Understanding Breast Implant Illness (BII) and Chronic Inflammation With Dr. Robert Whitfield

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Katie: Hello and welcome to the Wellness Mama podcast. I’m Katie from wellnessmama.com and this episode won’t apply to everybody but will be extremely applicable to some listeners. This is all about understanding breast implant illness and addressing the chronic inflammation that can go with it, whether or not you ever get the implants removed. And I’ve gotten an increasing number of questions about this topic. So I wanted to address it directly, even though it’s not something I have personal experience with. I hear from so many people who are on some part of that journey and I wanted to be able to provide some good answers or at least food for thought and a starting point for research on this topic.

And I’m here with someone who I consider one of the foremost experts in the world on this particular topic, who is Dr. Robert Whitfield. He’s been a plastic surgeon for 26 years and board certified for over 16. And he specializes perhaps a bit more than anyone else I’ve ever heard of in breast implant illness specifically, as well as breast implant removal surgery and other advanced procedures. And he’s highly sought after in this realm for his Holistic Accelerated Recovery Program, otherwise known as HARP, which help reduce systemic inflammation and assist patients who are both preparing for or recovering from surgical procedures. And this applies to, I would guess, many other procedures besides just breast implants. But I think this is a really important part of the conversation because often it’s well known now that breast implants can contribute to chronic inflammation and they can be removed, but that alone does not necessarily address the inflammatory side.

And so he does both and he takes a very holistic approach to this starting before the ex-plant surgery process and addressing the pre-surgical, the during surgery in a very unique way and then post-surgery recovery as well. And he’s, like I said, the only one I’ve seen who’s actually looking into all of these factors, delving into genetics and inflammation, actually testing to see what’s actually going on in the body and helping women in a very personalized and direct way. So if this applies to you, he is, I believe, the foremost expert in the world on this. And I think he has very, very intricate answers and very personalized answers. So I was very excited to get to have this conversation with him and understand this in a deeper way. So let’s join Dr. Whitfield. Dr. Whitfield, welcome. Thank you so much for being here.

Dr. Whitfield: Thank you.

Katie: And we’re going to get to go deep on breast implant illness and what to do about it today. But before we jump into the nitty gritty of that, I also have a note from your bio that you are also a huge Ted Lasso fan. And I would love to just hear your because this is the only show I have ever watched more than once. And it’s so heartwarming and so genius. And so I love that you love it too. But what originally drew you to Ted Lasso?

Dr. Whitfield: So our son has been playing soccer since he was five and it is a very different universe to go to Europe where football is played and that’s the world’s game and experience it there versus being here. So I took our son to Europe to play in Spain when he was he’d been 11. And so he’s been playing typically every summer there since he was 11. So when that came out and the premise was an American coaching soccer. He had never played or coached soccer before it was an interesting. Obviously, premise and if you know Brendan Hunt’s history and the genius of both Brendan Hunt and Jason Sudeikis. They Make that show and Roy Kent’s gold scenes character is amazing.

Katie: That’s awesome. I love it. Well, huge recommendation to anybody who hasn’t watched it to watch it, but that is of course not the focus of our interview. I’m actually really excited to delve into and learn from you on the topic of breast implant illness, because this is something in the health world that I don’t have direct experience with, but I hear from so many listeners and readers who have experience with or are in currently in kind of the trying to figure it out phase of that. And it seems like it can go so many different directions. It can cause so many different things in the body, and it can be really hard to pinpoint.

And also that there are a lot of caveats on how to correctly deal with it. And you are one of the foremost experts in the world on this, so I’m very excited to learn from you on that. But for anybody listening who maybe doesn’t have a full understanding of the topic, before we jump into specifics, can you define what breast implant illness is and kind of the fundamentals of what marks that, common symptoms, etcetera?

Dr. Whitfield: So breast implant illness, as we take care of women with it in our clinic, and I try to help explain it as chronic inflammation. So the reason as you mentioned, it’s a little confusing both to the clients. Experiencing it and to the provider who’s trying to help understand what they’re their clients experiencing. Each system of the body whether it’s your neurologic system your cardiovascular system, your pulmonary system. Your gut, your muscles and joints. Endocrine system, pretty much if you just go through the list, a patient who’s experiencing what we’ve come to term breast implant illness has symptoms in each of those categories.

