Breast Implant Illness

Breast Implant Illness Symptoms

Suspected Culprits in Breast Implant Illness

Biofilms and Autoimmune Diseases

Biofilms are complex structures made of bacteria, yeast and other organisms that adhere to a surface, in this case, implants. Biofilm development was analyzed in a combination of implant types including, silicone (47), textured implants (44), saline (3) and smooth implants (6) in women who had Breast Implant Illness (BII) compared to women without symptoms. The BII group had a 6-fold greater rate of positive cultures with the most prominent organism being Propionibacterium acnes, compared to the women who had implants without BII symptoms. The researchers identified positive cultures in 36% of BII pts compared to 6% of controls. Uncertainty is present as to the impact of the biofilms contribution in individuals that experience BII. However, P. acnes has been connected with various rheumatological disorders, including CREST disease, thyroid disease, sarcoidosis, and endophthalmitis (inflammation of the eye). The commonality was that P. acnes was found in the lymph nodes of these patients. Staphylococcus epidermis was another organism cultured in both the BII and control groups. Other pts in the BII group had polymicrobial growth of gram neg bacilli and candida. This is not the first time organisms were studied in this way. Previous research found E. coli and staph epidermidis colonizing the implants as well.

Breast explant via en bloc explant capsulectomy (removal of the implant including the capsule around it) of the 44 women in this study improved or their symptoms resolved with high statistical significance. Most common symptoms of these patients were: fatigue, arthralgia (joint pain), brain fog, myalgia (muscle pain), memory loss, difficulty concentrating, autoimmune diagnosis, rash and visual disturbance/ dry eyes. 43 of these women had at least one of these 9 symptoms, with 18 reporting at least 5 of these symptoms. 15 patients reported an autoimmune diagnosis sometime after breast augmentation occurred including: Grave’s thyroiditis, Hashimoto’s, celiac disease, rheumatoid arthritis, Sjogren’s syndrome and ankylosing spondylitis. The implication of biofilms and particularly the presence of P. acnes in women with BII may shine some light on why some women are getting sick. More research needs to continue to be done on this topic to better understand if antibacterial medicines should be considered post explant.

(https://journals.lww.com/prsgo/Fulltext/2020/04000/Breast_Implant_Illness__A_Biofilm_Hypothesis.1.aspx)

Local Immune reaction in BII

Synovial metaplasia and giant cell formation are common reactions against foreign objects in the body, particularly silicone. This is caused by a conglomeration of tissue repair cells found along the edge of the textured type of breast implants primarily, but can also be found along the edge of the smooth implants as well. This process doesn’t discriminate between implants filled with silicone gel or saline. It can result in formation of a constrictive fibrotic capsule post-implantation, known as capsular contracture, which results in firmness, deformity and pain. Rates of occurrence in silicone implants is 14.8-20.5%. (https://www.archivesofpathology.org/doi/pdf/10.1043/0003-9985%282002%29126%3C0727%3ASMASFO%3E2.0.CO%3B2)

The biofilm study mentioned earlier also determined that women with BII had a 50% higher rate of synoviocyte metaplasia compared to controls and a slightly higher rate of foreign body granuloma in the BII group but not significantly different in control groups. (https://journals.lww.com/prsgo/Fulltext/2020/04000/Breast_Implant_Illness__A_Biofilm_Hypothesis.1.aspx)

Inflammatory reaction, including lymphocytes, monocytes, and plasma cells, has been identified in silicone implant patients with or without overt leakage. The presence of these cells including Interleukin 2 have been detected in capsules surrounding breast implants. (https://www.sciencedirect.com/science/article/abs/pii/0049017294901023)

We don’t completely understand the systemic impact this process has on the body, but we do know that women with BII symptoms had significantly more synoviocyte metaplasia than women who did not have symptoms. This can lead us to believe that there must be greater ramifications throughout the body than only a local effect.

