Latest / Libido Lounge / Unmasking Breast Implant Illness with Dr. Robert Whitfield

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Unmasking Breast Implant Illness with Dr. Robert Whitfield · Libido Lounge

• 0:00
  Welcome to the libido lounge where we focus on all things love, lust, and libido.
• 0:05
  We believe that fabulous sex is important to health as exercise and good food.
• 0:11
  Everybody, welcome back to another episode on the libido lounge.
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  I'm your host, the libido expert, doctor Diane, and I'm so excited about the conversation that
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  we're going to have today.
• 0:23
  This is board certified plastic surgeon, doctor Rob Whitfield.
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  And this conversation we're about to have is amazing because I've seen this so many times in
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  my practice where people are sick for a long time.
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  Their libido is feeling.
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  Their relationships are in are in struggle.
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  They are fatigued.
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  They feel foggy.
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  They don't know what's wrong.
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  And one of the key components to their health is bless breast implant illness.
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  And that's one of the reasons I wanted to get doctor Rob here today to talk to you all
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  because, personally, I I don't feel like a lot of people are talking about this.
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  Like, how how much like, let's start there, Rob.
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  Like, how many people are actually talking about this?
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  Like, do people even know what breast implant illness is?
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  Are people aware of this?
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  Where should we start?
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  Well, thank you for having me on.
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  I I'm I really appreciate, sharing this with your audience.
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  I feel like, you know, for seven years, we've been on this kind of journey to help patients,
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  and I just, came from seeing one who had been told they were a hypochondriac, and they have,
• 1:30
  nothing really wrong with them.
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  So for everybody listening, I consider breast implant illness to be a really a chronic
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  inflammatory process, and we all face inflammation.
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  In this setting, somebody's developed chronic inflammatory symptoms, and they have a breast
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  implant.
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  So are all of the symptoms from the device?
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  Not my experience.
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  No.
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  So about 30% of the time, the device will have a bacterial contaminant.
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  And we published or I'm sorry, submitted for publication a large series of over 700, cases
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  of this, and about thirty percent will have a bacterial, contaminant.
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  It can be, in our instance, cutie and other studies that's been staffed epidermidis.
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  So that interaction can lead to more symptomology like fatigue.
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  They're starting to show in studies that.
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  So if you can have fatigue, it's not a stretch to think there's a lot of hormonal disruption.
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  You couple that to environmental exposures or mycotoxin exposures, to phthalates from
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  plasticizers, from water bottles.
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  Y'all should not drink out of plastic.
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  Enough said.
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  That's enough to affect any woman's endocrine system.
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  And if that gets affected, your thyroid typically goes off first.
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  But in my clinic, we look at everybody's sex hormones in addition to thyroid functions
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  because we want to know at a baseline where things are so I can have a better way of of
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  presenting how to optimize someone for surgical recovery.
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  And we do that through a preparatory, process we call SHARP.
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  And that just really helps us set a a playing field, and we wanna level it for each patient
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  so that they're not taking months or years to recover from one what should be a
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  straightforward, you know, procedure, but we do see a lot of testosterone suppression.
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  So walk us through because I know a lot of the the women in my audience are in the
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  perimenopause, menopause range, sometimes earlier.
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  But a lot of times, there is already these hormonal abnormalities.
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  So would you, like, suggest that anybody that's had breast implants should, you know, should
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  consider this?
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  Like, what are people looking out for to really think like, oh, there's something going on
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  here.
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  Is it that your thyroid test is abnormal, like you said?
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  What what really should be kinda be that trigger to go see somebody like you?
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  Well, I'll answer this way.
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  If it was a male having the same type of symptoms where decreased libido energy levels
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  focus, they would look at their testosterone level.
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  But for whatever reason in a in a woman, we don't do that.
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  Women need about one twelfth, I would say, the amount of testosterone a male needs in terms of
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  replenishment.
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  And, I mean, it's pretty obvious.
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  I just ask the questions like, do you have a libido?
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  I mean, can you work out?
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  Do you have stamina?
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  Do you feel like you have enough energy?
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  I just had a woman in here.
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  She she doesn't feel like she has enough energy to go interact with her seven year old.
