Episode 223 - Breast Implant Illness and Explant Surgery with Plastic Surgeon Dr. David Rankin

Follow me on Substack - it's free, it's insightful & it's designed to help you think about how wellness relates to you: body, mind, spirit & soul.  https://sandykruse.substack.com/

Dr. David Rankin is currently Chief of Plastic Surgery at St. Mary’s Medical Center in Florida and is board-certified by the American Board of Plastic Surgery.  David Rankin M.D. practices Cosmetic and Reconstructive Surgery throughout Palm Beach County. His main focus and passion has become Breast Explant Surgery. His advanced training, attention to detail and natural artistic skills help him achieve beautiful patient results.  Dr. Rankin has appeared in many local and national publications including The Doctors, Inside Edition, Daily Mail, People, US Weekly and more.

To get in touch with Dr. Rankin's team, go here:  https://aquaplasticsurgery.com/breast-explant/

Can you imagine a world where the journey to natural beauty outweighs the allure of extreme cosmetic alterations? Today, Dr. David Rankin, Chief of Plastic Surgery at St. Mary's Medical Center in Florida, and I discuss the emerging awareness of breast implant illness and the growing trend toward embracing one's natural physique. Dr. Rankin shares his extensive expertise, providing insights into the complexities of breast explantation and the meticulous process required for removing implants and scar tissue.

Dr. Rankin sheds light on the significant health risks associated with breast implants, including symptoms like joint pain, fatigue, and memory loss. We discuss the rise in demand for explant procedures and the differences between silicone and saline implants alongside black box warnings. Delve into the challenges faced by surgeons during explantation, especially when dealing with ruptured implants and complications such as hematomas. Gain an understanding of the aesthetic concerns post-explant and potential solutions like breast lifts and fat grafting, particularly for patients with minimal breast tissue or those who have undergone mastectomies.

Transcript

Speaker 1: 0:02

Hi everyone. It's me, sandy Cruz of Sandy K Nutrition, health and Lifestyle Queen. For years now, I've been bringing to you conversations about wellness from experts from all over the world. Whether it be suggestions on how you can age better, biohacking, alternative wellness, these are conversations to help you live your best life. I want to live a long, healthy and vibrant life, never mind all those stigmas that, as we reach midlife and beyond, we're just going to shrivel up and die with some horrible disease. Always remember balanced living works. I really look forward to this season. Hi everyone, welcome to Sandy Kay Nutrition, health and Lifestyle Queen.

Speaker 1: 1:03

Today I am doing another episode on breast implants, breast explants and breast implant illness with Dr David Rankin. He is board certified by the American Board of Plastic Surgery and he now only does explants. I think he's got a pretty extensive waiting list. He has done television appearances. He is so knowledgeable and has so much experience in breast implants, breast explants. He's seen many incidents of breast implant illness and I invited him to the show because last year you can check it out it's episode 146. I think it was about a year, year and a half ago I recorded an episode on breast implant illness. Now some of the feedback that I received from that episode was that it was very biased. It was with a health coach and a nutritionist you can look it up, episode 146, and it's more about their experience on what they have experienced themselves experienced with clients about breast implant illness, and some of the feedback I heard was well, you're getting information from somebody who is quite biased in that they don't believe in it. They're not doctors. Listen, everybody's entitled to have experience and opinions on this. I don't believe that you have to have an MD behind your name. However, in order for me to be objective, I thought why wouldn't I invite a world-renowned plastic surgeon who sees this every single day, which is why I brought this show to you. It is quite clinical. It is not biased, it's just observational according to experience with actual implants and explants and breast implant illness, seeing it firsthand. So I'm going to ask you to please, please, share this episode with anyone who might benefit. I personally don't have much of an opinion on this. I have learned through other practitioners about this. I do not have breast implants. I certainly don't need them. If anything, I would love a breast reduction. Dr Rankin, hello, just kidding around, but my point is I don't really have any bias towards this. I'm just bringing this more for informational purposes to anyone who might want to listen. But the evidence is pretty clear and if you go back and listen to episode 146 and then listen to this, you're going to get a pretty clear indication of what's right for you personally.