Toxicities in BII

Concerns have been raised about illness related to chemical toxicities associated with the implant materials. The evolution of newer and “improved” implants to help reduce capsular contractions led to even more chemicals on the surface. There are more than 40 + toxic chemicals including heavy metals present in breast implants. Toxins can impact brain function and contribute to immune dysfunction by weakening the immune system or over activating it like in auto-immune disease. Chemicals can cause distress on the endocrine system (thyroid, adrenals, female hormones), intestinal health and bombard the liver and kidneys as the body is trying to rid itself of these chemicals on a daily basis. Both the saline and silicone implants have a semipermeable silicone shell. Silicone Gel bleed is a term used to describe the diffusion or leaching out of chemicals from the silicone gel through the shell into the rest of the body. This discovery is extremely alarming and somehow controversy exists around whether this is of any concern.

Toxins found in Saline Implants:

• Silicone rubber shell made of polysiloxanes
• Silica
• Heavy metals tin and platinum
• Volatile organic compounds like xylene

Toxins generally found in Silicone Breast Implants:

• Cyclohexanone
• Methyl Ethyl Ketone
• Polyvinyl Chloride
• Toluene
• Ethyl Acetate
• Phenol
• Xylene
• Toluene
• Ethylene Oxide
• Benzene
• Denatured Alcohol
• Chloromethane
• Urethane
• 2-Hexanone
• Formaldehyde
• Silicone
• Sodium Fluoride
• Talcum Powder
• Methyl 2-cyanoacrylates
• Steric Acid
• Zinc Oxide
• Thixon-OSN-2
• Epoxy Resin
• Epoxy Hardener 10 and 11
• Heavy metals: platinum, aluminum, tin, and arsenic

Volatile Organic Compounds (VOCs) and BII

The first half of the list of chemicals found in silicone implants are known as VOCs and some of these can also be found in saline implants. Solvents have been implicated in creating adverse health effects as it has been studied in different applications. When the body is inundated with these exposures over time it cannot break the VOCs down efficiently enough to adequately remove them from the system. This particular category of chemicals has been shown to be neurotoxic as the lipophilic VOCs can accumulate in the brain, they can also be stored in the fat cells and then slowly released into the bloodstream over time. Neurological symptoms that may be experienced include numbness, loss of sensation, brain fog, mood swings, headaches, memory loss, weakness and fatigue. (https://www.ncbi.nlm.nih.gov/books/NBK215288/)

Formaldehyde, benzene, toluene have been some of the more researched solvents and they are considered to be proven human carcinogens. (https://iaqscience.lbl.gov/voc-cancer)

Silicone’s Impact on BII

Silicone is considered a toxic substance based on the following concepts and research exposing this harmful chemical. Silicone is not only a threat from breast implant rupture but also can be a health hazard due to its ability to release into its surroundings. To substantiate this concern the Public Safety Commission (PSC) released documents that were produced by Dow Corning in national litigation which they determined that.: “Silicone degrades into silica, usually at the surface of the gel implant, then fragments and subdivides into millions of microdroplets capable of migrating throughout the body”. Silicone and its contaminants which bleed through its surrounding implant envelope into neighboring tissue have the potential for significant toxicity in the implant recipient. The PSC also collected research that has shown silicone has an effect on the liver and adrenal glands, and induced chronic inflammation.

There are several studies looking at silicone implant incompatibility syndrome. One study identified the increased risk of developing autoimmune disease and immune deficiencies in women who have silicone filled breast implants. Silicon exposure has been associated with different autoimmune disease including: Systemic lupus, rheumatoid arthritis, progressive systemic sclerosis and vasculitis. This study looked at the immune system of 32 women with silicone breast implants who were patients of an autoimmune clinic. All 32 patients had silicone implant incompatibility syndrome and complaints fulfilling the diagnostic criteria of ASIA (autoimmune/inflammatory syndrome induced by adjuvants). Furthermore, in 17 of the 32 patients, a systemic autoimmune disease was diagnosed, and 15 of the 32 patients had an impaired humoral immune system. Patients developed symptoms and signs after long-term follow-up, suggesting that these symptoms and signs started after implant aging and/or rupture. (https://www.ncbi.nlm.nih.gov/pubmed/23576058)