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  That's a incredibly disturbing thing if someone in their thirties to not have enough energy to
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  go interact with their child.
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  So, you know, of course, we're gonna look at that, and we look at a total, and we look at a
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  free level of testosterone.
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  And and, you know, I recommend, you know, a supplementation.
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  I I typically will do a pellet, not a shot, but we do that strategically.
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  So for the audience, I'm not proposing one therapy over another.
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  I'm I'm telling you how I do it in the context of recovery around a surgical procedure.
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  So I want a good hundred and twenty days of the right level.
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  And so my patients come in with a lot of inflammation, and I'm gonna make more by doing
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  surgery.
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  So I'm really gonna spike it.
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  And men have a little, you know, protection because of testosterone to buffer out cortisol
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  and estrogen.
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  Obviously, women don't have that because they have, like, we discussed one twelve the amount
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  really, if not even less in my patient population.
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  So I'm trying to be more protective around that time to help them recover more quickly more
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  efficiently.
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  That makes sense.
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  And then testing wise, like, are you how are you determining how it's like what kind of
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  tests are really out there for this component of things?
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  Yeah.
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  We look at it.
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  These are still serum tests for us.
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  Okay.
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  Because I'm dosing off of a particular algorithm for them based on that those serum
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  tests.
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  So that's a blood test.
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  I still I like that based on what we're looking at in terms of, dosage when we do a pellet
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  therapy.
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  I do have a lot of people dosing in and around Texas using a, injection.
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  I have some people doing compounded, testosterone, and then, we have people doing
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  trochees as well.
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  And then as far as testing for breast implant illness, is there any other test that you're
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  doing there?
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  So we have stuck with the a core group of tests right now, saliva for DNA testing to look for
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  both, estrogen metabolism and then detox pathways, vitamin d metabolism, methylation,
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  glutathione metabolism, and, antioxidant metabolism pathways.
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  And then we also are looking, you know, at a gut microbiome test.
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  We wanna make sure that there's not extreme imbalance.
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  We look at a tox test.
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  That's a urine test.
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  So we're looking for mycotoxins, which are for molds.
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  We look at heavy metals, and we look at other environmental toxins like we mentioned.
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  Phthalates come from plasticizers.
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  I just had a a client.
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  He was talking about they grew up in a a household with a smoker, so they're gonna have
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  nace on their tests.
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  And so there's a lot of things that we just kind of we don't know because we don't know,
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  and they're gonna show up on these.
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  And that in conjunction with I do look at food sensitivities through a serum test, and then we
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  look at the the hormones.
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  So that's kind of gonna paint a broad picture.
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  We're looking at adding metabolomics in.
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  I haven't adopted that in every situation yet.
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  I feel like we'll we'll get there.
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  That's the next kind of step.
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  There's not one particular thing that I hang my hat on.
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  I I think everybody gets exposed to a lot of toxins.
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  And once your genetic capability is is exceeded, you become, you know, symptomatic.
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  So it sounds like then when we're dealing with breast implant illness, like, kind of the
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  treatment process you're really guiding people to is removing the breast implants, but then
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  also clearing up all these other toxins that have accumulated around the body that are gonna
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  be unique from person to person.
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  Do I have that correct?
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  Right.
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  Our team has a group of functional, practitioners at my, both at my clinic and
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  remote that help with detox, and we use CellCore for detox.
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  But we we get our our baseline testing done to create a plan because, obviously, people are
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  gonna have different, you know, issues depending on where they grew up and what they
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  got exposed to, maybe where their family worked or or, you know, what, industries were around
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  where they where they grew up or The States.
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  I mean, it it's it's a lot.
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  It just depends.
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  So Yeah.
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  Well, what about other things like like leakage of the breast implants?
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  Or I'm also wondering if you see situations with breast implants where the lymphatics
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  because we have such a huge part of lymphatic system in the breast tissue.
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  So I'm also wondering, like, about leakage, how much of a problem that is, if that's something
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  that people should be concerned about as well as the lymphatic system and any congestion that
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  could be created from the breast implants.
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  Do you see that?
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  Yeah.
