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GUIDANCE FOR EXPLANT  

 This is not medical advice, I’m simply sharing what I’ve learned through my own experience with breast implant illness, explant surgery and working closely with hundreds of women as a patient advocate to Explant Surgeon and BII expert, Dr. Robert Whitfield

FINDING A QUALIFIED EXPLANT SURGEON

   This is the first and most important step. You will notice as you begin searching for a surgeon that many plastic surgeons are now suddenly offering explant surgery. There are so many women who are opting to remove their breast implants BUT proper removal of implants requires expertise. This specialized surgery requires that the entirety of the scar capsule that forms around the breast implants be removed. This is called an EN BLOC TOTAL, TOTAL CAPSULECTOMY and is VERY important.
   Thousands of women have reported that when they did not remove all of the capsule at the time of explant their symptoms of BII did not resolve.

   Sadly, in many cases, their symptoms even worsened. 

QUESTIONS TO ASK YOUR EXPLANT SURGEON:

This is a brief list to get you started on the MOST important questions to ask when interviewing explant surgeons. 

Q-1: Do you perform breast implant removal via en bloc and remove the entirety of the scar capsule?
A-1: The answer must be a resounding “YES”! They should remove the scar capsule all in one piece and leave nothing behind. 


Q-2: Do you test the capsule for biofilms and bacteria and do you send the capsule to pathology?
A-2: Answer should be YES to both parts of the question.


Q-3: Do you still perform breast augmentations with breast implants?
A-3: Ideally, the answer should be NO. The most important factor to take under consideration is that they regularly perform proper en bloc removals. 


Q-4: Where will the the incision be placed for removal of the implant?
A-4: The incision for removal is almost always in the crease of the breast fold. However, for very small implants, some highly skilled surgeons are able to perform explant through the areola. 


Q-5: Do you repair the pectoral muscle if it is in a position to do so?
A-5: This really depends on the condition of the pectoral muscle and if it has atrophied to a place that cannot be repaired. 


Q-6: Do you believe breast implants can cause symptoms in women and do you see improvements after surgery?
A-6: The answer should be YES.


Q-7: How do you cleanse out the breast pocket after removal of the capsule and implant?
A-7: Many surgeons use an antibiotic rinse but some bacteria may be antibiotic resistant. Ideally, a low ph solution will be used to neutralize all bacteria. 


Q-8: What is your protocol if my implants are ruptured?
A-8: Again, this is why en bloc removal is so important. Many implants are found to be ruptured at the time of surgery but are still contained within the scar capsule. In cases where the rupture has spread outside the capsule, ask the surgeon to explain how they will remove the leaked silicone.


Q-9: Do you take video and pictures of the capsules once removed?
A-9: Answer should be YES.


Q-10: Do I need a lift and if so what kind? Donut, Anchor, Lollipop?
A-10: This is the point when you should discuss the surgeon’s opinion of whether or not they think a lift is a good option for you. If you’ve had very large implants for a long period of time a lift is the best way to tighten loose skin and raise the position of the nipple complex. It’s my opinion that those with breast smaller than a B cup “may” want to hold off on a lift. Some breast tissue is excised with a lift and for those of us with very little to begin with we want to keep all we have. I am an AA cup and did not have a lift. 


Q-11: How long is the surgery?
A-11: Proper explant surgery takes 2 – 2.5 hours. If a lift is being performed as well, the entire surgery typically runs a total of 3 hours.

 
Q-12: Do you use drains? Why or why not?
A-12: Most surgeons use drains but there are a select few, like Dr. Whitfield, who perform drain-free explants. The space where the implants were removed will be prone to filling with fluid during the first week. It is important for this area to be free of fluid so the space can heal. When drains are used they may develop infections so avoiding them when possible is ideal. There are surgical techniques that can be used to drain fluid internally. 


Q-13: How often will I have check-ups after surgery? 
A-13: Preferably, your surgeon will see you a few days after surgery and then again at two weeks. After those initial visits, ideally, you will have check ups at one month, three months, six months and one year. 


Q-14: What services does your office offer post-explant to aid in recovery?
A-14: For example, at Dr. Whitfield’s clinic, we provide lymphatic massage services, hyperbaric oxygen, red light therapy, vitamin rich IV’s, supplements, detox and healing protocols to all our post-explant patients.


Q-15: If I have any surgical irregularities or adhesions, do your services include your expertise in addressing those issues or will that be additional cost to me?
A-15: These situations should be covered within your initial surgery cost.


PREPARING FOR SURGERY STARTS NOW

   Reducing inflammation is the first thing we begin doing with our patients.

   The easiest place to start is with with your diet.