Speaker 1: 4:21

I'm going to tell you a little story. Last weekend it was my 24th wedding anniversary. We went out for dinner and I'm going to tell you a little story. Last weekend, it was my 24th wedding anniversary. We went out for dinner and I'm looking around and it was so interesting because my husband and I were looking and like, wow, like all these waitresses and waiters were so good looking, mind you, they were young, okay. And we looked over and I'm like, wow, look at this woman.

Speaker 1: 4:46

So you could tell, okay, mind you, they weren't older like myself, but everyone was natural, and I'm seeing a trend with younger people, especially women, changing their looks. And I'm like, why? I saw this young woman? She had curves, so obviously not on a Zempik, but she was still fit. She wasn't obese or overweight. You can tell that her breasts sat lower on her body and she had sizable natural breasts and I was thinking, wow, this is beautiful. I thought it was beautiful because it's so rare.

Speaker 1: 5:34

And now, most often we see women with breasts right under their chins. I'm like that's not natural and you can spot it a mile away. That's not natural and you know, you can spot it a mile away. And I'm not saying and I'm not criticizing you if you have implants, I'm just saying natural is beautiful. And you know, as we get older, if we breastfed babies and then there's genetics, of course our breasts are not going to sit as high as they used to. But who cares? Right, mine certainly don't.

Speaker 1: 6:07

And then there was another woman there who was a waitress and she was quite small-breasted and very tiny and I was like, wow, she's beautiful too. And nobody had lips that were so blown up, ridiculous looking. And again had lips that were so blown up, ridiculous looking. And again, I'm not against filler as we age. Jeez, like you all know, I do a tiny, tiny half of one syringe just to make sure that my lips don't start to curl, under no offense, but you know, I'm just not into old lady lips, that's all. But everything that I do is to keep my looks looking like me, maybe just a better version, a more slept version. Not that I don't sleep, but my point is I understand it a little bit more as we age. But when I see young women with these giant breasts that are, you know, under their chins, and I'm like man, like right now, personally, I would give anything to have smaller breasts. Truly, that's how I feel and I have naturally large breasts.

Speaker 1: 7:29

Rambling here because I'm seeing this thing in society, where women are like we can age however we want to. And you see Paulina Porizkova, she's a big advocate for aging naturally and she's very extreme on the one hand. And then there's very extreme on the other hand where you see a lot of fillers and faces looking distorted and giant lips and giant breasts, and for me I'm like I just want to settle in the middle and I don't want to do anything that's going to harm me. So you know, if I was to find out that my baby Botox dose of 26 units every three months was doing me a ton of harm and it was contributing to my toxic burden, I'd probably stop that. So you know, people, I feel like we've kind of lost balance and oh and how could I not forget balance? Oh and how could I not forget? Everywhere you turn.

Speaker 1: 8:29

Nowadays you're seeing Ozempic face and I know it's a big thing, everyone's talking about it. But I'm like, listen, there's a place for Ozempic and GLP-1s. There's definitely a place for it. If you are obese, this is probably a good option for you because being obese is likely going to do more harm than Ozempic, right? But when you're seeing women who are maybe 5 pounds, maybe 10 pounds overweight not such a big deal going on Ozempic losing muscle, not eating enough to even sustain aging better and aging well and their longevity, I think it's a problem. And not only that. It's a bigger problem because it distorts what is natural and what is humane and what is normal for a woman's body, especially as she ages. It distorts that. Remember Marilyn Monroe she wasn't obese, but she had curves, she was beautiful, she was natural.

Speaker 1: 9:37

And so all in balance, my friends, all in balance, and that's all I wanted to say here. Friends, all in balance, and that's all I wanted to say here. Please go and follow me on my Substack. I'm really working hard on this. These days.

Speaker 1: 9:52

Substack is actually going to be linked in this podcast it's sandycruzsubstackcom and consider subscribing. First of all, it's free and it's a very different take on wellness. It's more explorative, philosophical, insightful, theoretical, and it's to teach us to think critically for our bio-individual self, versus being told how to think about wellness. I started this substat to encourage everyone to critically analyze whether something resonates or not, as it relates to wellness on all fronts body, mind, spirit, soul and it will align with my upcoming book Bridging the Gap Between Science and Soul. We live in a world where we're constantly getting pinged with new health information and I truly believe that a world where everyone can genuinely decipher resonance and have the choice to do so would be a happier and healthier world to live in. So please go join. Also, follow me on all of my other social media outlets. It's Sandy Kay Nutrition anywhere and everywhere.