Siliconosis is a musculoskeletal pain syndrome characterized by overwhelming fatigue, arthralgias and myalgias. A minority of patients report skin rash, alopecia, fever, swollen lymph nodes, and arthritis. A significant number of patients had Sjogren’s- like disorder. All of the symptoms were present without the ANA diagnostic positive marker. Studies suggest that individuals with the DR53 gene mutation may be more predisposed. Improvement with removal of implants was significant but not immediate. For some it took 12 months to improve post explantation, but there was improvement. (https://www.sciencedirect.com/science/article/abs/pii/0049017294901023)

Platinum exposure

Platinum is a metal used in the manufacturing of the shell and gel components of the silicone breast implants. This tends to be the most prominent metal researched and found present in all forms of implants. It appears that platinum may enter the body by diffusing through an intact shell. Research has shown diffusion of platinum into the surrounding tissue, including fat tissue, in some of the women tested. Further studies have substantiated this effect, but the FDA believes these studies are flawed or minimize how little may be leaching out of the breast implant. Their belief hinges on the concept that platinum has minimal health effects based on the zero oxidative state that the platinum is found in. (https://www.fda.gov/medical-devices/breast-implants/fda-backgrounder-platinum-silicone-breast-implants)

Breast Implant Associated Anaplastic Large Cell Lymphoma (BIA-ALCL)

BIA-ALCL is a rare form of T-cell lymphoma that occurs in some people who have had breast implants. This type of cancer is becoming more prominent in the textured silicone and saline implants. The lymphoma occurs in the tissue surrounding the implant and in more advanced cases may spread to lymph nodes closest to the breast. In fact, Allergan, one of the textured implant manufacturers, ordered a recall of all of its Biocell textured breast implants after the FDA flagged a series of reports that the implants were causing cancer. There are 481 cases of BIA-ALCL tied to Allergan’s product. Symptoms to watch out for that could be present due to BIA-ALCL are: swelling around the breast, lumps, pain, changes in the shape or size of the breast, redness. Contact your doctor immediately if you ever experience any of these symptoms.

Importance of Capsulectomy in Women with BII

A study was done evaluating 750 women. Preoperative and postoperative survey scores were taken. The survey was to determine symptoms present in patients who had Breast Implant Illness before and after capsulectomy which included: numbness and tingling in the extremities, joint and/or muscle pain, hair loss, memory loss/cognitive problems, dry eyes and/or blurred vision, chronic fatigue, breast pain, rashes or hives, food sensitivities/intolerance, flu like symptoms and/or low grade fever, and difficulty breathing. Patients were asked to rate symptoms on a scale from 0 (absent) to 5 (very severe). Significant immediate and sustained improvement occurred after removal of the implant and the capsule surrounding the implant in majority of patients 30 days post explant.
All patients were treated using total capsulectomy and implant removal. Implant fill and texture was diverse: 303 of 750 had saline implants, 413 had silicone implants, 555 had smooth implants, 150 had textured implants, 6 had polyurethane- coated implants either smooth or textured. Histologic analysis of capsules surrounding an intact and ruptured implant showed chronic inflammation into the tissues surrounding the implant. The theory is that the silicone shell can trigger the reaction and symptoms in women who have both saline and silicone implants. (https://journals.lww.com/annalsplasticsurgery/Fulltext/2020/07001/Understanding_Breast_Implant_Illness,_Before_and.19.aspx)

Treatment strategies for the BII Healing Program

Step 1: Consult with a Surgeon

The ideal candidate is one who has extensive knowledge about BII and the importance of explantation using the En bloc procedure.