And so it becomes very confusing for the provider or a doctor of any variety to understand all of that going on at one time. And it took many, many years to get to where we are now. But in 2016, I had a breast cancer patient who ultimately, I did their explant and helped make them flat because that was their wish. And they had a implant infection that was undiagnosed prior to and found afterwards on microbiologic exam, which is basically taking like a Q -tip and doing a little swab and letting it grow on a plate in an incubator. It’s pretty shocking for me, so I felt curious about that, you know, and wanted to try to better characterize that my sister’s a breast cancer survivor and I never would have wanted anybody to have missed anything on any patient, let alone obviously my sister. That patient put me on, I believe a Facebook group that ultimately led to many many patients self referring themselves to me.

And fast forward we started utilizing PCR which most of the audience will understand after the pandemic is a very specific test to help recognize the DNA and this we use to check the scar capsules from the patient against a whole series of DNA from bacteria and fungus and micro bacterium. And so in my experience of over about 1600 now that roughly is about 30% of the samples we test. So that leaves this, you know if we say 70% uncategorized and so what does that really mean in that setting and in my experience with functional genetics so we do saliva testing for genetics, we do food sensitivity testing and GI maps for gut microbiome, we look at hormone balancing, and we look at something called total toxicity test. And each of those provides an element to characterize what types of toxins whether they’re environmental, whether they’re a mold toxin or heavy metal toxin, whether they have a trigger in their diet or they have a really significant problem with their gut maybe they have leaky gut for some reason. Maybe they took a lot of antibiotics for infections over time or maybe they took Accutane as a teenager for acne that could lead to some gut problems.

You take all of that and paint the picture to provide the biggest broadest understanding of what that person’s experiencing versus just a regular blood test to look at their blood count or what we call their sed rate or CRP, which don’t always really paint a picture of what’s going on in a patient with breast implant illness. So the end game for me is to look at how much inflammation they’re experiencing, and I characterize it as chronic inflammation with the implant playing a role.

Katie: I love that you’re testing for all those things because that probably helps people uncover root cause things that may or may not even be related to the breast implant illness but are important to address. And it seems like this term has only entered the sort of mainstream conversation a little bit recently, but that women have been reporting symptoms for a really long time. And I’m curious, is there any way to know what percentage of women who get breast implants will experience symptoms? Do you think it always creates some kind of like low lying inflammation or do some women actually do perfectly fine with it?

Dr. Whitfield: So the way I characterize it is there’s a certain genetic profile that definitely puts you at higher risk. And through our clinic and working with genetics from the DNA company out of Toronto, we’ve identified a genetic archetype that definitely will experience more symptoms. They have difficulty with their vitamin D metabolism, their methylation pathways, their use of glutathione in their body, and their antioxidant pathways. And these set them up to have more trouble because that’s how their immune system functions. And think of the analogy as if you only have so much room in a bucket and you keep filling the bucket up and eventually the bucket overflows and you can’t manage it anymore. So at that point you become more and more symptomatic. There may be lots of events that trigger that but eventually you exceed your ability to perform detoxification if you want to make it that plane.

Katie: Got it. So that sounds similar to like, I know different functional medicine doctors have had different theories of sort of like autoimmunity or inflammation where if you have like a bathtub or a bucket, many things can go into that. But once it reaches its overflow point, you’re gonna see symptoms. They just will express sort of dependent on your genetic predisposition or whatever inflammation you already have existing in your body is where you’re probably going to see it first is that kind of the same thing with this whereas anywhere that you already might have a weakness or inflammation, it’s more likely to sort of show up there if you add implants to the mix.

Dr. Whitfield: Yeah, same. The analogy is just you have so much capacity, you exceed capacity, and then you start becoming symptomatic. People will express it differently. I mean, the gut is typically a starting point for this because there’s so much lymphatic tissue in the gut.

Katie: Makes sense. Okay. So as a general recommendation, and I know every patient is individualized and every person is different, but would you say that in general, like the risk and benefits of getting breast implants, that it would be preferable not to get them in general if a woman’s pre-eminent in the decision making process? Would you advise against it at this point?