Speaker 1: 11:03

And now let's cut on through to this amazing interview with Dr David Rankin. Hi everyone, welcome to Sandy K Nutrition, health and Lifestyle Queen. Today with me I have a special guest. His name is Dr David Rankin and he is currently Chief of Plastic Surgery at St Mary's Medical Center in Florida and is board certified by the American Board of Plastic Surgery.

Speaker 1: 11:29

Dr Rankin practices cosmetic and reconstructive surgery throughout Palm Beach County. His main focus and passion has become breast explant surgery. His advanced training, attention to detail and natural artistic skills help him to achieve beautiful results with his patients. Dr Rankin has appeared in many local and national publications, including the Doctors Inside Edition, daily Mail, people, us Weekly and more mail, people, us Weekly and more. And today I asked Dr Rankin to come and talk to us a little bit about breast implant illness, about breast explants, what to expect, and I thought why not go directly to the expert? Because somebody in my community told me about Dr Rankin. So I reached out to his team and I am so happy and grateful that you came to talk to us today, so welcome.

Speaker 2: 12:33

Thank you very much. It's a pleasure to be here.

Speaker 1: 12:35

Yeah, I'm happy to have you here because, as I mentioned to you, I had recorded a show last year and there was a lot of attention on that show on the topic of breast implant illness, and I really want to hear it directly from you and I'd like to know how you got into this specific area of plastic surgery.

Speaker 2: 13:02

So I've been practicing in private practice for going on 20 years now. When I started I did a full gamut of plastic surgery a lot of trauma and reconstructive and oromaxil facial surgery, upper extremity. It's just been the last five to six years where I've really focused almost exclusively on breast ecoplan surgery and it just happened naturally by starting to do X plans, seeing my patients get better, seeing their responses, and then I kind of had a calling to do this as my career.

Speaker 1: 13:34

Well, obviously there was a demand for it, right? Yeah, absolutely, people are talking about it. So much for joining us.

Speaker 2: 13:55

Well, breast implants themselves are not lifetime devices. So that's number one. Number two breast implants may cause health issues in women, which we're finding out more and more as time goes on. Multitude of signs and symptoms that women experience directly related to the breast implants. We don't really know at this time what the cause is. We're just seeing more and more women affected. It's important to state that not every woman is affected by their breast implants, but it's the ones that are have problems or complications. Those are the patients that I find in my practice.

Speaker 1: 14:45

You know, you, I don't know if you would have heard of this, but the first time I had ever even heard of explant surgery was from the real housewives of I think it was Beverly Hills Yolanda. She's one of the famous models and she went through all these problems and it was like you know, she talked about it nationally on TV and I'd never heard of this before. So you know, it's interesting because a lot of women don't want to believe that some of their symptoms might be associated with the implants. So maybe we should talk about, you know, what is the safety profile? What kind of implants are used? Now?

Speaker 2: 15:30

Most of the implants in the United States are from two major companies. There's FDA approval for those here. In other countries we find different types of implants, but predominantly they are either a silicone implant or a saline implant. They're both both the silicone, saline implant. They have a silicone outer shell. The saline is filled with saline solution and the silicone is filled with the silicone gel. So those 95% of the implants that are implanted in the United States are from those two types and those two companies.

Speaker 1: 16:03

And do you find? Do they have the same warnings? Because I had also learned that there is a black box warning on implants. Is that?

Speaker 2: 16:14

true? Yeah, that is true, that's recent. They have found in some women, in the scar tissue that forms around the implant, certain type of cancer formation. They're very rare so we don't want to alarm every woman with breast implants, but it's a possibility. So it's something important to know. Also, they found that women are experiencing some systemic symptoms, which are symptoms throughout the body affecting their health. We don't know the numbers yet of what percentage of women are affected and what are not, so we're trying to elucidate those things as time moves forward.

Speaker 1: 16:52

What are those symptoms, and is it more with the silicone or the saline that these symptoms are experienced?

