There is a growing army of women complaining of breast implant illness. Their symptoms frequently include fatigue, chest pain, hair loss, headaches, chills, photosensitivity, chronic pain, rashes, body odor, anxiety, brain fog, sleep disturbance, and depression. What can be done to relieve these health problems?

I perform the en bloc explant procedure. I remove the implants and their diseased capsules in one whole piece to prevent spreading of the nasty silicone gel. The capsule is formed as a defense by the body to wall off the big foreign body — the breast implant. Over the years, these capsules can become pathological with calcifications (think thick egg shells) and massive inflammatory tissues. The capsules are frequently embedded with large amounts of free silicone gel.

The en bloc explantation procedure is very demanding because the capsule is “glued” to the pectoral muscles, ribs, breast, subcutaneous tissues, and even the underlying breast skin. It requires a slow, meticulous dissection to remove the implant and capsule and do minimal harm to the tissues. Because of this, the procedure can take approximately 4 hours under general anesthesia. The area of surgery is much too large to anesthetize with local anesthesia. I insist my surgeries be pain free.

I need to use drains because the dissected tissues leak a fluid called lymph for a couple weeks post op.

The biggest question with the en bloc explantation is what to do after the implants once capsules are removed. Some women opt for nothing, which can result in small, sagging breasts that might deform due to adhesions of the healing tissues inside the breasts.

Other women would like to have “perky” breasts after surgery. For these women, I perform an immediate breast lift to remove loose, sagging skin and lift the nipple and areola to the perfect height.

Another segment of the en bloc/explantation group want to maintain the original size and shape with a much safer saline implant. I believe this is a good choice even though the envelope of a saline implant is solid silicone. I am convinced that everything in life is dose-related — even water! Too little water, you die of thirst. Too much water, you die of hypoosmolar coma. Because the dose of free silicone is so small in a saline implant, it should not pose a health problem.

When covered by insurance, I perform the en bloc / explant in the hospital as an outpatient procedure. When not covered by insurance because of a breast lift or new saline implants, I prefer my fully accredited office operating room.

The most important “caveat” for women having en bloc explantation: post operatively, you may have complete, partial, or no relief of your symptoms. This is because these symptoms have multiple other etiologies besides silicone “allergy.” In my experience, the vast majority of women having en bloc explantations see improvement in their symptoms. Beware of doctors who promise you complete relief of symptoms.

Doctors performing en bloc explantation are frequently booked years in advance. Fortunately, I am usually able to help women with breast implant illness within a month.

Please contact my office by phone or email for your free complimentary consultation.

I’m here to help you.

From my H-Art,

Yale M Kadesky MD

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