EXPLANT BREAST IMPLANT REMOVAL
A timely and proper explant (removal) of your breast implants and the 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 properly and thoroughly removed, you will likely notice a reduction or clearing of some of your SYMPTOMS. However, some symptoms may linger and even return until your body has completed a DETOXIFICATION process and had a chance to heal. Many thousands of 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 or quality of life due to breast implants and some women who develop deadly disease due to breast implants.
CHOOSE THE RIGHT SURGEON WHO IS EXPERIENCED AT EN BLOC / TOTAL CAPSULECTOMY EXPLANT AND IS COMMITTED TO REMOVING ALL OF THE CAPSULE TISSUE
No matter what you read or are told from your 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 a breast implant removal technique first developed in France which prevents contamination from the contents inside the capsule such as chemical textures, silicone, silicone particulate, silicone chemicals, heavy metals and microorganisms known to grow in capsules. En Bloc means the surgeon leaves the capsule tissue sack intact around the breast implant and carefully dissects around this capsule and implant without disrupting the capsule or the implant so as to avoid the contents of the capsule from contaminating your chest cavity. Here is Dr Lu Jean Feng explaining and demonstrating an En Bloc Total Capsulectomy explant. If you are symptomatic it should be obvious to you and your surgeon that the tissue 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 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 and this is well known to plastic surgeons. 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 capsule tissue that was not removed when they explanted only their breast implants in order to finally get well. Please ensure that your explant is En Bloc and or Total Capsulectomy so you are able to heal fully.
In the case that your implants are only a couple weeks old, an En Bloc removal may not be necessary as there would be very little opportunity for contamination and very little 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 weeks or a few months and we have documented that in the facebook group.
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 may be washed through the capsule into your body and may cause a serious health decline. Several women 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 don’t drain your implants prior to explantation.
THE REAL REASON PLASTIC SURGEONS AVOID TOTAL CAPSULECTOMY AND EN BLOC EXPLANTS
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 your breast implants have contaminated the surrounding capsule and 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. 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 removed implants and intact capsules, we suggest not using him/her for your explant.
DON’T BE CONFUSED BY THE DIFFERENT TERMS CAPSULECTOMY AND CAPSULOTOMY
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. Keep a copy of the signed document for your records. Do not get confused by the terms En Bloc, Total Capsulectomy, Capsulectomy and Capsulotomy:
En Bloc – is the French term that references the proper procedure developed in France for removing silicone and textured breast implants in a manner to avoid contamination to you. En Bloc means the surgeon leaves the capsule tissue intact on the breast implant and dissects around this intact unit without disrupting either the capsule or the implant so as to avoid contamination to the body. An En Bloc/Total Capsulectomy explant will take at least two hours and should be done with an under the breast incision. Very few surgeons will be able to do En Bloc/Total Capsulectomy through the nipple as the surgeon does not really have enough access to do a proper En Bloc through the nipple. All silicone and textured implants should be removed En Bloc/Total Capsulectomy for your highest well being.
Total Capsulectomy – may be your surgeon’s reference for an En Bloc explant and capsule removal but please clarify this with him. Total Capsulectomy usually means the surgeon will remove the implants and then go back in and remove any and all left over capsule tissue.
Capsulectomy – is a procedure in which the capsule of tissue surrounding a breast implant is surgically removed and this procedure is generally used to fix capsular constracture but does not necessarily mean all capsule tissue is removed.
Capsulotomy – there are two types of Capsulotomy: Open Capsulotomy is a procedure in which the capsule is surgically released and/or partially removed through an incision within the breast area. Closed Capsulotomy refers to a procedure where the surgeon breaks down capsule tissue while leaving the implant in place using vigorous compression. Closed Capsulotomy is not recommended due to risk of rupture of the implant and voids the warranty on most breast implants.
WORD OF MOUTH REFERRALS FOR GOOD EXPLANT SURGEONS
A good way to find a surgeon for explant is by word of mouth referrals from properly explanted ladies. Here is a list of world wide EXPLANT SURGEONS which we gathered from ladies recommending their surgeon to us in our facebook group.
Thousands of ladies have breast implant illness and as such we created a Facebook support group Breast Implant Illness and Healing By Nicole where you can chat with 80,000 other ladies who have been through the same symptoms, finding a surgeon, surgery, recovery, detoxification and healing. Or you can click the Facebook button at the end of any page of this website which will also take you directly to the support group.
OTHER IMPORTANT THINGS TO KNOW IN REGARD TO EXPLANT
READY YOUR BODY BEFORE SURGERY – Depending on the time frame before your explant, you can prepare your body by nourishing yourself as well as you can, fueling with extra high quality vitamins and minerals to support healing and improving your gut health through an organic, wholefoods diet and lots probiotics. 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 – Obtain a copy of the operative report for your implantation from the placing plastic surgeon. The operative report will help the explant surgeon and will be helpful if you decide to get your implants analyzed and or explore legal avenues.
OBTAIN A COPY OF YOUR EXPLANTATION OPERATIVE REPORT – Obtain a copy of the 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 so they can be tracked because they are classed as medical devices. The serial number is on the breast implant itself and should be recorded in your placing 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. I 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. Ensure there are side photos showing the posterior of the capsule is also present. Secondly, a set of pictures 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 removal.
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 (or even perhaps not) you should be or may want to 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 discolored 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 IMMEDIATELY AFTER REMOVAL – You paid for your implants and by law they belong to you and should be returned to you directly after explant or after pathology. 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 the manufacturers and so they make up all kind of excuses that implants cannot be returned to you. In Canada, some of the capsule tissue does have to go to pathology for cancer testing but the implants do not have to go to pathology. You will want to inspect your breast implants yourself after their removal. Mine smelled strongly of chemicals and that is how I realized that chemicals bleed through the shell and are poisoning us. You may want to send your implants to Dr. Pierre Blais of Innoval Consulting, under RESOURCES, for analysis to understand why your breast implants failed and caused you symptoms and illness. 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 them in a manner that serves your case.
YOU MAY WISH TO 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.
I wish you the very best in a speedy explant and full recovery of your health. If you have any questions or concerns, please contact us below.