Speaker 2: 17:05

Yeah, in my practice I probably remove, I'd say, more silicone than saline, but I'm seeing issues with both types. The symptoms there's really a multitude. If you look now on the Food and Drug Administration website, they list the most common symptoms of breast implant illness, which are joint pain, fatigue, memory loss, hair loss. There's quite a few In my practice. I see quite a few more, just anecdotally, throughout my patients see quite a few more just anecdotally throughout my patients.

Speaker 1: 17:46

So I guess a pretty big question is how do you know? How do you know? Are there any tests that can be done before you actually undergo surgery?

Speaker 2: 17:55

Yeah, unfortunately there is no test for breast implant illness or BII rate. Yeah, unfortunately there is no test for breast implant illness or BII. It's a diagnosis of exclusion. I think when women are having issues, first thing they need to do is get checked up by their normal practitioner and do a workup for any other causes that may be leading to these problems. If nothing can be found and my patient is still having a lot of issues many of them make the choice to remove their implants and see if that improves their health. And lo and behold, in my practice I find most of my patients do have improved health once they explant.

Speaker 1: 18:30

See, that's the key. Right there is that I guess you follow your patients to see how their symptoms are afterwards.

Speaker 2: 18:40

Absolutely, absolutely. I try and follow most of my patients at least up to a year and the majority of patients, when I say how are you feeling? Do you feel better? I'd say 85% plus in my practice do feel better after expanding, sometimes very, very significantly.

Speaker 1: 18:56

Wow, that's interesting. Is autoimmune on one of those autoimmune conditions, on one of those warnings, or is that just something that people are talking about?

Speaker 2: 19:07

It is. We know that there is a correlation. If you look at the very fine print and some of the manufacturer's own handouts, you can see some of the autoimmune diseases that have a higher incidence with patients with breast implants. Whether or not it's causing autoimmune or it's just exacerbating a predisposition, we're not 100% sure.

Speaker 1: 19:28

You see, that's what I always say too. I'm always like there's just so many factors to our health and our wellness and everybody's so unique. So, for example, I might be a woman who is overweight. I don't exercise, I don't eat well, Um, you know, I eat a lot of fast food, a lot of fry. Of course I'm going to be more at risk for anything. And then, like you said, if I have implants, that just might be like the last. I don't know how to even explain that, but that might be the last thing. That just kind of triggers the offset of many issues and diseases.

Speaker 2: 20:12

Yeah, it can be a tipping point and I see a lot of my patients. They really have fine-tuned their health, they've seen their doctors and naturopaths and take supplements and they're able to maintain their level of health. Basically, it's patients that, like you said, are unhealthier and not exercising and not eating good foods, they have more of a propensity to develop problems, I feel.

Speaker 1: 20:40

Well, it makes sense. And then I guess it's two different. The way I'm looking at it as a non-physician is I look at it in two different ways. There's the symptoms, and then there's the fact that you might actually see something. You might physically see something wrong, like I mean, listen, everybody who's on TikTok has seen those surgeons that show um explanted implants with the casing and the scarring and you know, can you actually physically see something? And then you go oh yeah, okay, that explains it.

Speaker 2: 21:22

In some patients you can. So on the flip side of non-breast implant illness related issues that women have that makes them want to have their implants out are things like rupture, ruptured silicone implants, ruptured saline implants. Calcifications is when you get a calcium shell that forms around the implant. Capsular contracture, which is where the scar tissue around the implant kind of goes crazy and squeezes and causes pain and a misshapen breast. Also, women that have had five, six, seven, eight breast surgeries. They've gone bad, they've had infections they've had, and so there's a whole multitude of things that make women say I want to remove my implants. Then, on top of that, now we have the possibility of having symptoms directly from the implants themselves.

Speaker 1: 22:11

Right. And how are those issues diagnosed? Do they do ultrasound, like what? Do they do MRIs? How do they find out if they're, let's say, there is a rupture?

Speaker 2: 22:22

Rupture diagnosis the best thing is an MRI. It's almost 100% conclusive. A step down is ultrasound, which is also very good, but not quite MRI level, and a mammogram can sometimes differentiate a rupture as well.

