Explant Breast Implants
A timely and proper explant of your breast implants and capsule tissue that grows around the breast implant is the most crucial step to your recovery from breast implant illness. As soon as the implants and capsule tissue are thoroughly removed you will likely notice a reduction of some of your symptoms; however some symptoms may linger or reappear until your body has completed a detox and healing process which generally unfolds over a year. Most women who were symptomatic and had proper explants feel that they recovered their health within one or two years after removal of implants; however, some women heal faster than a year and some take longer than two years to heal. Unfortunately, there are some women who do not recover their full health due to silicone ruptures and some women who develop deadly diseases due to silicone.
Choose a Surgeon Committed to
En Bloc / Total Capsulectomy
No matter what you read or are advised by a plastic surgeon about explant of breast implants, if you are symptomatic all breast implants should be removed EN BLOC if possible and always with a TOTAL CAPSULECTOMY no matter the type of implant. En Bloc is an explant technique developed in France, which prevents contamination from the contents inside the capsule (textures, silicone, silicone chemicals and heavy metals and microorganisms known to grow in capsules and on implants). En Bloc technique means the surgeon leaves the capsule intact on the breast implant and dissects around the intact capsule and implant unit without disrupting the capsule so as to prevent contamination of the patient. Here is Dr Lu Jean Feng of Ohio, USA demonstrating En Bloc / Total Capsulectomy explant:
If you are symptomatic it should be obvious to you and your surgeon that the capsule around your implant is contaminated and an En Bloc / Total Capsulectomy explant is necessary. Proper removal of your breast implants is your best chance at recovering your health. Even if you are not symptomatic and you have silicone or textured implants an En Bloc/Total Capsulectomy explant should be done for your utmost health because there will likely be contamination in the capsule. If you are not symptomatic and you have smooth saline implants then Total Capsulectomy may suffice, which means the surgeon will remove the breast implants and then go back in and remove all capsule tissue. In all cases of explanting, all capsule tissue if possible should be removed from the chest which is called Total Capsulectomy.
In addition to breast implant illness, there are many other reasons that a Total Capsulectomy is recommended when removing or replacing breast implants. Leaving capsule tissue in the chest can cause pain, inflammation, calcification, infections, interference with radiology, swollen lymph nodes, continuation of symptoms and continuation of autoimmune responses and toxicity. Many women in our community have had to undergo second surgeries to remove left over capsule tissue that was not removed when they explanted their breast implants in order to finally get well. Please ensure that your explant is En Bloc / Total Capsulectomy so you are able to heal fully and don’t have to endure a second surgery.
In the case that your implants are only a few weeks old, an En Bloc removal may not be necessary as there would be very little opportunity for capsule tissue built by your body in the couple weeks of having implants however any capsule tissue that is there should be removed by your surgeon and it is possible that capsule tissue can grow within a few months.
Do not drain your implants before explanting. Draining saline implants before explanting is relatively new and being suggested by some plastic surgeons and we highly advise against this. Silicone chemicals and particulate from the shell and biofilms of bacteria/fungus from the capsule and inside the implant may be washed through the capsule into your body and may cause a serious health decline. Several woman in the group have noted a marked health decline right after draining implants prior to explanting. There is no benefit to you whatsoever in draining your implants prior to a proper En Bloc / Total Capsulectomy explant. Please be safe and don’t drain your implants prior to explantation.
Reasons Plastic Surgeons Avoid En Bloc / Total Capsulectomy
Some plastic surgeons argue against En Bloc/Total Capsulectomy removal saying it is unnecessary as they do not believe implants cause illness, or unnecessary due to thin capsules or it carries undue risk to the patient. Again, if you’ve had your implants for two months or longer you will have capsule tissue and if you are symptomatic, it should be obvious that an En Bloc / Total Capsulectomy explant is necessary.
