Breast Implants, Explant Surgery, and Breast Implant Illness with Robert Whitfield MD - Episodes Tagged with “Fat Transfer”

Episode 135: The Conversation About Breast Implants Every Woman Needs to Hear, with Dr. Alan Gonzalez

Robert Whitfield MD — Thu, 25 Sep 2025 03:00:00 -0400

Today’s episode highlights breast health concerns and educates women to make informed choices, as Dr. Robert Whitfield sits down with Dr. Alan Gonzalez, a fellow expert in plastic surgery. They break down what BII is, talk through common symptoms, and dive into complications like capsular contracture and even rare cases of lymphoma. The doctors walk listeners through the different surgical options for removing implants, including total capsulectomy, and discuss alternatives such as fat transfer for those considering a different look after explantation. They don’t shy away from discussing the emotional and physical challenges that can come with implant removal, and the conversation is one all women need to hear.

Bio: Dr. Alan Gonzalez

Dr. Alan González is a leading plastic surgeon in Colombia and Latin America, with over 25 years of experience and more than 20,000 aesthetic and reconstructive procedures performed. Known for combining cutting-edge surgical techniques with a focus on minimal scarring and fast recovery, he is dedicated to enhancing patient well-being through thoughtful, results-driven care. Dr. González is also a global speaker, researcher, and media contributor, and currently leads multidisciplinary research on the link between breast implants and ASIA syndrome. He is affiliated with several international surgical societies and serves as the scientific director of Care Me 360 Institute.
Learn more about Dr. González at dralangonzalez.com and connect with him on Instagram or LinkedIn.

Show Highlights:

Dr. Gonzalez’s Background & Early Experience (00:01:09) Dr. Gonzalez shares his medical background, early views on implants, and initial belief in their safety.
Recognition of Implant Complications (00:04:25) **Discovering complications like lymphoma, chronic inflammation, and the shift in understanding implant risks
**Capsular Contracture & Surgical Approaches (00:10:11) **Capsular contracture, historical surgical practices, and the evolution of implant placement techniques
**Patient Symptoms & Chronic Inflammation (00:14:11) Normalization of symptoms, and the importance of recognizing chronic inflammation from implants
Capsulectomy Techniques & Cancer Concerns (00:17:26) Debate on total vs. en bloc capsulectomy, surgical safety, and handling abnormal capsule findings
Case Study: Lymphoma & Pathology Challenges (00:19:53) Dr. Whitfield shares a case of rare lymphoma, challenges in diagnosis, and the importance of surgical expertise
Patient Education & Informed Choices (00:25:47) Educating patients, the need for transparency, and the importance of understanding all surgical options
**Alternatives to Implants: Fat Transfer & Lifts (00:27:20) **Non-implant options like fat transfer and breast lifts, and the importance of individualized patient care
**Surgeon Expertise & Surgical Evolution (00:44:07) **Importance of expert surgeons, reconstructive techniques without implants, and the evolution of breast surgery

Links and Resources

Let’s Connect
Podcast: https://podcasts.apple.com/gb/podcast/breast-implant-illness/id1678143554
Spotify: https://open.spotify.com/show/1SPDripbluZKYsC0rwrBdb?si=23ea2cd9f6734667
TikTok: https://www.tiktok.com/@drrobertwhitfield?_t=8oQyjO25X5i&_r=1
IG: https://www.instagram.com/breastimplantillnessexpert/
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Linkedin: https://www.linkedin.com/in/dr-robert-whitfield-md-50775b10/
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Read this article - https://www.breastcancer.org/treatment/surgery/breast-reconstruction/types/implant-reconstruction/illness/breast-implant-illness
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Danger Coffee - Use our link for mold free coffee - https://dangercoffee.com/pages/mold-free-coffee?ref=ztvhyjg
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Episode 128: The Breast Explant Story Every Woman Needs to Hear, with Kathy Dixon

Robert Whitfield MD — Thu, 07 Aug 2025 03:00:00 -0400

Ready to get real about breast augmentation? In this episode, we’re diving deep into the world of cosmetic surgery with a no-holds-barred conversation you won’t want to miss! Today, Dr. Robert Whitfield speaks with a patient, Kathy Dixon, who’s here to share her personal journey. Kathy opens up about how her cultural background shaped her decisions, her struggles with breast implant illness, and what led her to choose explant surgery. Tune in to hear so much more!

