ORA rings. I like ultra human and WHOOP because they're super accurate.

More than ORA? Yeah.

A WHOOP is really the most accurate that I've had ever. The ultra human ring is about three milliseconds different than my WHOOP for HRV. For everybody listening, your heart rate variability just helps you establish how you're recovering. In my patients that I had with the other day, come in and say, Dr. Whitfield, my HRV is 18.

That's terrible. What should it be at?

I'm 55. Mine will sit between 30 to 50, which is not great. Someone who's a well-conditioned athlete who's young, it'll be 100, 200 because they're so fit. We could all be 18 again. That'd be great. We're Cables can help you know how long you were in deep sleep, how many sleep cycles you got.

Here's my question. What I like about Aura Ring is that you can turn the Bluetooth off, so you can wear it all day on airplane mode. It's still collecting data. Then at the end of the day, you just turn your Bluetooth on for a second, get your data, see how you did or see how you slept over the night and without EMF exposure. The other rings that you just mentioned, are you able to turn the Bluetooth off on those? No. Okay. I'd probably get more. See, then to me, I would recommend Aura more to my audience than those.

Just for listening, I get EMFs up the backside. I have two phones all the time, and I have a ring on and a Whoopstrap, and Lord knows. Yeah, I get The only thing good about the EMS is when I get my hyperbaric chamber, I have a me health device where I can turn on some of them.

Once you establish and diagnose that somebody does have BII, what is the protocol to treat it? Is there circumstances where sometimes you remove the implants and the symptoms still don't go away? Or for the most part, are people seeing their health just completely transformed?

We started doing and developing our We own systems and processes around functional medicine, and we have a whole team of functional practitioners in my clinic. We do all of our testing and keep it in-house now, and we do our detox plans, and those run for a year. When someone comes to us and is going to engage with me for surgery, they start our supplementation and pause theirs because of how we mentioned it. I want to know they're getting the supplements that are needed based on genetics that we understand. Then they do that series of tests, basically to craft the picture of how we're going to help them from a detox standpoint. I get a lot of people come to me wanting a fat transfer simultaneously. They want to explant their old implants, and they want volume back with their own fat. A lot of toxins hang out in fat. We're always trying to help people detoxify so they get a better balance. If I can help them get into a good situation prior to what is going to be their explant journey, and they can do a fat transfer, we want to just make that as smooth and easy for them as possible.

If we can't, they can do one later. It's everybody's prerogative to do what they want at that time.

If you are wanting a bigger cup size, but you do not want to get breast implants, you can just transfer fat from another area of your body, and there's way less risk as far as breast implant illness or maybe none?

Yeah, it's not going to be a breast implant illness situation. It would be One, do you have enough fat?

Yeah. Can people with low BMI get a fat transfer?

Yeah, those are the hardest patients. It seems like my whole career has been defined by seeing how hard a patient I can find to take care of. Whether it's breast implant illness or somebody who had breast implant illness who now is super lean, a fitness influencer who now wants a fat transfer and an explant. Those are my most difficult people. We want somebody to do what's obviously best that I can do for them in their situation. But people are super low BMI, I'm going to get a DEXA scan. I have them start eating some fats or just eating in general. You should pause your hit F45, Orange Theory, spin, cycling 20 miles a day lifestyle if you want a fat transfer. I just have women concentrate on resistance because to avoid osteoporosis, it's not that you have to lift weights like a bodybuilder, but you need to move heavy things, do things that create resistance with bands or whatever your choice is, because that's really a better avenue for this.

How long after breast explant surgery does it take to recover?

The thing that I can't control is the muscle. If somebody who is listening and wants an explant and your implant's above the muscle, your recovery is going to be super straightforward one to two weeks. If your implant's behind the muscle, it could make it difficult in terms of recovering and getting Back to what you want to do in terms of working out and things like that for several months.

What is the weirdest thing that you found inside somebody's breast?

Well, recently, there was an implant that was shaped instead of round, more like a rhombus.