Dr. Whitfield: So for about from 05 until 19, I just focused on oncologic reconstruction for breast cancer and other forms of cancer. So we always had very lengthy discussions, especially if someone showed up with. History of autoimmune disease or family history of autoimmune disease and they in the discussion of an implant. You have to explain as best you can to that patient like this may be a difficult scenario for you and explain all the options. I fortunately performed a type of reconstruction with the person’s own tissue called the D I E P free flap that left itself for me to be more sub specialized in that area and I did a limited number of implants and then I corrected a lot of failed implant reconstructions. So I just would have the conversation.

Many times people, you know once explained you know they’ll come to a conclusion on their own versus you know you don’t want to you want to have shared decision making. You don’t want to like, this is what you have to do, or this is what you can’t do. You want to make sure they’re informed and they can come to their own. Educated decision about.

Katie: That makes sense with informed consent and actually understanding the risk and benefits being a huge factor for this for sure. It seems like maybe it’s just that we’re hearing more about this as women are more talking about it more recently, but it seems like from the outside there might be an increase in breast implant illness recently, or at least, like I said the conversation around it. Do you think we’re actually seeing an increase in it? And if so, why do you think that is?

Dr. Whitfield: Well, there’s definitely more awareness based on the number of higher profile women having explants and then reporting their experiences, whether it’s Danica Patrick or Lauren Bostic, everybody who’s sharing whether or not they feel it was breast implant illness is just trying to be, I feel more open about the whole explant process. So I feel that’s raised the profile and certainly I get asked a lot more of course my focus has been trying to solve this as a problem. So by virtue of that I get a lot of you know referrals and guest appearances on shows because that’s my focus.

Katie: Makes sense. And I definitely want to get into, I know you have a whole protocol and process for helping women recover from breast implant illness. Before we get into that, if women are for either like post cancer or just post, I know after having six babies, there was huge changes there for me. Women who just want a change there but are potentially cautious about implants, are there any other viable options that you see as good options at this point that women can choose besides implants?

Dr. Whitfield: We do holistic transformations with fat. So much like a Brazilian butt lift, we can do that for the breasts. I’ve done that my entire career. So if you’re just looking for a change of a cup size, that would be the most holistic way to do that. If you’re looking for more than a cup size, I haven’t placed implants in over three years. So for me, you can have a fat transfer and an additional transfer and that will typically get you where you want to go. If someone has a very particular thought process about the appearance change they want with a much much fuller upper hold and that’s basically the purview of an implant. And so I don’t do that and I explain that very plainly. That’s not how a natural breast looks. So there’s not anything beyond that. When I do these explants, I do provide options for lifts to address skin laxity, reshape the breast, improve the nipple position so it’s at a more youthful level and then certainly providing fat back to provide more volume albeit in a way that’s more natural because it has to conform to the existing breast tissue. That is the transformation we can provide at one time.

Katie: Got it. Okay, so it’s good to know there are options that are just not going to recreate the potential experience of an implant itself, but that there are actually more natural options which that’s great to know and establish.

Dr. Whitfield: Right, because the implant itself is very stiff. Relative to your own tissues, your natural tissues.

Katie: Got it. And I guess at the end of the day, also for context for people anytime there’s an implant you are putting a foreign substance into the body, which I guess the body could have varied reactions to, but that doesn’t no matter the reaction, this is still a foreign substance that the body is going to interact with in some way, right? Because I know women have been told for a long time, especially in the past decades, that it was completely safe or that there was no risk to implants especially with different types. I’ve heard different versions of that but at the end of the day, to me it seems like this is still a foreign substance that you’re putting in your body.

Dr. Whitfield: Sure. Or anybody is going, your body is going to have a reaction to anything. So it doesn’t matter if it’s a knee implant, a hip implant, a breast implant, a shoulder implant, a cardiac implant. Everybody has a reaction because your immune system recognizes it as foreign, so of course it reacts. It builds a scar around it. It causes a foreign body reaction. So that’s been known forever. So, um, everybody’s, you know, genetic makeup and how they detoxify in their environments and the air they breathe, the water they drink, the food they eat make a difference in how that plays out in their body.