Kathy’s Business, Oh Yes Communications

Show Highlights:

Kathy’s Cultural Influences & Decision for Augmentation (00:02:45) **Kathy discusses her Colombian heritage, body image, and initial decision to pursue breast augmentation.
**Cultural Trends in Plastic Surgery (00:08:21) South American vs. U.S. beauty standards, Brazilian butt lifts, and safety concerns.
Fat Transfer Misconceptions & Technical Details (00:09:11) Differences between fat transfer to buttocks, face, and breasts, and addresses misconceptions
Kathy’s Surgical Journey & Onset of Symptoms (00:16:29) **Kathy recounts her initial surgery, complications, and the gradual onset of physical and emotional symptoms.
**Medical Dismissal & Search for Answers (00:18:36) Being dismissed by doctors, pursuing hormone testing, and discovering breast implant illness
Testing, Mold, and Mycotoxins (00:20:34) High mold count; surgeon discusses PCR testing, bacterial contamination, and importance of thorough pathology
Challenges in Women’s Health & Medical Gaslighting (00:28:00) Lack of support for women, medical gaslighting, and inappropriate reliance on birth control for hormone issues
Mold, Detoxification, and Environmental Factors (00:33:37) **Environmental and dietary sources of mold, detox challenges, and lifestyle changes
**Post-Surgery Recovery & Lifestyle Adjustments (00:44:11) **Recovery goals, physical therapy, emotional healing, and the importance of support systems
**Support Systems & Patient Experience (00:48:25) Importance of family support, patient education, and realistic expectations for recovery

Links and Resources

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Episode 69: What is Breast Explant Surgery?

Robert Whitfield MD — Thu, 06 Jun 2024 03:00:00 -0400

Breast explant surgery or breast implant removal is a surgical procedure commonly done for various reasons such as implant issues, breast reconstruction, implant rupture, dissatisfaction with the appearance of the implants, or other cosmetic purposes.

In breast explant surgery, the implants alone may be removed or the surrounding scar tissue may also be included. In some circumstances, a breast lift may be done with the explant procedure to enhance the look of the breasts.

In today’s episode, we’re going to discuss what breast explant surgery is and why people want to undergo such surgery.

What is breast explant surgery?

When we’re talking about breast explant surgery, we’re referring to the removal of breast implants and any scar tissue formed around the implants. Nowadays, many plastic surgeons do explants for various reasons.

My approach to explant surgery is to everything out in its entirety, which is why many people seek me out for that very reason. Typically, my clients are those who had a placement of a device either for cancer reconstruction or other cosmetic purposes and are experiencing symptoms associated with breast implant illness.

The most common symptoms experienced by my patients are anxiety, depression, brain fog, dry eyes, headache, light sensitivity, sound sensitivity, shortness of breath, heart palpitations, nerve pain down their arms or legs, joint pain, and other gastrointestinal issues.

Oftentimes, patients find me through what I offer in terms of holistic rejuvenation with fat transfer. In fact, I’ve been doing fat transfer since the 2000s for cancer reconstruction and other cosmetic purposes. I'm very comfortable with doing these operations and I have already refined my process, having done over 1,500 fat transfers.

Why do I prefer fat transfer?

When it comes to breast lifts, we have different kinds of techniques such as vertical, crescent, peri-areolar, and anchor breast lifts. The patients may have a preferred kind but it actually depends on the necessity.

If the patient had a peri-areolar placement, then we try to use that scar and remove the implant intact through it. The average length of a surgery is about two and a half hours. If we add a lifting procedure, it's a little over three hours.
If I'm doing a combination procedure of fat removal to be used for fat transfer, it usually takes between four to five hours. The main reason as to why I like to use fat is because it's your own tissue. It has actually been used as a filler for over 100 years.