That couldn't look normal.

No, but it looked way abnormal when I took it out.

Was it like a bootleg surgeon?

No, they just had a scarring, a confirmation that just changed from a round confirmation to that. I just joked, I just looked like a rhombus. I was like, This is far from being a breast shape. Then I'll have unfortunate instances where somebody has a really bad ruptured implant, and those are not good, obviously. I encourage people, if they're concerned about that, to obviously get seen and examined for that. Thermography is being touted a lot in my patient population as a way to screen for cancer. It's not.

Wait, this is very interesting. I've had several guests recently that talked about that instead of mammogram. Do you disagree?

The thing when someone asked me, How am I supposed to communicate about it? I have patients coming from all over the United States, and we have a system in place currently with ultrasound and mammogram that I hope is replaced with a technology called QT imaging. That itself will probably set the standard, but it's not been studied and shown because there's this language, it's called BI-RADS, and that allows every provider around the country to communicate about what they found. If you went and got an ultrasound or a mammogram, they would say BI-RAD, and they would say 1-5, and that would characterize benign to malignant. But thermography doesn't have any standardization like that. We have thermography in the office, but we're using it really to look for areas of inflammation, and then over time, try to follow the trends to see how that's recovering because I'll have people come with swollen lymph nodes and armpit swelling and pain in different areas. Sometimes there'll be some really characteristic changes, but in terms of being able to communicate about that from a cancer perspective, I can't. I get asked a lot, but I can't.

If somebody is listening to you and they are certain, they're like, I am this person. I know that I have BII, but I am just not in a place where I can get surgery right now, what should be doing to support their body in the meantime?

If you're at a place where you know you're super symptomatic, you got to do the things you can control to get your symptoms diminished, if at all possible. If someone was really struggling, I still lean into diet really hard. So definitely cutting out gluten and dairy and doing your best to control your air quality and fluid quality. Those things will help right off the bat. The Next step definitely is supplementation of those pathways. We use liposomal vitamin D3K2, we use liposomal glutathione, liposomal methylated Bs and liposomal Cs. Then I have some carnitine and glucorate to enhance detoxification, support those pathways. Then when you do the testing with us, we're looking at your genomics and your toxicity. Those things help us gage, Okay, you're at this point. Now, if you're going to get somebody who who's three months out, six months out, 16 months out, they're going to do things differently. You can't really run them through in a really aggressive detox program because you can get a Herxanhyver reaction if you have someone detox too much too quickly. This is why I get in trouble when I talk about saunas like I did on Lauren's show.

Lauren Vostik was cooking herself in her sauna and not melting her implants, but causing leaching from her implant. The metals were coming out of the shell of the device. The device was degrading, and it was shown in her urine toxicity test, which I have. And after she explanted, she felt amazing. She was taking selfies with me in the recovery room, which is not normal. That's very Lauren. Correct. The people who do that have that characteristic, that a lot more heavy metal exposure. And then when we repeated her heavy metal toxicity test, she had all of those gone.

Should people with breast implants be avoiding saunas? Yes. Wow. Okay, what other things are we not told? If you have breast implants, you should not be doing this. You should not be doing this.

I are supposed to penetrate deeper, right?

You're talking about Infrared sauna.

Infrared sauna is supposed to penetrate deeper, not as much high temp. Nobody knows what that does to devices.

Medical devices.

Yeah, it's not been studied. I do have people get more symptomatic. If you're in your infrared sauna and you're up to 170 and you feel crummy when you get done with it, you're probably detoxifying too much. So that's more like a Herxanimer reaction. I just have my patients who are going to engage with us, stop doing IR sauna, any sauna, because heating seems to make my patients more symptomatic. I'll just have them pause that, and then 90 days after, we'll have them resume. We have some guidance about taking a binder with it, et cetera, so that it does help detoxify. But if you have something in your body that's leaching, then you're going to make that detoxification process more complicated in each person. When it comes to lightening your load of environmental toxins, makeup and skincare is a great place to start.