Katie: Okay, so I would love to now talk about solutions for women who have implants and maybe are experiencing some of the things that you’ve talked about. It seems like this is maybe a multi part conversation in that there’s the explant part, and then there’s still the even once the implants are removed, there’s still the reactions that could be happening in the body that also need to be addressed.

But maybe let’s start with the explant procedure, because it seems like within this realm, there’s also some nuance that’s not as widely talked about, about the different ways that they can be removed and some considerations to be really careful about during that process. And I don’t feel like if a woman just walks into any normal surgeon she might get that full range of information. So what do women need to be aware of if they’re considering explant?

Dr. Whitfield: Well, I think the experience we’ve had is in the first several hundred I did, we did complete removal of the specimen as intact as possible. Because there was and still is this association with lymphoma in certain types of implants. So lymphoma can develop around an implant. Inside the capsule of the patient. So it’s not outside in the tissues, especially if it’s caught early. But in order to remove all that, you don’t want to for lack of a better word, piecemeal it out. So I try to take all those out intact and I always have.

And in my experience, about one in a thousand of my patients have had a lymphoma. And then about, as I mentioned before 30% have an infection. So in essence we’re just trying to take that material out carefully, safely, and that should end any of that immune response at that point if it’s coming from that device. And you know, I did that for several hundred, like I said and then on the back end people would still have symptoms of chronic inflammation. And that’s really how we reverse engineered the testing and looking at everything. And all the pieces come together with toxicity testing and food testing and gut testing and your genetics.

So when you do all of that now instead of doing on the back end, we preemptively do it. Because of the length of time between my bookings and consultations we have time to work with patients. And I have a holistic practitioner who provides detox for them prior to any surgical procedures so we’ll lower your inflammation. And then based on test results, really identify the other root causes of inflammation and work with you on those. We do detoxification using cell core products. And so we’re really trying to get everybody on a level playing field so that when they have an explant surgery and irregardless of it’s, I can’t do everybody’s explant. So you can run my program remotely.

But depending on what you’re having you can have that surgery which is a finite period but the period of detoxification can range from several months to a year. It just depends on what each patient is facing with and their test results, how that treatment plan is developed on our end.

And then for true long term wellness, you want to take care of those things. You miss 100% of the things you don’t test for all the time. And once you know them and can help provide a treatment plan, then that patient I think they feel the most comfortable in that setting. So you’ve identified the other root causes for them. They have you know objective evidence of that. They’re not being placed on specific diets without reason or merit, they’re not being given certain supplements without you know this report and that helps them I think feel like we’re heavily invested in the outcome. We’re not just providing surgical services and then moving you out. We do all this within our clinic space. And then if folks are here in Austin with us, we have a very specific post-op program where people come into my office for lymphatic massage and hyperbaric oxygen therapy. Obviously, you know they’ll see me because we’re here and then, you know, if they travel back after a week to their state or their city, wherever they’re from, we follow up either virtually or in person, you know, given the logistics of their travel. So it’s a very well rounded comprehensive program at this point.

Katie: That’s awesome. And I’ll make sure, I know that you have this online information about it. I’ll make sure that’s linked in the show notes. I wish that was common practice to address the inflammatory side of the genetics and actually test for that with any kind of surgery. I know we’re not there yet quite across the board in medicine, but I love that you offer that even remotely so that women who aren’t able to get to Austin can still get some of the benefits of addressing the chronic inflammation side, even pre and post op. I think that would probably improve outcomes drastically. And it doesn’t seem like we’re seeing this actually across most forms of medicine at this point.

Dr. Whitfield: This is a blending of my allopathic training and functional medicine and surgery and the experience with this problem, which is a pretty interesting problem I have to say it’s I’ve always been pretty curious and trying to solve things from a cancer perspective with different surgical maneuvers. This has been more of a challenge to figure out what are the other causes and how to address them. I knew for a long time that genetics played a role, but it’s taken years to get the testing ramped up to sophisticated level where we can truly have a lot of confidence and say these are the factors. Now I feel very good about it.

Katie: And I love that you’re looking at the genetic side, and I would guess this is more you’re looking beyond just for a implant women who have the BRCA gene. Are there other genes that come into play here, and what are you looking at when you delve into a patient’s genetics to see if they, I would guess you look at this before to see if they’re a good candidate for the surgery to begin with, but also that there’s probably genetic factors you’re addressing before, during, and after. So what are you looking at on the genetic side?