Speaker 2: 22:39

I have to ask you this Are mammograms safe for a woman who has implants? Well, I mean, there is a possibility of rupturing an implant with a mammogram. I think, as a woman, breast diagnosis, breast care safety evaluation is just extremely important. So I would never tell a woman don't get a mammogram. I would say to speak with your breast practitioner and say maybe an MRI, maybe ultrasound would be a better exam for some of these women, particularly with thin breast tissue or capsular contractures. So there is risks involved. But diagnosis of breast cancer is just. We know how important that is for women, of course, of course.

Speaker 1: 23:29

So if a woman has implants, it doesn't necessarily mean she's at higher risk for breast cancer, unless it's that specific one that you mentioned.

Speaker 2: 23:43

That's correct. We have not found a higher risk of breast cancer in women with breast implants, unless it's of the ones that I was speaking of. That can be a cancer diagnosis of the capsule itself, but again, very, very rare. We don't want to scare people on that.

Speaker 1: 24:02

Yeah, yeah, okay. So I know a lot of women in my community who are extremely health enthusiasts, enthusiasts. And you know, some women might say, well, I do everything, I, you know, I don't see why I would take my implants out. And then some are starting to research and read more about this. So if you have no symptoms, would you say that there's really probably not a lot of risk?

Speaker 2: 24:39

Would you say that there's really probably not a lot of risk. I would tell a woman if they came into my office and said I have implants, I like the way they look, I'm very healthy and I feel great. What do I do? I would say just monitor your health. You know, if you have a silicone implant there's some criteria for getting MRIs every number of years, ultrasounds every number of years to make sure they're not ruptured. But I think in those patients they shouldn't rush to explant. If you've had a silicone implant for a number of years and different plastic surgeons have different numbers 8 to 12 years those women do want to probably at least make a change. I don't do any implants in my practice but they want to consider doing something in that time. Saline is a different story. Saline implant like the way they look, no symptoms, healthy woman should just monitor.

Speaker 1: 25:34

Okay, so it just sounds to me. I don't know because I don't have implants, so I just hear from other women. So is saline just less riskier, would you say?

Speaker 2: 25:50

Well, to a certain extent. Yes, you know, if you get a saline implant you can keep them in much longer term than a silicone, not worrying about silicone gel leakage and rupture and not knowing if a saline implant ruptures, a woman usually finds her breast goes smaller right away. So you know there's a rupture and it's saline fluid. It's not silicone gel. In my practice and we don't have the specific numbers of silicone for saline, I see less problems with a saline implant than a silicone. With that being said, the silicone implants. Clinically it's a better feel. It feels like more of a natural breast. There's less chances of rippling or palpating the implant. So there's definitely pros and cons of both, but I think if you asked me which one was safer, I would personally say I think saline is a better choice.

Speaker 1: 26:41

Okay, but silicone might be a more popular choice.

Speaker 2: 26:46

And that is correct, and it is a more popular choice, I believe. In Europe, you know, it's approaching 100%, and in the United States it's gotten way higher since they were put back on the market in 2006.

Speaker 1: 27:03

So they were taken off for a while.

Speaker 2: 27:06

Yeah, there's always been some questions of problems with the silicone. We've been through it and been full circle on these things for many, many years. So they were taken off and saline was only available for a number of years, and then they were put back on the market in November of 2006.

Speaker 1: 27:24

Okay. So I mean this. I'm okay with going a little graphic, but what do have you ever been shocked in a surgery? When you go into surgery to do an explant, and it's just much worse than you expected.

Speaker 2: 27:46

Absolutely. It's usually just really bad ruptures of older silicone implants. The older implants were more of a liquid consistency. Patients that have had hematomas are bleeding inside the chest cavity and that blood sits a long time. Those can be really messy surgeries also. More often than not, the implants, they look okay, they look normal, that I remove. I do a lot of ruptures also, but the ones, the shocking ones are, you know, in my practice I see them more often than most doctors could do a lot of explants but um, those are uh, those are more rare.

Speaker 1: 28:29

So, then, your job as the surgeon is to clean up whatever's in the area as well, like you have to like're saying that they can be pretty badly ruptured and hematomas. Like you have to clean up the area, and is that even possible? Is there long-term damage?