   Cutting out dairy, gluten, processed foods, alcohol and sugar is crucial. Eating a low inflammatory diet ideally that is organic, with good sources of protein will greatly help your body prepare for surgery which ultimately aides in your recovery. 

CLEAN SKINCARE AND BEAUTY PRODUCTS

   This is so important. We run total toxicity tests on all of our patients and we see high levels of parabens, phthalates and heavy metals in women who use commercial beauty products. As an actress I have high standards when it comes to the performance of my skincare and makeup. I personally switched to BeautyCounter (https://bit.ly/3NousS0) three years ago. I am a product junkie and freaking love this brand. 

AVOID HIGH HEAT

   Heating up your implants in a sauna or jacuzzi may make you feel much worse and increase symptoms. Listen to The Skinny Confidential’s podcast with Dr. Whitfield’s podcast episode if you haven’t yet for more on this. 
The effects of heating up implants within the body has NEVER been studied. Women report having an increase in body rashes, fatigue and nausea for up to 48 hours after high heat.

SUPPLEMENTS

   Many women I work with are taking lots of supplements trying to feel better. While supplementation is important there are certain herbs and medicines that increase the likelihood of bleeding or can affect blood pressure during and after surgery.
Always check with your doctor for their recommendations. Common herbs and OTC’s that should be stopped two weeks before surgery are; ibuprofen, naproxen, aspirin, Vitamin E, Fish Oils, Omegas, Kava, Ginkgo, Garlic, Turmeric, Echinacea, Ginseng, Valerian, St. John’s wort, Feverfew, Saw Palmetto, Ginger, Licorice, Goldenseal, Milk Thistle. 
Also remember NO ALCOHOL.

AFTER SURGERY ITEMS:

   Having these items on hand will help your recovery process to be much easier.

ZIP UP HOODIE & LOOSE FITTING SWEATS

   On surgery day you will want to wear a zip up hoodie, sweats and slip-on shoes. A nurse will get you dressed after surgery and you won’t be ready to put your hands over your head just yet. It’s ok if you are on your period, just bring extra pads or tampons with you.

EXTRA PILLOWS
   You will want to sleep elevated for the first week, so extra pillows, a pillow wedge or a pregnancy pillow come in VERY handy. 

LOOSE FITTING CLOTHES 
   You will be swollen and bloated from surgery so loose fitting clothes and undies for the first week will be the most comfortable. 

PRETTY ROBE & PJ’S
   Finding some pretty new button-up pajamas or a beautiful silky robe  to wear while you recover make such a difference. This little detail will help your overall mood which is important for healing. If you follow me @olisticolife you know how much I LOVE my silk robes.

ICE!!
   Stock up on gel ice packs or frozen peas. Ice is the best anti inflammatory there is. Icing 30 min on and 30 min off will help tremendously with pain and swelling. Make sure you always have something between your skin and the ice. A thin shirt or dish towel works great. 

NOTEPAD
   Your doctor will have prescribed you certain pain meds and other medications to take after surgery. It’s important to take them exactly as prescribed. Having a notepad by your bed to keep a log of medications and times you have taken them is key. You’ll be sleepy and may not always remember when you took your last dose. Always write it down or have someone else help you keep track of your meds the first few days.

 

MEAL PREP
   Having your meals prepped and your fridge and pantry stocked with a week’s worth of food is one of the best gifts you can give yourself. This ensures you’ll stick to your nutritional needs, especially that first week, when you won’t feel much like cooking or going grocery shopping! Pick a snack or two you think you’ll want right after surgery and pack it in the bag you take with you on the big day.

 

GET YOUR PROTEIN!!
   After surgery, your system is going to be in a state of increased stress. This creates more fluid and many of you will have drains to help with fluid accumulation. The fastest way to take your body from a “leaky” or a catabolic state is to increase your protein intake to 100-120 grams of protein A DAY!! This transforms your body into an anabolic state so it can repair and stop the excess fluid production. You need to stay on the low inflammatory diet, no gluten, no dairy, no processed foods, alcohol or sugar while healing. Eating an organic, non GMO diet with grass fed meat or wild caught fish is ideal. Bone broth is a great way to get healing amounts of protein.  If you are vegan, using an organic, high quality protein is essential such as ORGANIFI


HYDRATION
   Make sure you have good quality filtered water and loads of coconut water waiting at home. If you have access to hydrogen water that is extra hydrating. Drinking plenty of fluids is important for healing and flushing out the anesthesia used during surgery and the pain meds afterwards. 

EVERYBODY POOPS! 
   But after surgery you can become constipated from the anesthesia and pain meds. You need to make it your mission to be going regularly by the next day. Pooping is how you clear out the anesthesia and pain meds. The longer it takes for you to poop, the more out of it you will feel. Taking magnesium citrate or ALOE 500 every night are best for you because over-the-counter laxatives have other not so fun side effects. Dr. Whitfield has both of these available on his website. 