Dr. Whitfield: Right, when you look at genetics and what we’re trying to evaluate. We’re always hoping to identify specifics related to immunity. And when you have those then you’ll understand how they detoxify. So in your think of immunity and the components of immunity that we’re looking at is how you metabolize vitamin D. Now women have a lot of trouble with vitamin D in general and it leads to a lot of problems as you’d imagine osteoporosis so you can have trouble converting vitamin D2 to D3 which is active and then you can have trouble absorbing it and then getting it to its receptor so it can be utilized.

So we use vitamin D3K2 and the vitamin D is important for a lot of cellular functions and calcium absorption. So if you don’t have proper calcium absorption so you get hypo calcemic all the time, you’ll have a lot of muscle weakness and spasm and or cramping. And if you will prolong periods of time where your vitamin D is poor or you can’t absorb or you’ll get the lack the ability to make your bones strong and obviously osteoporosis is an end cause of having that sort of a problem.

Methylation problems about, you know, we’ll say roughly a third of the population has a problem with methylation. So that’s specifically taking things like Vitamin B9 and Vitamin B12. And attaching the methyl group as a chemical group.S o that you can utilize them better and I don’t methylate well. So things like prolonged periods of physical exertion like if I were to run a marathon, or alternatively if I were to get a viral illness I would experience longer periods of inflammation because my B vitamins because I don’t methylate well, it’s harder for me to utilize them for cellular energy. So that’s a component methylation.

And then when we’re doing and thinking about how our liver works, specifically glutathione and our liver is used to bind up a lot of those chemicals we mentioned from things like glyphosates which are basically herbicides that are used to treat food that’s grown. Things like phthalates which are things that make plastic bottles firmer so think of like a plastic water bottle. And each of those, just to name a couple of them and parabens and women’s health products so of course you should be paraben free and things like that when you’re using products because they affect a woman’s endocrine system and it can affect basically your estrogen balance. So when your body combines these things in the glutathione pathway we’ll say it helps detoxify you and if you have a limitation of that, much like the bucket analogy, when it gets full and you can’t do it anymore then you get more symptomatic

And then finally the antioxidants portion of your immune system think of vitamin C as an antioxidant Tocotrienols are like vitamin E so like think of like vitamin E and vitamin C are important. This immune pathway. So everybody’s heard of like emergency has a bunch of vitamin C in it. And we all like we’re taught as a kid take vitamin C when you’re sick because it’ll help you recover.

So if you have a limitation in that pathway, the things that your body produces on a cellular level build up and then can’t get eliminated so you become less efficient at energy production so you may get more and more fatigue. So think of having all of those problems with vitamin D, the methylation pathway ,glutathione and antioxidants. And that’s a picture of a poor detoxifier.

And then in my clients who obviously are female, if they have a problem with estrogen, maybe they’re estrogen dominant. That is a really bad combination. So then you’ll have even more difficulty with detoxification because you may have so much estrogen and production of estrogen metabolites that further make it complicated to detoxify. It’s just such a bad, you know stew if you will like you put all that together. And that’s really complicated for anybody to deal with and then you add an implant to it that creates more inflammation. So you’re adding all these different factors together and that makes the situation happen for breast implant illness or chronic inflammation.

Katie: Got it. And as you said, I feel like more and more high profile women are sharing their stories with breast implant illness and talking very openly about this. So I would guess there are people listening who may be wondering if they have some symptoms of breast implant illness or wondering if that will be a concern for them in the future. So when someone comes to you in that trying to figure it out stage, is there like a protocol that you walk them through or where do you start with someone who is concerned that they might have breast implant illness? You’ve touched on a lot of the parts of your protocol, but what do you do when someone comes to you and is concerned?