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  We see congestion in the lymphatic system preop and postop.
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  And and we use, some devices from New Zealand called Flopresso for lymphatic massage, and I
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  have a really skilled lymphatic massage therapist.
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  But when we're doing the whole body or the trunk, it's hard to get enough time with each
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  individual patient, so we do the the use the devices.
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  In terms of leakage, that's a great question because the the rupture rates will vary, but
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  about a half percent per year after eight to ten years is is is what we would quote.
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  So I just you know, I assume anybody with 10 year old implants has a rupture because most of
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  the studies are not sensitive and or specific enough to show you a posterior leak, so up
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  against the chest wall.
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  You would need a devoted breast MRI really to show that, or like, doctor Jen Simmons has QT
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  imaging now that would be super helpful.
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  We hope to have that at some point.
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  But I always consider that.
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  And if someone has lost the ability to, on exam, have a structure, you're worried about
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  that implant having lost its integrity and leaking.
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  If someone became extremely symptomatic after an event, like a car accident or a fall, then
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  you would be concerned about that, and they would have to get some some kind of imaging to
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  help further delineate that.
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  That makes sense.
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  And then I'm also curious about, like, in the process of the removal, like, where is that
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  done within the process of everything else?
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  So, like, for example, if you test somebody for mold and metals and other environmental toxins
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  and they have leaky gut and thyroid abnormalities and, you know, these that they
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  have the breast implants, like, what is the is there, like, a certain order where where it's
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  like you always gotta start detoxing a little bit before you do the removal, or is there is
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  there another is there another kind of step by step process that you see to be common?
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  So the the way we go about it, I I I create this pathway based on what the patient's, you
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  know, expectations are.
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  And if they have a really obvious, toxicity issue, I tell them it's better to get all of
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  your testing done.
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  Supplementation begins and lasts about a year.
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  And I want everybody to have this level playing field.
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  I wanna see, like, what is their talks burden now and their ability to handle that and get
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  them started.
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  Because usually I'm booked several months out for surgery, so it gives them a chance to get
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  started.
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  And if they really are interested in having a fat transfer, we really need to know where they
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  begin with that because toxins are, as we know, stored away in fat tissue.
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  And so we want to have a better understanding about that because fat transfers work extremely
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  well.
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  We have a lot of experience in my practice.
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  I've done several thousand fat transfers, and it's more about making sure the patients
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  optimize rather than is the equipment right or our strategy correct.
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  We we have all those things, all those elements in place.
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  You know, technically, all that sorted out.
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  It's trying to get them in a optimized situation is, you know, we're obviously I see
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  people who are out of balance all the time and trying to get them into a better balance so
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  that recovery is more efficient.
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  I I think my my patients and women in general tolerate a lot more because of what their
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  position is like.
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  They're working.
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  They're taking care of their families.
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  They're, you know, basically, the primary, you know, caregivers for the everybody.
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  And so they just kinda push through things.
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  This is not one of those times where you're just gonna force your way through and and
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  recover.
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  So I know that, and I have to put the brakes on a lot of people and tell them not no, but not
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  no for a fat transfer sometimes.
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  And and nobody probably really wants to hear that.
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  But I don't if I don't feel like it's it's going to work or the tests, show that it's it's
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  going to be harder for you, we want you to work with the detox practitioners in our clinic and
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  remotely if that's necessary, and get yourself into a better position.
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  And if we if we can't or you're not feeling well, then we do an explant with a a lift and
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  and wait to to help do the fat transfer at another time.
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  Many times we do this under local in the office, which is another option.
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  So there's not another anesthetic involved that it minimizes the recovery in that respect.
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  So there's a lot of ways to get it done.
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  So my my curiosity with that is and and that this might be an unknown, but we do know that
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  we store toxins in our fat.
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  Right?
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  So my my curiosity then is some of what the concern is in people that are just, like, not
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  maybe a good fit for the fat transfers.
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  They're ever, like, a worry about, hey.
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  We are gonna mobilize too many toxins with the with the transfer of the fat because of how
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  many toxins are stored in the fat cells, and that could lead to a real big, like, Herxheimer
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  negative type of reaction.