Besides providing or enhancing the breast volume, it also helps offset some visual changes that the patient's not happy with. This is why as much as I can, I try to help patients learn about fat transfers and make them understand from my perspective.

Doing these operations can be draining, especially mentally, so it’s best for patients to have a great support system that shows up to help them and provide much-needed support.
What I always emphasize is if you’re considering explants or doing other procedures, it’s important to find a reliable professional with whom you can communicate your concerns.You can check my website to help you along the way.

Links and Resurces

Dr. Robert Whitfield’s Website

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Let’s Connect...
Podcast: https://podcasts.apple.com/gb/podcast/breast-implant-illness/id1678143554
Spotify: https://open.spotify.com/show/1SPDripbluZKYsC0rwrBdb?si=23ea2cd9f6734667
TikTok: https://www.tiktok.com/@drrobertwhitfield?_t=8oQyjO25X5i&_r=1
IG: https://www.instagram.com/breastimplantillnessexpert/
FB: https://www.facebook.com/DrRobertWhitfield
Linkedin: https://www.linkedin.com/in/dr-robert-whitfield-md-50775b10/
X: https://x.com/rob_whitfieldmd
Read this article - https://www.breastcancer.org/treatment/surgery/breast-reconstruction/types/implant-reconstruction/illness/breast-implant-illness
Shop: https://drrobssolutions.com
SHARP: https://www.harp.health
NVISN Labs - https://nvisnlabs.com/

Get access to Dr. Rob's Favorite Products below:
Danger Coffee - Use our link for mold free coffee - https://dangercoffee.com/pages/mold-free-coffee?ref=ztvhyjg
JASPR Air Purifier - Use code DRROB for the Jaspr Air Purifier - https://jaspr.co/
Echo Water - Get high quality water with our code DRROB10 - https://echowater.com/
BallancerPro - Use code DRROBVIP for the world's leader in lymphatic drainage technology - https://ballancerpro.com
Ultrahuman - Use code WHITFIELD10 for the most accurate wearable - https://www.ultrahuman.com/ring/buy/us/?affiliateCode=drwhitfield

Episode 36: Do Breast Explant Surgery Patients Also Need a Lift?

Robert Whitfield MD — Thu, 19 Oct 2023 03:00:00 -0400

Breast explant surgery represents a significant juncture for patients who have previously undergone breast augmentation, a procedure often embraced to enhance one's physical appearance and self-confidence. However, as time unfolds and perspectives evolve, some individuals opt to have their implants removed and return to a more natural state. We are thus faced with an important question of whether or not breast explant surgery patients also need a breast lift.

In today’s episode, I’ll discuss an important topic, breast explantation, and how it relates to breast lifts. We’ll explore the various factors that play a role in making this decision Join me for an insightful discussion on this subject.

Breast augmentation and inflammation reduction

People often ask me if a breast lift is necessary after breast explant surgery. I firmly believe that a breast lift is not a mandatory requirement after a breast explantation. Each individual's journey through this process is uniquely personal, shaped by their distinct goals, preferences, and body dynamics.

Recently, I had a patient from New York who was petite and had small implants, similar to many low BMI patients I see whose goal was to achieve a more feminine appearance. Initially, these patients weren't presented with alternative options like a fat transfer or a smaller implant. They had implants sized between three and 400 ccs placed through an axillary approach. In those cases, I focused on the safest and most controlled approach, which was under the breast, to minimize complications.

As an innovator in the cosmetic surgery field, I create products to optimize outcomes and expedite patients' recovery. Reducing inflammation in the body is a crucial focus for all my patients, achieved through diet and supplements. That is why I've designed a specialized inflammation support bundle to aid in this process, understanding the challenge of managing fatigue for many patients. This bundle includes liposomal versions of essential vitamins and minerals for better absorption without being overwhelmed with pills.

Breast lift surgery techniques and patient preferences

In one case, we did the implant placement through the armpit to avoid visible scarring. However, the armpit approach was not suitable for removing all the capsule and scar tissue. Alternative approaches under the breast or a donut lift were discussed with the patient to minimize excess skin during the procedure and to leave less visible scarring. It's emphasized that not everyone requires a lift during the explantation. Thus, individual choice and skin evaluation over time are important considerations.