Dr. Whitfield: So sure, you know, the interview process it’s very enlightening, you know, in terms of speaking with clients about it from, you know, what we consider in our clinic to be the jumping off point is genetically, how do you detoxify? So we’ll ask questions about or related to those pathways, so people typically have symptoms within those and it’ll all make sense once you listen to about do they have problems with inflammation and their neurologic symptoms so they may have light or sound sensitivity, they may have a lot of trouble with headache, if you just talk to them about their heart and lungs, they may have tightness or shortness of breath a lot. And, you know, and they may have palpitations or like, it feels like their heart rate is racing a lot. In your nervous system, there can be all sorts of things. I’ve had people report, you know, tremors neuropathic pain where it feels like their extremities or arms and legs are like burning they can have shocky pain in just in general in their arms and legs they can have muscle pain, they can have joint pain. Skin rashes can be a big, big, big problem in this group that don’t make any sense to any dermatologists they don’t follow any path. There’s not a specific, you know. Thing they can nail down so they give a steroid and it may get better or may not get better. And many people may get put on a almost like a chemotherapeutic agent to block their immune response and that helps a little bit but eventually your body figures that out and it navigates around that.

So pretty much if you can think of a system and what could be inflamed and bothersome, you know, and then of course like the your GI tract has a ton of lymphatic tissue. So abdominal swelling or bloating, constipation, and diarrhea, reflux just all these different things can happen and it just it becomes overwhelming to the client. And then they have, as we discussed this, that usually my clients have come in because of this. So I rarely see somebody who’s just kind of on a fact finding tour. Now they’ve, they show up pretty clear about the process and they’re just curious more about how my specific program can work to help them. But and those were like the listing of symptoms and most of the time they come in, and I’ve already really articulated this very well. They’re almost as well educated as I am about the subject at this point.

Katie: Which is probably awesome to you to see as a doctor. I say often at the end of the day, we are our own primary healthcare providers and the best outcomes happen when we work with really experienced practitioners who have specific knowledge, but the responsibility still lies in us as the patients to make the daily choices and do the things that are gonna improve our health. So I would guess with your approach, it seems like you would actually be encouraged to work with patients who have an understanding of this, who have done the research and who are willing to take the steps toward actually recovering.

Dr. Whitfield: Yeah, I mean, we’ve put through a show like yours and other appearances I’ve made as well as our own shows. I’ve tried to really lay out a very clear understanding of this so that it’s not as complicated to follow along. And I feel it’s helped there’s still a long way to go certainly about education on it from the client side and the provider side. We’re making headway, we’re always moving forward.

Katie: So for the patients that you actually see that are aware that they probably have symptoms and that they want to get their implants removed, what does the explant process look like? Because like I said, I have no firsthand experience with this, but it sounds like the explant process can actually be a more intensive recovery at times than the implant process itself and that there are more considerations there. So what should someone expect if they choose to get an explant surgery for the recovery process, for the prep, and for all that goes into that?

Dr. Whitfield: Right, so we’ll take the prep part first from the time we have a visit, well you know try to highlight specific things within the interview process about those symptoms we mentioned especially in the immune system and it will work to create a treatment plan based on that. And we’ll work to get testing done to help you understand your root causes of why you have so much inflammation remember the implant’s just one component of it. Once that’s identified we work through almost if you will phase one detox process in combination with supplements of mine that lower inflammation. And because we have so many patients with so many problems with their guts my supplement regimen is mostly a liquid. You hold in your mouth for 30 seconds, whether it’s the vitamin D3K2, are B complex, our glutathione. The only thing you can’t really do the antioxidant other than vitamin C and then we have something specifically to support your mitochondria. Those themselves will have lower inflammation. They also facilitate the toxicity testing so once that is back you can then build out a detox protocol that we call our phase one detox protocol with Cellcore. And that’s ran and so that may be from the time that visit initially happens till testing and detox, that may be a few months. And then you’re in a much better place because we don’t operate on folks who are constipated, having tons of gut trouble, because we’re not gonna make that better.

We want to get everybody doing better before surgical intervention because lowering inflammation is the goal of the entire of what we’re doing. Surgery is an aspect of it but preparation’s important to have the best outcomes and then when patients come here to have surgery with me, they’ll see us we’ll go over everything and then the medications that we use around the time of surgery are further meant to lower inflammation, reduce nausea, reduce nerve pain.