Step 2: Testing

Based on the initial appointment with the doctor and detailed intake including an environmental questionnaire it will be determined what testing may need to be done to get a more complete picture of additional obstacles in regaining health after explant. Testing considerations are based on the individual but may include: auto-immune markers, thorough thyroid testing, adrenal assessment, nutrient testing (minimally Vitamin D, B12), viral testing (EBV, HHV 6, varicella zoster…), urine mold/mycotoxin testing, heavy metal testing, food sensitivity, gut health analysis, and Lyme testing.

Step 3: Diet and Intestinal Health

A healthy diet is crucial when it comes to wellness. Regardless of personal food preferences it is crucial that the diet is based on whole food, organic, and GMO free. Some patients will choose to do a IgG Food Sensitivity Test to better direct their eating plan. These tests point out the foods that alter the immune system and create inflammation and give specific guidance as to what is best to eat for their bodies. Those who choose not to do testing will be given a specific candida and common food sensitivity avoidance list to follow that will include avoiding dairy, wheat, yeast and sugar. The longer the diet is in practice the better the outcome from healing post-surgery and a quicker road it will be to regaining health. We recommend a stricter dietary focus for a minimum of 8 weeks prior to surgery. A healthy intestinal tract is a necessary foundation for wellness and should be made up of diverse good bacteria, limited pathogenic bacteria and yeast/candida. When out of balance it can be responsible for development of food sensitivities, compromise the immune system by either weakening it or driving autoimmunity, alter brain chemicals, and impact healthy bowel function which is responsible for elimination of toxins. Symptoms that can be connected to dysbiosis are headaches, fatigue, depression, anxiety, joint pain, foggy headedness, IBS, and constipation. Stool tests may be completed for those who have severe GI symptoms. Herbs to address suspected or proven imbalances will be recommended while simultaneously adjusting diet to be more successful at regaining balance. Herbal combinations like berberine, caprylic acid, garlic, oregano are examples of what may be recommended at this time.

Step 4: Pre Explant Protocol

Ideally 5 weeks prior to surgery we want to add in supplements that are going to encourage healthy healing from the operation. Since the system of a BII patient is already compromised we want to put forth extra effort in being proactive.

• Liposomal Vitamin C
• Zinc
• Vitamin D
• Probiotics

Best to discontinue these nutrients at least 72 hours prior to surgery.
Two days prior to surgery begin Arnica Montana 200C 3 pellets under the tongue 2 x day to help with healing. Take 3 x day on surgery day and continue this dosing 2 weeks post-operation

Step 5: Post Explant Protocol

Remain on Arnica Montana 200C 3 pellets under the tongue 3 x day for 2 weeks
Resume Liposomal Vitamin C, zinc, Vitamin D and Probiotics when able per surgeon.
Continue healthy eating.

We recommend 10 sessions of Hyperbaric oxygen therapy (HBOT) for increasing healing and providing anti-inflammatory benefits when able post-explant. HBOT has also been shown to have a positive impact on the immune system and anti-bacterial action which would greatly impact the Biofilm theory on why women develop BII symptoms to begin with.

• Option #1: 5 days a week over 2 weeks
• Option #2: 3-4 days a week over 3-4 weeks

Step 6: Detox Wellness Plan

Everyone has their own timeline when it comes to healing, but it is acceptable to start detoxing 6-8 weeks post-surgery. The path that is taken here is based on the initial intake and test results as to what direction we take to detox and support the body. Detox is highly recommended for everyone with BII. I think this is the step for some that is missed and may hinder full recovery. More detailed suggestions will be made based on what the body’s burden appears to be through supportive testing that was done in Step 2. EVND Treatment Center is known for our in-depth detox approaches. To better understand EVNDs General Detoxification Strategies click on the Detox Link. How we pursue detox in our BII patients is similar as you will see below. The degree of illness will relate to how long and how intense our detox strategies will be.

Goal #1: Remove toxic obstacles.

Good news, removing the implants was a major hurdle that you have overcome to getting well. Your physician in your initial intake will also take inventory of any other known barriers to wellness and if not discussed already will be addressed now.