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If you're somebody that has, I don't screws in your leg or something, and you're doing infrared sauna, could that be something also causing problems? I haven't seen that with those titanium implants. Those things are massive as well because I used to do those surgeries for people who had to have their whole knee joint replaced with a prosthetic. I haven't seen it in that client's situation, but there are case reports in literature about shoulder implants getting biofilms. That would be a more likely early group.

Does it matter if it's before breastfeeding? Is it a really bad idea to do it before 20?

Well, there's always two big spikes. There's the people who were younger and didn't develop. In that earlier group, 18 to 25, there's going to be a big bump of people who get them. And it goes back to our discussion, could some of those had a fat transfer and been happy? So it really boils down to what is the expectation visually you're trying to achieve? Why are you trying to achieve that? It goes back to that thing we talked about earlier. If someone asked me, what would I say to my daughter? I'm like, my daughter is Leo like me, and she's stubborn. And if she just sat there and decided, I want implants, you, I, everybody I know couldn't call her and change her mind. They're going to do what they're going to do. Is it easier when you're older to probably handle that as a life decision? Sure. There are a lot more options, though. As we age, we usually gain more weight, so we do have more usable fat at that point for fat transfer. It's also usually after breastfeeding, if there's tissue, it's easier to do a lift and add fat. There's examples of that in our work.

I've hired another surgeon like we talked about, Dr. Cheung to help because I'm just one person, so we got to have more help, more like-minded people.

Does a fat transfer look similar to breast implants, or does it just look like bigger real breasts, or what's the look?

It looks like bigger real breasts. Okay. Yeah. An implant is always going to give on profile this extension away from the chest wall, the old high shelf look. That's not normal.

Right. Okay. Is fat transfer an option after mastectomy?

Yeah. Depending on how they've had their cancer surgery, I did a show about this the other day where... We used to soften results with fat transfers of all types of reconstruction. If somebody wants a flat closure, and that's what they're going to do, they could add fat on that later. I wouldn't typically do it at the same time. If they're explancing and going flat, I have done fat transfers for that group at that time, letting them know that in any client who has a fat transfer, you're always able to add to that result. It's not fixed, and that's all you can get.

How long is the surgery just explant, and how long is an explant plus fat transfer? In the surgery room?

You don't want a surgery that's too short because then they have to wake you up quickly, and people have a lot of times a lot more difficulty with nausea and vomiting things. Our sweet spot is about two, two and a half hours on the short end to do an explant. Lift or an explant lift. Then on the top end, we're doing an explant with or without lifts, and then fat transfers. Those are four or four and a half. But really, I've done thousands of these now, so it's just that's a really efficient time frame to get all of that work done. Some people take 6 hours, 8 hours.

How much does breast explant surgery cost in comparison to breast implant surgery?

Yeah, it's typically going to be less to have an augmentation. It's a much less involved procedure.

What's the average range?

To engage with us, you have to do our SHARP program, so it's not a surgery fee for an augmentation and just an explant. I think we start currently at 20 and go up from there.

And does insurance cover any of a breast explant?

We haven't done insurance since around 18. I stopped taking it, and then the contracts expire over time. The only people I've had have successful reimbursement were typically people who had self-administered plans or had a way to communicate directly with the insurance companies. But typically the insurance companies do what they do, which is not cover it.

If somebody's hearing this, they're like, I don't care. I don't care about the risks of BII. I know that I want implants. What are the top three questions that they should be asking a plastic surgeon to see if they're a good one?

What size fits my frame?

Okay, what size fits my frame?

Then for the placement, they're going to recommend behind the muscle because that's going to help hide it. That's later on, if I or someone has to do the explant, that's a harder explant to do.

Do you recommend getting it in front of the muscle?

The short answer is a smaller one above the muscle when the situation is right is probably the easiest. You'll have a lot of people who don't like having implants right away after having them, and that's Can you imagine you built this thing up in your head and you go have it done, and then you're like, Oh, my God, I don't like this. Yeah. Not easy to go and get a redo, a do-over.