And then we use in the operating room after an explant is done on one side, local anesthetic that lasts about a week. So most of my patients don’t use much of any narcotic. And those clients don’t want to have narcotics, you know, in general they’re concerned about them which we understand. And then each day after that when they come to the clinic here in Austin, they’re having a experience where they’re getting hyperbaric treatment or they’re getting lymphatic massage and that further helps get the process moved along. For us the X -ray process is slightly different I don’t ever use drain tubes in those surgeries anymore. It would be uncharacteristic for me to use one we just rely on the body’s lymphatic drainage system to take care of that so we don’t really have problems with infections we’re not using drainage, which is a foreign drain, which is a foreign body. We don’t use any other antibiotics. So there’s a lot of respect given to gut health and then obviously comfort for the patient.

You know, at that point, after about a week here they’re ready to return if they’re not local to us, which about 80% of my clients are out of state at this point or out of the country. And then they return home with a follow up remotely typically with our service both for detox and our practice for surgical follow up. And then I try to see folks at intervals of three, six, nine, and 12 months now because the logistics obviously not everybody is going to make it in person, but we do want to have that connection whenever possible.

Katie: That’s awesome and definitely seems like a very unique approach that takes into account the whole patient a lot more. And probably, I would guess, gives you much better outcomes. What about for patients who are either still with informed consent considering getting implants and or have implants and are trying to avoid actually getting them removed but maybe are still having symptoms? Are there any things that can help if a woman still chooses to get implants or if she has them and doesn’t want to get them removed?

Dr. Whitfield: Sure, I think the experience we’ve had with that is a group of clients like that want to do detoxification with us as part of our protocol, but not have an explant. Right? So they’re trying to lower inflammation and do detoxification.

We feel like that has a role and it really depends on the patient how large a change that’ll experience. Because if you still have the device and the device is playing a role, how big or small that role is that’s what we don’t know. So certainly, I feel like the fastest growing group of clients in my practice is those who want to run our programs with or without. So they can’t come here, they are aware of the program, they want to take advantage of what we offer, which is unique in terms of prep and after with detox. So that’s a very common situation for us and then I have a whole group of people that want to get counseled about what they should do prior to or if they’re a good candidate for augmentation and then I feel like that conversation of understanding completely the ramifications based on their genetics and other parameters. Is that a good idea for them or not?

Katie: That makes sense. Do you think that with more awareness about this, we will see a decline in the number of women who want to get implants and or if women are going to continue to get them at the same rates? What future developments do you anticipate for the treatment of breast implant illness?

Dr. Whitfield: I don’t know that we’ll see a substantial rate of change because there’s two typical peaks, one when folks are younger between say 18 and 25 and one when they’re older between 30 and we’ll say 40. So there’s this kind of double peak and one has to do with adulthood, you know, merging into adulthood and wanting a physical change having that, you know, conversation.

The second peak is after having children and breastfeeding, body changes looking for more of a rejuvenation of whether it’s the breast or admin or what have you. So I don’t know how substantially those two peaks will change to be honest. I do think we’re providing far better informed consent and our clinic regarding you know, augmentation with your own tissue versus augmentation with the device. And so I’m happy to explain either to any interested patient and just with the caveat is I don’t place implants anymore. I did for a long period of time as it related to cancer reconstruction and cosmetics but the last three years I haven’t because this has been our focus and providing a list of transformations with your own fat.

Katie: Gotcha. Okay. That’s good to know. And like I said in the beginning, that there are other options as well even for women who still want to pursue some form of augmentation, but don’t want to put something foreign in their body. It’s great to know that there actually are options there now. I would guess that considering everything we’ve established about implants being a potential contributor to inflammation and to all these problems within the body, that women see some really profound results when they’re able to address both the implants themselves and the inflammation that’s connected to them. So I would love to hear if you’re willing to share some stories from your patients or just what you see in general as sort of the outcomes of women having explant surgery and addressing the inflammation.

Dr. Whitfield: Well, I think that’s been the, you know, journey right? Trying to characterize those people who do well right away like, why does that happen versus those who take nine months or eighteen months? Whatever, however many months it takes to get better.