CELLULAR HEALTH
   Cells are the foundation of EVERYTHING! Healthy cells are the key to longevity, good skin, organ function and overall well being. I recommend ASEA to all the women I work with to help their body prepare and recover. ASEA is a liquid supplement with trillions of redox signaling molecules. Redox molecules are sort of like “DNA whispers” created by your mitochondria. These molecules are responsible for turning on and off the functions in your cells. 
The topical gel form of ASEA, called RENU28, has an incredible superpower that aids in restoring blood flow. This helps with the breast “fluffing” we all are counting on after explant surgery. 

THE NIGHT BEFORE SURGERY
Pack the bag you’ll be taking with you.
Water, coconut water, gluten free snack?
 
   The night before surgery, emotions and nerves can be high. I tell the women who I counsel to find some favorite affirmations to keep them in a positive mindset as they drift off to sleep. Personally, I love to listen to Abraham Hicks or Louise Hay. Make sure you’ve double checked your pre-op instructions and follow them accordingly. 

SURGERY DAY!
   It’s finally here! It’s completely normal to feel a mix of emotions of excitement and, even, sadness. Allow yourself to feel it all. This is a great time to use a journal to write yourself some affirmations and focus on the things in your life for which you’re grateful. Positivity and gratitude reframes your mindset. Remember, nothing to eat or drink this morning! In my experience, most everyone at the surgery centers and hospitals are kind, supportive and comforting. Remember they do this everyday. You’re in good hands. 

IMMEDIATELY AFTER SURGERY 
   When you wake up in the recovery room, you’ll feel very tired and sore and the nurse will give you IV meds for pain. Once you’re awake, you’ll be thirsty and may even be ready for a snack, go slow and give yourself time to wake up fully. I recommend bringing your own water bottle and healthy snack. The surgery centers NEVER have anything healthy. Unfortunately, they always have plastic water bottles and will often give you processed snacks. 
   When you get home, prop up those pillows, get into bed and rest. Follow the surgeon's post-op instructions. Remember to keep track of your medications times and amounts in your bedside notebook and make sure to eat something before you take your pain pills. 

THE DAY AFTER SURGERY
   Hopefully, you got some sleep but sometimes the first night can be a bit uncomfortable. Stay on top of your medication and icing, you’ll be setting yourself up for optimum healing!
Gentle walking around the house or a stroll outside every few hours helps with lymphatic draining and healing. Be sure to eat healthy, stay hydrated and get in that protein!
Pooping is going to be your next job. Continue to follow your doctor's post-op instructions.
Don’t hesitate to contact them if you have any concerns. 

YOU DON’T HAVE TO LOOK
   Many women aren’t ready to look at their breasts for a few weeks and that is totally ok. You’ve got to remember that during these first few days and weeks your breasts are going to look the worst they’ll ever be during the entire explant process. Also the pain meds and anesthesia can mess with your head making you feel very emotional and sometimes sad. 
   As a patient advocate, I always remind women that just as your tummy doesn’t snap right back after pregnancy, neither do your breasts. Your breast tissue has been compressed for years from the implants. This living tissue behaves like very slow acting memory foam and it will expand and fluff. I swear by applying RENU28 to increase blood flow and accelerate the fluffing process. Your beautiful body has been through a lot. I highly recommend the book Busting Free by Dr. Amanda Savage Brown to read while you’re in the process of healing. 
 
THE FIRST FEW WEEKS
As your body heals, you may discover you too can take a deeper breath without the weight of the implants on your lungs. You’ll be sore for a while but you’ll be able to use your arms. Be extra careful not to do any lifting, stretching or other strenuous activity. Continue with your high protein diet to reduce fluid buildup and keep those bowels moving! 

RECOVERY
   If it hurts, don’t do it!
You won’t be hitting the gym until your doctor clears you which is usually around six weeks. It is important for you to take it easy with the upper body and chest while you slowly build back your pectoral strength. Don’t rush straight to planking or swinging those kettle bells because you can rip your pecs. You can walk everyday and do lower body exercises with no weights. There’s no benefit to getting your heart rate up during the first few weeks of recovery. 

LIFE AFTER EXPLANT
   You’ll notice many positive changes in your life as you live this next beautiful chapter. A number of symptoms will lessen or completely dis
appear! You may begin to feel a sense of freedom and a deeper connection with your body. One of my most favorite things about life after implants are the heart-to-heart hugs. I never knew how much my implants were blocking energy for me and didn’t realize how much I missed that exchange. 

TIME TO DETOX!
   We run a BII detox program with all our patients which is available to anyone remotely.

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