The real reason some plastic surgeons avoid En Bloc/Total Capsulectomy explant is because it takes a high level of surgical skill, attention to detail, more time and requires a general anesthetic which carries more risk than a local anesthetic. Your placing plastic surgeon will not make much money from the removal of your implants and so they prefer to do as little as possible such as a short 20 minute procedure, in their office, under a local anesthetic simply cutting you and pulling out the implants leaving the contaminated capsules inside your body. Easy for them but bad for you! Leaving the capsules in your body whether thin or thick means all the contamination within the capsules will be left behind and eventually taken up into your body which results in a longer and more severe illness for you and even substantially hampering your recovery. Some plastic surgeons even rupture the implant while removing it causing additional contamination. Some surgeons suggest draining your implants a few weeks prior to surgery which will also cause contamination to you. Some plastic surgeons will argue that an En Bloc / Total Capsulectomy explant could result in disfigurement of your breast but this is mostly untrue. A skilled and experienced explant surgeon will be able to avoid further disfigurement than the disfigurement already caused by implantation.
If your plastic surgeon does not acknowledge breast implant illness, silicone toxicity, argues against a Total Capsulectomy or cannot prove their En Bloc / Total Capsulectomy skills and experience to you via photographs of En Bloc removed implants and intact capsules, we suggest not using him/her for your explant.
Explant Surgery Contract
Have your surgeon explain to you in step-by-step detail exactly how the explant procedure will be done and then record the details in writing for you so you both can sign off on it. Ensure that you both sign off on the correct procedure using the words Total Capsulectomy on your contract. Most surgeons do not use the term En Bloc as it cannot be guaranteed but they should state Total Capsulectomy on the contract.
Find an Explant Surgeon
Finding a good explant surgeon should not be difficult so we compiled a list of Explant Surgeons used by the over 100,000 ladies of our Facebook group Breast Implant Illness and Healing By Nicole. Come to the facebook group where you can chat with these ladies who have been through the same symptoms, finding a surgeon, surgery, recovery, detoxification and healing.
Other Important Things to Know in Regards to Explant
Other Important Things to Know
in Regards to Explant
Ready Your Body Before Surgery – You can prepare your body by nourishing yourself as well as you can, fueling with extra high quality vitamins, minerals and antioxidants to support healing. Your surgeon may request that all supplements be stopped at least two weeks prior to your surgery so as not to affect the actual surgery itself.
Obtain a Copy of Your Implantation Operative Report – If possible obtain a copy of your implant operative report from your implanting plastic surgeon which will help your explant surgeon.
Obtain a Copy of Your Explantation Operative Report – Obtain a copy of the explant operative report for your explant from the explanting plastic surgeon. The operative report will explain in detail exactly what the surgeon did during your explant.
Obtain Warranty Information and Serial Numbers of Your Implants From the Placing Surgeon – Breast implants have serial numbers because they are implanted medical devices. The serial number is on the breast implant itself and should be recorded in your implanting surgeon’s files. Breast implants usually have a warranty of ten years and the manufacturer may cover some expenses of surgery due to a ruptured, leaking or defective implant. However, please be aware that you may have to sign away your right to future legal proceedings if you accept warranty reimbursement. We suggest getting legal advice to protect your rights before considering signing anything from implant manufacturers.
Insist on Pictures of the Explantation – Good surgeons will video tape their explant procedure or take various photos of implants once removed with the capsule tissue still on to prove they were removed En Bloc / Total Capsulectomy including your name and surgery date. Ensure there are side photos showing the posterior of the capsule is also removed. If the capsule comes out in pieces make sure all pieces are included in the photo so you discern if all the capsule is removed. Secondly, a set of photos of the implants themself without the capsule tissue on the implant. We have several pictures now of moldy and colonized implants taken right at the time of explant as well as silicone cohesive gel implants that are puddles of silicone.