Goal #2: Support the organs of Detoxification- Liver, Kidneys, Lymphatic and Skin

Our variety of genetics require an individualized plan to support our liver, kidneys, lymphatics, and skin in detoxifying the body. A combination of nutrients, herbs, IV therapies, Infrared sauna therapy and Foot baths can provide specific and needed support as we push the organs of detox to remove toxins from the bones, fat, lymphatics, organs, and brain tissue.

Goal #3: Binding of Toxins

The premise of adding in binding medicines is their ability to attach to bile secreted from the liver which carries the fat-soluble toxins. Taken carefully away from food and supplements or prescriptions, binders such as charcoal, zeolite, citrus pectin, chlorella, silica, and cholestyramine, provide a concerted effort to reduce total body burden of recent and past toxic exposures. Detox without the binders will allow a significant amount of processed toxins through the liver to be reabsorbed, repeating the same work and toxic trauma again.

Goal #4: Replenish Nutrients to Support Elimination Pathways

A number of nutrients are present within the research to support detoxification pathways in the liver, kidney, intestinal tract, and skin. Vitamins and antioxidants become depleted over time in the presence of toxins as this is the body’s way of removing them from the system. If the toxic burden continues to be present, then this will lead to the depletion of these essential nutrients and tip the toxic scale over further. Saturation into our system becomes essential through either oral, injection or IV forms of our favorite vitamins and nutrients: Vitamin C, Vitamin Bs, glutathione, NAC, and Mitocore multivitamin. Glutathione specifically is a standout in individuals who have BII due to the high content of VOCs present in the implants. It will aid in ridding the body of this type of solvents, but also heavy metals and mycotoxins if present.

Goal #5: Repair Cellular Damage and Cell Danger Response

The toxic load within the extracellular fluid matrix bathes all the organs and deprives them of oxygen leading to build of lactic acidosis, mitochondrial damage, slowed metabolism, and reduced ability to detoxify. The aide in cell repair will begin once the toxic load is reduced and essential nutrients and antioxidants are replenished. Often with chronic illness and exposures other measures need to be taken to regain balance in the body. Sometimes a block in complete healing can be related to the cell’s memory of the toxic agent (emotional and physical) and in its inability to unlock itself from harm. The theory on Cell danger response shines a light on this very issue. Even though the implants may be removed, some may not see complete resolution of disease or symptoms that came on since BII. The cells have to be “Re-set” and we have found that Frequency Specific Microcurrent is dynamic in its ability to correct this error. FSM uses specific and directed frequencies to enhance detoxification of specific organs like lymph, liver, kidney, and fat cells and reduces trauma created from the toxins in the cells throughout the body to facilitate repair. This synergistic therapy optimizes the return and function of the various organs and systems of the body for improved energy, focus, mood, sleep, and vagal stress response.

Goal #6: Heal the Brain

Most BII patients will feel better after completing the first 5 goals to wellness. The brain is being addressed through this whole process through nutrient repletion, HBOT, and FSM therapies. There may be some patients who need some more specific attention to brain health and for these patients we utilize brain mapping (QEEG) where we can decipher Delta, Theta, Alpha, and Beta brain waves and create customized approaches of rewiring the brain for individual optimal functioning. Neurofeedback provides a true restoration of brain functioning with improved stress response, elevated and steady moods, and enhanced memory and cognitive abilities.

Specifics on the BII Healing Program

At EVND we want individuals to take initiative in their healing and we hope to provide the tools to allow you to do so using our Treatment Center therapies without the need of establishing yourself with one of the doctors. If you are not achieving the results that you would expect to after following Phase I of this program, however we highly recommend that you meet with one of our doctors for a more deep and specific look into your overall health state. We may need to see if there are other obstacles that are hindering you from healing or 6-8 weeks may not be long enough in the detox portion and may be recommended to detox longer. Entering into Phase II of the BII Healing Program is appropriate when you are being led by one of our physicians as they know and understand what to look for in the healing process.