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  Is that ever part of the concern?
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  Yeah.
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  And that's where the session is just back to balance.
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  So if if we get somebody who's obviously out of balance, which the majority of my clients are,
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  and trying to get them on the right diet and supplementation, air filtration, water quality,
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  food quality situation, that will help them.
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  And then looking at their detox situation and creating a plan for them and starting that is
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  has been our best answer to that question that, you know, everybody's got toxicity, both you
• 15:24
  and I do.
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  And, you know, I think you would say to me, like, Rob, you need to do x y z.
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  And, you know, all of us have to be doing something in order to to keep our our talks
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  burden under control.
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  Absolutely.
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  Yeah.
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  No.
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  None of us get away from exposure or even build up.
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  It just doesn't doesn't happen.
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  Nobody I've never seen a clean talks panel in my entire life, so maybe somebody will surprise
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  me, but we all we all get exposed.
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  What do
• 15:54
  you feel for, like, people in situations like double mastectomies?
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  Like, what do you recommend for people in those situations?
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  Is there is there ever a situation where you would recommend implants, or have you just seen
• 16:08
  so much, you know, problems with them that that is just something that you feel that people
• 16:12
  should avoid in in basically every situation?
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  No.
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  I I think, you know, the way I think of all these discussions is when I was doing cancer
• 16:23
  reconstruction predominantly, if someone came in, you know, their options were an aesthetic
• 16:29
  flat closure, a, expander implant based reconstruction, or a single stage implant based
• 16:35
  reconstruction, or a autologous, or using your own tissue reconstruction.
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  And because I did microsurgery, predominantly, people referred to me to do autologous
• 16:46
  reconstruction with the DIEP reflap.
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  Now from time to time, you know, I couldn't do that or the patient, you know, didn't want that
• 16:54
  and they wanted implant based reconstruction.
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  Most time that was done with the expander then converted to an implant.
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  And, you know, it's not about, like, not doing the, the procedure because cancer puts you in a
• 17:10
  predicament where these are the available levers, and each case, you you just have to
• 17:17
  help them make the most informed decision.
• 17:20
  That that's basically yeah.
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  Obviously, I know a lot more now than I I did when I was doing reconstruction for over twenty
• 17:27
  years, but they always was very reticent to, recommend a implant based reconstruction who's
• 17:37
  who and somebody who already had an underlying problem with, like, IBS or, like, show grit.
• 17:44
  Like, any any autoimmune thing, I always put off.
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  I was like, you know, I know if I did an autologous reconstruction, there's zero chance
• 17:53
  it's rejected.
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  All I have to do is make sure that from standpoint, I get the blood vessels hooked up
• 17:59
  so that it would perfuse properly.
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  And we were above ninety five percent, you know, for my career.
• 18:06
  So that was, you know, not a given, obviously, but it was very high success rate.
• 18:11
  And so then you would know that there's no chance that patient's having a reaction because
• 18:17
  it's their own tissue, provided everything obviously went well.
• 18:20
  So I always lean that way.
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  And then I think because I did so many of those cases, I built up a a system of people who had
• 18:29
  problems with implants got referred to me.
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  So that started happening early in my career in the oh, gosh.
• 18:35
  It was probably as early as 02/2007.
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  So I just started taking care of and converting those reconstructions that had problems either
• 18:43
  from capture contracture or radiation injuries or infections or, just pain.
• 18:51
  Sometimes people would just have pain, and there's, like, you know, do something with
• 18:55
  this.
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  And that ended up you know, it was, like, my gateway into taking care of those problems.
• 19:02
  You know?
• 19:02
  But every implant's gonna have a version of this knee, hip, breast, dental, cardiac,
• 19:09
  spinal.
• 19:10
  I mean, there's not one thing you can name that I haven't helped somebody take care of.
• 19:14
  Yeah.
• 19:15
  Yeah.
• 19:15
  And it sounds like what I'm hearing and one of the things I wanted to point out for our
• 19:19
  listeners is that everybody, it's, you know, it's your own decision with what you do.
• 19:24
  There's but the biggest thing is there are other options to be informed about that, hey.