This experience reinforces a pivotal understanding in the realm of breast explant surgery - the acknowledgment that a one-size-fits-all approach is not suitable nor advisable. Every person is different, and it's so important to tailor the surgery to each person's specific situation. Considering what the individual needs, wants, and their body's characteristics is key to making the surgery successful. It's all about giving personalized care, understanding what's best through good communication, and really grasping what the person hopes to achieve from the surgery.

I’ve been performing numerous explantations, or removals, of breast implants since 2016 before I started doing lift procedures. My priority is to minimize scarring and achieve the desired outcomes. I mainly utilize circular or doughnut lifts and lollipop lifts for surgical skin tightening, avoiding anchor or crescent lifts due to their potential impact on future fat transfers. Moreover, I focus on optimizing outcomes with minimal surgical steps and adjustments for patients who opt not to have a lift. Ultimately, the decision for a lift is up to the patient, and I strive to provide them with the information they need to make an informed choice.

If you're looking for additional resources and support, be sure to visit our online store: https://drrobssolutions.com/collections/all

Links and Resources

Dr. Robert Whitfield’s Website

Follow Dr. Rob on Instagram
https://www.instagram.com/drrobertwhitfield/

For more information on Virtual and In Person Consultations, we always answer our messenger personally:
https://www.drrobertwhitfield.com/contact/

Episode 34: Why Does Dr. Whitfield Not Use Drains?

Robert Whitfield MD — Thu, 05 Oct 2023 03:00:00 -0400

Drains play a crucial role in breast implant procedures because they help reduce post-operative swelling by preventing fluid accumulation and minimizing any infection risks. That is why I’m often asked why I don’t use drains for breast implant procedures.

This dates back to an experience that sparked my interest in offering more fat transfer options to patients, particularly those dealing with breast implant illness. It's all about providing the best care and experience for our valued patients and that’s going to be our focus for today’s episode.

Why do you not need drain tubes?

The answer to the frequent question of why I don’t use drain tubes after breast surgery dates back to a pivotal moment in my career when a client came to me requesting to have her old implants replaced with a fat transfer despite having no breast implant illness symptoms. Consequently, I agreed to perform the procedure by incorporating drains as part of the process.

However, one significant issue I encountered during surgeries was the discomfort associated with drain tubes. After completing a fat transfer, we place liposuction garments on the patient, wrap them gently with a bandage, and then insert a drain tube. The downside, however, is that these drain tubes typically create openings in your body that can be susceptible to infections. As such, the more openings you have, the higher the risk of infection.

By focusing on comprehensive preoperative preparation and cutting-edge techniques, we can achieve excellent results without the need for drains. As a matter of fact, the Tummy Tuck procedure has long been successfully performed without the use of drains. This involves a specific suturing method and the use of internal surgical glue to seal the area, effectively reducing dead space and the risk of complications.

Minimizing the need for drain tubes in breast implant surgery not only reduces the risk of infections but also streamlines the recovery process, ensuring a safer and more comfortable experience for our patients.

How does a fat transfer work?

As I have mentioned, my decision to avoid using drains in breast implant surgeries dates back to my experience with patients who opted for fat transfers. When performing a fat transfer, a patient lies on their tummy, and we usually extract fat from regions such as the love handles, the posterior inner thighs, and the outer thighs.

We employ a discreet incision measuring just three millimeters, placed just beneath the crease of the buttocks to harvest the fat. These incisions are well-hidden and ensure minimal scarring. This method facilitates efficient fat retrieval and offers the potential for exceptional outcomes, particularly when integrated with skin tightening procedures.

To enhance patient comfort, we administer long-acting local anesthetic in these areas. Then, the patient flips over, and depending on their needs, we may add fluids to the abdomen, collect more fat, perform additional skin tightening, or proceed with their explant surgery if the abdomen isn't involved. This not only avoids the need for drains but also offers patients a streamlined and efficient procedure with minimal scarring and optimal results.

