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 procedure 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 intact on the breast implant and carefully dissects around this intact unit without disrupting either the capsule or the implant so as to avoid contamination of the body. Here is Dr Lu Jean Feng demonstrating En Bloc Total Capsulectomy explant: https://www.youtube.com/watch?v=OQbLpUHs1e0&t=5s. 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 should be sufficient 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 in plastic surgery schools and taught to plastic surgeons. I have a copy of the Guidelines and Indications for Breast Implant Capsulectomy published in September 1998 by the Washington University School of Medicine which details the numerous reasons why a Total Capsulectomy is highly recommended when a woman explants breast implants. If you would like a copy, please contact me and I will email it to you. 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 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.
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. There are stories of women who thought they were getting a proper explant but did not because their surgeon decided it was not needed, lied or they were confused by the terms Total Capsulectomy, Capsulectomy and Capsulotomy.
DON’T BE CONFUSED BY THE DIFFERENT TERMS CAPSULECTOMY AND CAPSULOTOMY
I read a brief piece on someone’s personal site that said some surgeons may refer to the French En Bloc removal procedure as “Total Capsulectomy” in North America and it may be essentially the same procedure but I would not count on this. 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 En Bloc/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 further contamination to you. En Bloc means the surgeon leaves the capsule tissue intact on the breast implant and cuts 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 and not through the nipple. Good En Bloc/Total Capsulectomy surgeons have stated that En Bloc removal cannot be done through the nipple as the surgeon does not have enough access to do a proper explant through the nipple. All silicone and textured implants should be removed En Bloc/Total Capsulectomy in order to minimize contamination to you.
Total Capsulectomy – may be your surgeon’s reference for an En-bloc style 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.
If your implants are placed sub-muscularly and are stuck to your ribs in any area then a small part of the capsule may have to be left behind. This was true in my case. I had cohesive gel implants which were stuck to my rib in one spot which is not uncommon and my surgeon left a small piece of the capsule tissue on one side because removing it may have damaged my rib.
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 I gathered from ladies recommending their surgeon to us from 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 60,000 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. Do not stimulate detoxification until about a month after explant as you do not want to spread anymore toxins than necessary through your system and organs. 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 help analysis and may also be required down the road for legal proceedings.
OBTAIN WARRANTY INFORMATION AND SERIAL NUMBERS OF YOUR IMPLANTS FROM THE PLACING SURGEON – All 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 pictures of your 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.
INFECTIONS AND PATHOLOGY – Pieces of your capsule tissue should be sent away and cultured for infections using longer, more sensitive broth cultures. Capsular contraction is known to be associated with microorganisms and microbial biofilms. Please note that fungus/mold is hard to culture and grows out more slowly than bacteria and so don’t use a negative fungus test to rule out fungus/mold if you have moldy saline implants and symptoms of mold in the chest. The rest of capsule should also be sent to Pathology to look for silicone particles, various immune reactivity cells, inflammatory cells, cancers and BIA-ALCL caused by textured implants if applicable. Saline fluid may be cultured to check for fungus or other microbes inside saline implants. Your implants and saline fluid can be sent to Mycometrics and Real-Time labs to be checked for fungus or other microbes. Please ensure you get your implants and capsule tissue returned to you after pathology if you want to pursue a lawsuit. Check with your lawyer before explanting about your implants and capsule tissue as they may have a specific protocol for the handling of your implants and capsules in order to preserve your case. All tests may cost extra over and above your surgery so please inquire about their cost.
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 localized 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 similar to wet silicone caulking and that is how I realized that those 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.
ENSURE THAT YOUR CAPSULE TISSUE IS RETURNED TO YOU – If you are planning on having your implants analyzed by Dr. Blais request your capsule tissue back too after pathology is done testing it for cancer. Capsule tissue will be able to tell Dr. Blais the story of what happened in your body in regard to the implants and illness. Again if your are interested in legal then please seek advice from your lawyer on how they recommend your capsule tissue be handled by your surgeon and pathology after explant in order to preserve them in a manner that serves your case.
YOU MAY WISH 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.