Pathology – Discuss pathology with your surgeon, the costs and what you both feel is necessary or not. Ideally, if you have textured implants and any symptoms of BIA-ALCL you should be tested for BIA-ALCL using a CD-30 test. A CD-30 test will include your surgeon capturing fluid from inside your capsules if it is present and sending the fluid samples and representative pieces of your capsule to pathology to be tested for BIA-ALCL. Further, and aside from BIA-ALCL, your capsules and implants should be sent to pathology where the state of your implants should be carefully documented and recorded (are they ruptured, leaking, are there shell or patch defects, are they discoloured or colonized) by the pathologist and your capsules should be carefully examined for textures/silicone which may have leaked or be present in the capsule. Then the pathologist will study your capsules and the cells of your capsules noting the tissue types and cell types, cell characteristics and any cell pathologies that may occur in capsule tissue. Then, pieces of your capsule should be cultured using sensitive broth cultures to see if any infections grow out that you may need treatment for. Bacterial infections grow out sooner than fungal infections. Your surgeon will order your pathology and so you need to discuss all of this with him and which of these tests you want and the costs, some of this may be very expensive and even unnecessary depending on your circumstances and what your surgeon sees during explant and so that will be a factor in your decision. Whether you get your implants back or not is up to you, some want to see them, if you are pursing legal check with your lawyer about how your implants should be handled in order to preserve your case.
Lymph Nodes – At this time the following quote and research by Dr. Lu Jean Feng is the best research on the subject of breast implants and lymph nodes: “I have done extensive research on silicone lymphadenopathy over the last 20 years as a result of breast augmentation. As a result, I have published a peer-reviewed paper with scientists from the Armed Forces Institute of Pathology in Washington, D.C. as well as from Case Western Reserve University in Cleveland. Silicone in the lymph nodes can be diagnosed by ultrasound and by needle
Breast Implant Associated Anaplastic Large Cell Lymphoma – Anaplastic Large Cell Lymphoma is a type of non-Hodgkin’s lymphoma, a cancer of the cells of the immune system that can be caused by breast implants. The main symptoms of BIA-ALCL are persistent swelling or pain in the vicinity of the breast implant, seroma, breast mass, capsular contracture and usually are associated with textured implants. These symptoms may appear after the implant surgical incision has healed and often years after implant placement. If you have swelling, seroma, breast mass, or capsular contracture and especially if you have textured implants please push hard for BIA-ALCL testing. Surgeons should consider the possibility of ALCL when they have a patient with late onset, persistent fluid around the implant (peri-implant seroma) before and during explant or exhibit symptom after explant. When testing for ALCL at the time of explant, surgeons should collect fresh seroma fluid and representative portions of the capsule and send for pathology tests. The test is called CD-30 and few surgeons are knowledgeable about BIA-ALCL at this point so it will be up to you to educate your surgeon and persist in getting the test if you have any symptoms and/or textured implants.
Ensure That Your Implants are Returned to you If You Want Them – You paid for your implants and by law they belong to you and should be returned to you directly after explant or after pathology if you want them. Don’t let your plastic surgeon keep them, dispose of them or tell you they cannot be returned to you because of testing or hospital rules. Plastic surgeons are rewarded for returning breast implants to manufacturers so they make up all kinds of excuses that implants cannot be returned to you. My implants smelled strongly of chemicals and that was how I realized I was being toxed by them. You may need your breast implants for future legal proceedings. If you are interested in legal then please seek advice from your lawyer on how they recommend your implants be handled by your surgeon and pathology after explant in order to preserve your legal case.
Contact the Implant Manufacturer for Warranty and Expense Reimbursement – If you obtained your implant information from the placing plastic surgeon or if you received your implants after explantation you will be able to determine the manufacturer. If you do not have an interest in legal action, contact the manufacturer to see what is available to you in regard to warranty or reimbursement for surgeon fees. Again, please be careful talking with and signing anything from the implant manufacturer so you do not sign your rights away. In general manufacturers make you give up the implants and your rights to legal proceedings in return for a little money.
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