And then the last question, if we're doing three questions to make sure your surgeon is going to be Yeah, I always like folks with a lot of experience and some experience as it relates to cancer.

We'll go out on a limit, say they're a little bit more empathetic and understanding, maybe not so quick to make recommendations without going through a pretty lengthy discussion. Any time I had a cancer discussion that related to reconstructive techniques or what options we could have, those things hour, hour and a half long. I think that's the issue. Are they going to take time to speak with you? Or is it just to be like, Oh, we're going to talk to your coordinator, we're going to get you hooked up, and you're on schedule.

How many women do you think are walking around with breast implant illness that have no idea?

Annually, there's 2.2 million implants placed worldwide. I can't give you the exact time it takes to develop EII because as we talked, it's different. But you just do that over 10 years, 30%, you're looking at 6 billion people.

What happens when somebody takes their implants out with the explant surgery and their symptoms are still there? What are you finding is going on typically in those situations? Patients.

That's why we developed our program. I think if you don't know their toxicity burden or their genetics and how they detoxify and their gut health, mood sensitivities, and hormone balance, I don't think you have a shot in the hell of actually taking care of them. You're just doing a surgery to do a surgery, and you're not really completing the loop.

It's rare that that would happen because you're doing all of the stuff on the front end to see what's going on with them. Okay. Botox, filler, or neither?

There's already too many natural people in the world, so filler looks It's stupid most of the time. Botox works because it relaxes muscles. Xeomin works, it relaxes muscles. Daxify works, it relaxes muscles. I prefer things that actually make impact, so I'll do more microneedling and or microcorine.

Do you think most men can tell if a woman has had Botox or not?

No, men are stupid.

Thank you. I went viral on Twitter for saying that. I said, Most men cannot tell if a woman has had Botox. They were arguing to the death, This is insane. We can always tell. I would never date a woman that has Botox. I'm like, Most of your wives probably get it, and you don't know. I said, What you're not liking is filler. That's what I said. I said, When you were like, I can tell if a woman has had it. They say Botox for this word, for anything, you know what I mean? But they're talking about filler, don't you think? Yes. Vindicated once again. I'm never wrong.

Men don't hardly know anything about women in general, but that would be something they definitely don't understand.

Is filler going out of style?

In essence, I think more younger people are trying to get away from an unnatural appearance. I think we've gone through regular TV and then high-def TV, and you saw how bad some of the facelifting was. Then now you've seen in pop culture how just using filler, overusing filler, expands old loose skin, and it doesn't tighten it. If you're going to age better, you got to do things that help build collagen and elastin and avoid the sun that gives you pigmentation issues and enhances aging. For longevity, the filler is not the play.

You talk about breast implant illness. Do you believe in Botox illness?

I haven't seen that, but anybody can react to stuff. There are preservatives in many of these things. The thing that has the least amount of preservative is Daxify. There's no human serum albumin in it. The first injectable was collagen. You just have to get a test for it and everything. Of course, you can react to anything that gets injected.

Well, I have an autoimmune condition, and the last time I got Botox, which is basically exactly a year ago, I had a fever for a week, and I haven't had it since. I was told maybe having autoimmune, Botox was igniting your immune system. I'm in this place. I love Botox. That's the one thing I love. Small amount It's like, I just do it once or twice a year. I don't think I need much. I guess I'm wondering, would you agree I need to be staying away from that, or is there another thing that I should be trying?

Yeah, if that's your response, I would stay away from that. I would do something simple like microneedling Scarring. The point is you want to do things that don't leave visible scarring, and microneedling is an easy hack for that.

How often do you get microneedling done? I'm in my early 30s.

You could do it quarterly, every six months, every year. Microneedling helps stimulate more collagen. People get lines because of animation from the muscles beneath.

How long do you look crazy?

There's some redness about 24 hours.

That's it. Oh, perfect. Is preventative Botox real?