A comprehensive program for optimal results

At my practice, we regularly perform fat transfers, and we've developed a comprehensive program to ensure optimal results. This program involves a thorough assessment, including genetic testing, toxicity testing, gut microbiome analysis, food sensitivity evaluation, and hormone balance checks.

Considering that we believe in offering a more comfortable and streamlined process for my patients, the resulting discomfort and inconvenience didn't align with our commitment to providing the best possible patient experience. In fact, we also provide a tailored preoperative plan to reduce inflammation using our supplement package and an inflammation support bundle.

Personally, I have never put a drain in any of the patients I've performed liposuction on as it goes against what I believe in. Whether I'm doing a breast lift with a fat transfer or just a fat transfer, I close the pocket using the incision created for the implant removal. I prefer adding fat through the armpit incision to rejuvenate the upper two-thirds and rebuild the cleavage area.

We mainly rely on the body’s natural ability to heal itself. Thus, the body naturally drains fluid downward through the breast pocket and beneath the skin through the channels created during liposuction. As we rely on compression, lymphatic massage, and your body's inherent healing processes, we limit any chances of any infections, establishing a safer and more effective approach to fluid management in breast implant procedures.

Links and Resources

Dr. Robert Whitfield’s Website

Follow Dr. Rob on Instagram
https://www.instagram.com/drrobertwhitfield/

For more information on Virtual and In Person Consultations, we always answer our messenger personally:
https://www.drrobertwhitfield.com/contact/

Episode 32: How Does a Fat Transfer Work with Breast Explant Surgery?

Robert Whitfield MD — Thu, 21 Sep 2023 03:00:00 -0400

For over 100 years in the field of aesthetics and medical surgery, operations to remove fats have been done. Fat transfers can be successful when approached strategically, considering individual factors to optimize results.

In my approach to breast implant removal surgery and fat transfer, I strive to create an optimal experience for every client. By combining fat transfer with planned surgery, we aim to enhance outcomes uniformly across various body types and ages.

Fat transfer for breast reconstruction with Dr. Rob

It's crucial to consider hormone balance, sex hormones, thyroid levels, and other parameters to level up each client for successful fat transfer.
We carefully assess functional genomics, toxicity levels, gut microbiome, food sensitivities, and hormone balance. These parameters play a pivotal role in preparing each client for an optimal fat transfer experience.

We place significant emphasis on evaluating and addressing the unique hormonal profile of every individual, aiming to enhance their readiness for the procedure. In addition to hormone balance, our approach encompasses a comprehensive assessment of functional genomics, toxicity levels, gut microbiome, and food sensitivities. By delving into these aspects, we gain valuable insights into a patient's overall health and suitability for a fat transfer. This detailed evaluation enables us to tailor our approach, ensuring the best possible outcomes for every client.

Our methodology has garnered attention within the United States and internationally. Clients from various parts of the world seek our expertise and trust our specialized approach to fat transfer procedures.

We harvest fat from specific areas like thighs, love handles, or abdomen, tailoring the approach to each individual's needs. Using a well-defined fat transfer system, we control the process to achieve the best outcomes. It must be noted, however, that the amount of fat transferred varies based on BMI and specific patient conditions, ensuring a controlled and effective procedure.

I’ve been using this method for nearly 15 years in my experience with fat transfer in breast implant removal surgery to address issues like rippling and enhancing implant-based reconstruction or augment DIEP (deep inferior epigastric perforator) free flap breast reconstruction. However, it's important to clarify that even individuals with a low BMI can undergo fat transfer successfully, as can those with a higher BMI with certain considerations.

Genetic factors affecting detoxification pathways

During consultations, I thoroughly assess each client's potential for a fat transfer based on their unique circumstances and fat availability considering that genetic factors play a significant role in determining a person's ability to process and eliminate toxins at both cellular and macro levels.

Genetic enzymatic capability is of great importance as inherited from parents, especially in effectively managing toxin elimination through sweat, urine, and feces. Our ability to metabolize vitamins like D and efficiently process B vitamins relies on such capability. Additionally, we use antioxidants like vitamins C, A, and E to support our immune system and cellular functions.