And that boils back down to you know, the program created which is my holistic accelerated recovery program and looks at genetics. So if you’re a bad actor in terms of detox, it’ll take longer. If you’ve got a lot of exposures including like toxic mold exposure which a lot of our clients do. Another difficult one is lyme disease. So there’s all these different things that you know, enter into the equation and can you know, lengthen your recovery. Because the last thing you need to do is have someone, you know, come visit us and have the expectation is. Well, this is all I have to do and I’m gonna be fine because I can tell you that’s not the case in upwards of 70% of my patients. So there’s a lot of work to be done and I don’t use the word trivially because it’s a lot of work on the part of the patients to go through and look at each component that may be affecting them in their diet or their environments. The products they use, the Air quality.

I mean people just take for granted that the air is okay or the water is okay. We shouldn’t I mean the air in Austin where I am in particular has a high mold count just in general. So, you know, there’s a lot of things that go into programmatically helping them from a wellness standpoint so that when they crap come have surgery and are in the recovery process that they’re going to get to the end point. And everybody’s, you know, for lack of a better word, more level on how quickly they get there. So it’s not a matter of if I’m going to get better, it’s just when is that going to happen? How long is that going to take in my case? And that’s the gap we’re always trying to work on and shorten for everybody because nobody’s interested in taking longer to recover.

Katie: And for people who are interested, where can they find out more about your programs and also working with you if they want to go through the explant process? I’ll put links, of course in the show notes, but for anybody who is on that journey, where can they find you?

Dr. Whitfield: So I have a show, Breast Implant Illness with Dr. Whitfield on Apple and Spotify that explains our process and goes through the most commonly asked questions. Then I have handle on Instagram at breast implant illness experts and then a URL on the internet breastimplantillnessexpert.com. You can fill out a contact form, you can take a quiz to see how relevant your symptoms are in association with breast implant illness.

And then certainly, anyone who feels obviously compelled to just get in contact or visit us, you can come see us in Austin and um I look forward to opening up and having more and more contact with clients around the country and around the world. Moving into more and more I had somebody from Australia call me last week and Cyprus and I get a lot of Canadian clients as well as all of our US based clients. So I’m always happy to help wherever I can.

Katie: Like I said, all those links will be in the show notes for you guys listening. You can find that all at wellnessphama.com. I’m so encouraged to hear that you are addressing all of the potential causes of inflammation and even the genetic side which has been a research project for me for the past decade. I think this is an area that a lot of women are having questions about and wanting to find answers on. So I love that you are there as a resource and have so many resources for women to be able to pursue even if they aren’t able to work with you directly.And there’s a few questions I love to ask at the end of interview.

Dr. Whitfield: Sure

Katie: The first being, if there’s books or number of books that had a profound impact on you personally and if so what they are and why?

Dr. Whitfield: I think one that affected me a lot about diet is Metabolical. It’s written by a pediatric endocrinologist and really describes just there have been a lot of documentaries and things about food, but it’s I found that one to be particularly interesting and then I guess I read too many books about entrepreneurship and business. That’s like, you know, who not how is an important book to me in this instance, you know, it’s important that I’m doing this work, but we need more people like me doing this work.

Katie: Awesome. Well, I will link to both of those as well. And lastly, any parting advice for the listeners that could be related to the things we’ve talked about or entirely unrelated life advice that you find helpful.

Dr. Whitfield: Sure, if you can’t come visit me or not quite ready, things you can take steps to do right away are cut gluten out of your diet, dairy out of your diet, don’t drink beer or wine because each of those has bad things in them. And you know, really think about where you live, your air quality, your water, really try to eat in a way that eliminates processed food. And that’s a way to lower inflammation and you can start that today.

Katie: Well, like I said in the beginning I’m so grateful that there are people like you who are helping women address this. And I love that your approach is so comprehensive and such a valuable resource. I hope that many people get to connect with you and find answers through your work. And I’m so grateful for your time and for all that you’ve shared today.

Dr. Whitfield: Thank you for having me. It’s been fun.

Katie: And thanks as always to all of you for listening and sharing your most valuable resources, your time, your energy, and your attention with us today. We’re both so grateful that you did and I hope that you will join me again on the next episode of the Wellness Mama.

If you’re enjoying these interviews, would you please take two minutes to leave a rating or review on iTunes for me? Doing this helps more people to find the podcast, which means even more moms and families could benefit from the information. I really appreciate your time, and thanks as always for listening.