I mean, we try to prevent everything. If I could prevent aging completely, that would be ideal. A toxin, no. How can you ramp up your collagen? People eat collagen now. They're drinking collagen. I don't know how well that works. I know if I poke a hole with a microneedling needle, that creates an injury response and that builds collagen. If you take a small 0.5 millimeter biopsy out, which is now a microcore, your body will heal that. There'll be no scar. That's really the hack, is leveraging how to take skin out without a scar and starting it earlier rather than later. I always tell everybody, it's a lot easier for me to take care of you the closer you are to 20 than 80. Because your skin laxity is increasing all the time.

My audience is They're very sensitive about Botox or anything, plastic surgery. They are aggravated that I'm not anti-botox being so into non-toxic. I think Botox is fantastic in small amounts. I also firmly believe, compared to other girls that I know that are the same age as me, I think I do look younger than them because I was getting a tiny amount of Botox a couple of times a year since I was about 26 or so.

The whole baby Botox thing, just relaxing things. You won't need as much when you're younger. You'll build up tolerance over time and need more.

Do you think that you should not get Botox before a certain age?

No. If somebody's like, you can look at their parents and tell most of what's going to happen to them. They'll have certain line configurations on their forehead. You'll see how they animate. I'm sure you know people that constantly have a squishy face. Yes. So they're going to have the worst lines.

What is the most popular procedure in plastic surgery at the moment?

It's still going to be a breast dog.

What is the most fun surgery to do?

If someone's getting currently an explant but has maybe a big B, small C type breast volume, and we can do a fat transfer. I can almost knock that out of the park and make it like it should have been when they got an implant.

Favorite wellness or anti-aging product right now?

I'm a really hyperbaric oxygen person. My thing in the morning is I'll go work out 5:00 or 5:30. I'll come back to my office. I'll get in my hyperbaric chamber and then do a red light therapy session. I have a big six-foot-tall juve in my office that I just- Oh, that's nice. I put it next to my chamber, and I get out of my chamber, I do that.

If you had to choose one remedy to heal a sick culture, and that could be physically, mentally, or spiritually, what would it be?

Fix the food.

Amen. If someone doesn't live in Austin, but they want to see as a patient? What's the protocol to go about that?

Well, there's lots of avenues now to get in touch with us. We do a lot of virtual sessions with patients. If you go to breastimplantillnessexpert. Com, and You can fill out a form and contact us. You can follow us on Instagram with the same handle. Now, I've got a podcast, Breast Implant Illness, and a YouTube channel, Breast Implant Illness. On there, I think the best way to learn about what discussed and really understand it better is to digest as much as you can, either through the shows or through the channels or appearances I've made, because that just will get you in the right frame of mind, really. I find the most difficult thing is I can't change a mindset problem. I can do the surgery. My team will take care of you. We'll make everything we possibly can to simplify the experience for you, but you have to accept what's going to happen.

Any last words or words of wisdom, piece of advice for women who just feel like, Everybody thinks I'm crazy, and I really think there's something wrong with me, and I happen to have breast implants?

You're not crazy at all. Tell them to watch my show.

That works. Great. Your Instagram is Breast Implant Illness Expert, and I think we got everything. You said your podcast. How often do you release new episodes?

Well, I had a rough producer, weekly.

Okay, weekly. Thank you so much, Dr. Whitfield, for coming on Culture Apothecary. I'm really happy.

Thank you for having me.

I am loving these beauty procedure episodes so much. I have quite a few in store for you this season. If you were someone close to you suffered from breast implant illness, by the way, I would love to hear your story in the Cuteservatives Facebook group. There is so much content on the Culture Apothecary Instagram. All the tips, tricks, content, and remedies you need to heal a sick culture. Please leave a five-star review if you learn something new and subscribe on whatever platform you're listening or watching on. New episodes every Monday and Thursday night at 6:00 PM Pacific, 9:00 PM Eastern. I'm Alex Clarke, and this is Culture Apothecary.