Addressing my clients' detoxification challenges involves a deep understanding of their genetic predispositions, allowing me to set out appropriate methods and approaches that optimize their detoxification processes.

Detoxification supplements and testing for inflammation and toxicity

The next step involves evaluating the level of toxicity each patient may be dealing with through a urine toxicity test. This is for the purpose of preparing them and providing appropriate supplementation to aid in expressing these toxins through urine.

I typically recommend using key supplements like vitamin D3, K, liposomal B complex, liposomal vitamin C, oral liposomal glutathione, D-glucarate, and glycine to facilitate this detoxification process. By assessing food sensitivities and gut microbiome through blood and stool tests, respectively, we gain a comprehensive understanding of the patient's inflammation levels and plan a suitable detoxification strategy. We then proceed with utilizing the Cell Core detoxification supplement line based on the gathered information.

Links and Resources

Dr. Robert Whitfield’s Website

Follow Dr. Rob on Instagram
https://www.instagram.com/drrobertwhitfield/

For more information on Virtual and In Person Consultations, we always answer our messenger personally:
https://www.drrobertwhitfield.com/contact/

Episode 29: Healing Breast Implant Illness: Latest Research and Treatment

Robert Whitfield MD — Thu, 03 Aug 2023 03:00:00 -0400

Due to limited resources and research studies related to breast implant illness and considering that it remains to be unrecognized as an official diagnosis by many in the medical field, many patients suffering from the condition are left untreated worsening symptoms. Symptoms may include fatigue, joint pain, cognitive issues, and other systemic complaints.

As we aim to continue raising awareness and advocating for more research on breast implant illness, we help shine a light on the experiences of affected individuals and help lead people to a better understanding of these potential health issues in the future. That is why it is important for us to discuss today’s treatment options for breast implant illness.

Holistic Accelerated Recovery Program

We developed an entire program called Holistic Accelerated Recovery Program so that many patients both in Austin, TX, and even out of state, can participate and get the help they need. Our program is founded on genetic testing, toxicity testing, food sensitivities, stool testing, and evaluation of your hormones, liver, kidney, and thyroid function. We use these evaluations to identify any symptoms of breast implant illness.

The results we get from these tests are used to start working on any deficiencies or problems, particularly in the immune system pathways of the patient. To improve the condition of the patient, we make sure to incorporate an appropriate and healthy diet, lifestyle changes, and supplementation.

Conducting a comprehensive assessment of a patient’s medical history, current condition, and any other specific concerns she may have is a must in understanding their different needs/conditions and allows us to develop a personalized treatment plan.

We always want the best for our patients, which is why we do the best we can to set them up for success. I have been doing this for six years now, going on my seventh year, and it’s been a long journey for me but I have been feeling fulfilled being able to help people advance in recovery.

How do you prepare for surgery?

Many patients worry too much about their surgery and I’m not saying that it’s wrong. Sometimes, they just need to be reassured by their qualified plastic surgeon about the operations they’ll undergo. As qualified providers, it is our responsibility to address these concerns and to provide patients with the information and reassurance they need to feel more at ease about their surgery.

Patients have the right to be informed about the details of their surgery, including the procedure itself, potential risks and complications, expected outcomes, and the recovery process. Transparent and open communication not only empowers patients to make well-informed decisions, but it also helps to build trust between the patient and the qualified plastic surgeon.

Personally, I encourage my patients to alter their diets and increase their protein intake before surgery to put them in their best condition. We call that ‘nitrogen balance’. It helps someone to go from the stress response of surgery to a healing phase.

We also do fat transfers to offset any appearance changes and reshape the affected areas of the breasts. Also, in relation to treatment, it’s beneficial to have a healthy and supportive circle. At present, I have two team members in my group who have had explants and suffered from breast implant illness, which is why their support for our clients comes from firsthand experience. They’re good at providing a great deal of emotional support.

Keep in mind that explant surgery, or breast implant removal, is not the only solution. Patients can also look into doing our Holistic Accelerated Recovery Program and take into account many factors affecting one’s conditions or triggering any symptoms of breast implant illness.

Links and Resources