• 19:30
  If you're interested in, like, looking at an implant that there might be other things that
• 19:34
  can be done.
• 19:35
  So that sounds accurate.
• 19:36
  Right?
• 19:37
  Yeah.
• 19:37
  We have a whole series.
• 19:39
  And and for patients, so the audience understands, when I would have a patient come
• 19:44
  for an augmentation, which was not common based on my inability to see patients because I was
• 19:49
  from a scheduling standpoint.
• 19:50
  It wasn't easy to see me.
• 19:53
  I would talk about fat transfers, which is taking your own tissue.
• 19:56
  So a fat transfer can be done if someone just wants, like, a cup size change.
• 20:00
  Or if they wanted purely their own tissue, it would be a series over time.
• 20:06
  You know, one a year for a couple years or three years or whatever.
• 20:10
  Or, if they wanted to go from a b to a d, that was always gonna be an implant based situation.
• 20:20
  That's cosmetic, of course.
• 20:21
  And then if somebody was getting a reconstruction, they were always going to have
• 20:26
  a much different scenario because the amount of tissue, you know, being exchanged for breast
• 20:32
  implant volume.
• 20:33
  So those were all things, you know, although I did predominantly cancer reconstruction, I had
• 20:40
  the same conversations almost with the, cosmetic patients in terms of options and
• 20:49
  recovery and how I ran recovery, I should say.
• 20:53
  So I always saw people, like, a week and a month and three months and six months and nine
• 20:57
  months and twelve months because that's how I saw my my my cancer patients more frequently.
• 21:03
  So I ended up seeing everybody kind of on the same schedule, and I just kept that throughout
• 21:08
  my career.
• 21:09
  Sure.
• 21:10
  Makes sense.
• 21:11
  Well, this has been amazing.
• 21:12
  This is so much information, and I think I think the biggest thing is helping people be
• 21:17
  aware of, like, the toxicity that these implants can cause just for a point of
• 21:22
  awareness.
• 21:24
  Everybody, we're gonna have information as far as working with doctor Rob's practice out of
• 21:28
  Austin, Texas.
• 21:29
  I know people fly in from all over to see him, and so there's ways of working with him in that
• 21:34
  way.
• 21:34
  We'll have all that information in the show notes.
• 21:37
  But before we close-up, is there any, like, final points, final, like, message or takeaway
• 21:41
  or anything you wanna leave us with?
• 21:44
  So you mentioned Horchsteinheimer earlier.
• 21:46
  We didn't really talk about this, but, you made me think about just saunas.
• 21:50
  So a lot of folks use infrared saunas.
• 21:54
  I've had patients have more reactions, like detoxing too quickly, and then I've had
• 22:00
  patients use barrel saunas.
• 22:01
  Then barrel saunas get up to, you know, like, above 200 degrees Fahrenheit.
• 22:07
  And I've had people cause leaching out of their implants, and we've seen this on their toxicity
• 22:11
  test.
• 22:12
  There's so many heavy heavy metals.
• 22:14
  So just be cognizant of that.
• 22:17
  I don't know how to guide people on the use of IR or barrel saunas.
• 22:22
  So I have them just pause that until we do their explant and give it about ninety days,
• 22:27
  till they resume any kind of sauna therapy afterwards.
• 22:30
  Yeah.
• 22:30
  Thank you for adding that.
• 22:31
  I've seen saunas do very similar things.
• 22:34
  It's a very easy way for people to just too do too much too fast.
• 22:38
  So thank you so much for adding that.
• 22:41
  Thank you for your time today.
• 22:42
  And everybody remember that this year, what we're doing is for the year of 2024, download
• 22:50
  the podcast, share them with your friends, you know, spread the word, and with whoever
• 22:55
  whichever guest has the most downloads and shares, we're gonna invite them back for a deep
• 22:59
  dive.
• 23:00
  And I know I certainly would love to have doctor Rob back.
• 23:03
  So please do download.
• 23:04
  Please do share this this with your friends, and please do check out his website if this
• 23:08
  would serve you at all.
• 23:09
  So it's been great talking to you, doctor Rob.
• 23:12
  Thank you so much for being here, and to everybody else, we'll see you real soon.