Hydration is extremely important when moving toxins out of the body. We recommend that you put great effort in drinking plenty of filtered water during this time. Also to properly detoxify regular bowel movements at least 1 x day is necessary and if you are having difficulty achieving this or have chronic digestive issues it would be best to establish yourself with one of our physicians to get to the root issue and help correct this before proceeding with detoxification.

Phase I: Detox

We recommend incorporating Goal #2-4 simultaneously for the best outcome. We recommend entering into the detox portion of the wellness plan at least 6-8 weeks after surgery allowing ample time for healing to take place. Moving to Phase 2 in the BII Healing Program is appropriate when you are being led by one of our physicians as they know and understand what to look for in the healing process. If there is minimal or moderate improvement then it may be suggested to hold in the detox phase longer before progressing to this next phase.

Supplement Protocol for 8 weeks:

• Liposomal glutathione 1 capsule 1 x day (Pure Encapsulations)
• Mitocore multivitamin 2 capsules 2 x day (Orthomolecular)
• G.I. Detox 2 capsules 1 x day (Binders must be taken 60 minutes away from other supplements and food)
• Micro Ingredients- Super foods Organic Chlorella Powder (Amazon) 1 scoop in alternative milk or smoothie
• Dr. Shade’s Liver Sauce ½ tsp first thing in the morning
• Pekana Detox kit 30 drops of each vial in the kit in 1 cup of water 1 x day

DETOX Weeks 1-8 Visual Guide

Morning medicines Detox Program

Mid-day Medicines: Can take 2^nd dose of medicines anytime in the afternoon and can be taken near food.

Enhanced Detox Recommendations

Additional detox strategies can be included to help the body better get rid of toxins and are highly recommended for patients who have been ill for over 5 years or had implants present for over 10 years.

Phase II:  Cellular damage repair and Cell danger Response (Goal #5)

If after Phase I Detox there are still some lingering symptoms we suggest that you enter into the phase II of BII Healing Program which includes Frequency Specific Microcurrent (FSM) and possibly IV Therapy. FSM uses specific and directed frequencies to enhance detoxification of specific organs and reduces trauma created from the toxins in the cells throughout the body to facilitate repair. FSM works by increasing the production of the substance ATP in injured tissues. ATP is the major source of energy for all cellular reactions in the body. Because treatment with FSM can increase ATP production by as much as 500% in damaged tissues, this may help with revitalizing the vital organs and nervous systems to function more optimally once again. Also as discussed previously, FSM can influence the Cell danger response. Even though the implants may be removed, some may not see complete resolution of disease or symptoms that came on since BII. The cells have to be “Re-set” and we have found that Frequency Specific Microcurrent is dynamic in its ability to correct this error. FSM uses specific and directed frequencies to enhance detoxification of specific organs like lymph, liver, kidney, and fat cells and reduces trauma created from the toxins in the cells throughout the body to facilitate repair. This synergistic therapy optimizes the return and function of the various organs and systems of the body for improved energy, focus, mood, sleep, and vagal stress response.

Your doctor will put together programs that are specific to what they feel your body’s needs based on your history and symptoms. Treatments are typically 1 x week for 5 weeks. Sessions last about an hour and 15 minutes. We request that you be hydrated before your appointment as that encourages better outcomes. You will lay comfortably on the table, while warm wash cloths are laid in locations directed by your physician and the FSM technician will attach the electrodes from the machines to the washcloths. You can read, or rest during the treatment.

Nutritional IVs are wonderful therapy that can be used to deliver a higher level of nutrients to the cells that would not be able to be received when taken orally. Detox Defender IVs are sometimes used for those who are considered nutrient deficient and need a boost of Vitamins to help facilitate not only better detox but cell repair. These IVs contain Vitamin C, B vitamins, calcium, magnesium, zinc and selenium and glutathione.