Speaker 2: 28:49

Well, usually when an implant first ruptures, your body has already formed scar tissue around it. We call it the capsule, and it's your body's way of walling off a foreign body, saying there's this foreign body inside me, I'm not sure what it is, I'm going to wall it off. So most of the ruptures are contained within that scar cavity. So if you can take out that scar cavity along with the implant and along with the ruptured material, you try and make sure that there's no contamination of the of the breast tissue, if you can. Beyond that, you're right. Cleaning out a lot of irrigation with antibiotic solutions and things like that as well is done on every patient as well.

Speaker 1: 29:34

Okay, because every single woman I know is afraid of what she's going to look like after she has her breasts removed, her implants removed, and you know, like the fact is is that your skin stretches. And if, if it's a woman who's in her fifties, well, the skin is not as elastic as it was when it was, you know, when she was 30. So what happens then?

Speaker 2: 30:05

So many of my patients I offer a breast lift or skin tightening at the same time as the explant because, you're right, You've stretched tissues, you've removed volume. Things tend to want to go south. So a lift at the same time is sometimes a good tool that we have. Every woman is different in regards to possible outcomes. The more difficult patients are patients with very thin or little breast tissue, patients with really large implants. Those are more challenging patients. Some patients the majority of patients turn out very well. Other patients are more challenging and you do have to talk afterward about things like revisions, fat grafting Fat grafting is a nice tool to have to do a couple of different things. It can fill in an area that has a depression. It can add volume and fullness to the breast, but it's very different than a breast implant. You know, with grafting you can maybe get a half cup size, maybe a cup size bigger, but it's more of volumization of the breast. It's not an implant type of look usually.

Speaker 1: 31:14

Right, and where does that fat come from? Does it come from a? What does it have to? What if a woman's really thin and doesn't have the fat?

Speaker 2: 31:23

Well, it has to come from you or an identical twin, but that doesn't happen very often. But it has to be your DNA because it's your tissue. If you take it from somebody else, like a kidney transplant or anything like that, it's going to fail, reject, right. Usually it's traditional liposuction. We collect it in a machine that's made for fat grafting and it's injected into the breast. You're right, the more challenging patients for fat grafting are the ones that have very little fat. I do a lot of fat grafting in my practice for patients with very, very little fat. I do have a referral doctor that I sent to that. He's in North Carolina and he's kind of a magician at finding fat in very thin patients.

Speaker 1: 32:10

So I guess where would it come from? The bum, the belly, the belly hips, abdomen, inner thighs, outer thighs, those are kind, kind of my, my go-to areas wow, okay, and and I have to ask this do you get patients who have had mastectomies to come and do like fat grafts only, or to do some sort of obviously not implants, because you don't do implants at all anymore, right?

Speaker 2: 32:40

Yeah, I do have patients that have had mastectomies, that want explants. They're very challenging patients aesthetically because they have no breast tissue. It's already been removed. Right Mastectomy patients also. I do have not had any successes in fat grafting them, because there's nowhere to really graft the fat. It's such a thin layer of tissue. So those patients either elect to go we call it a flat closure, which we try and smooth things out best we can. Sometimes these patients are candidates for what we call autologous reconstructions, so that's moving tissue from the abdomen into the chest. It's called a tram flap, so it's utilizing your own tissue and there's certain plastic surgeons that will specialize in those types of procedures. It's a pretty invasive, pretty intense procedure, but that's an option as well.

Speaker 1: 33:33

Do you get a lot of women who have had mastectomies come and have their implants removed?

Speaker 2: 33:41

I do, and I mean not as many as women without mastectomies, just with implants. But I have had a number of women with mastectomies. It's usually women that have had poor outcomes with their reconstructions or the implants are very painful, they've had infections, they have a lot of symptoms. So those are the patients that I would perform that type of surgery on.

Speaker 1: 34:07

And what happens once the implants are removed? What if you have a patient that has had, you know, pretty severe ruptures? I mean, what's the recuperation?

Speaker 2: 34:19

Yeah, so the recuperation is not too different than having your implants placed. I always recommend just three weeks of really taking it easy. You can still walk around and move around and do stuff, and then six weeks is pretty much back to normal activities. I use a long acting anesthetic called Expro. It really takes all the pain away for about three days, which is the most painful. So most of my patients after surgery just take Tylenol.

Speaker 1: 34:48

Wow, that's not too bad yeah.

Speaker 2: 34:52

You know it's been a. It's a medication that we kind of stole from the orthopedic surgeons that use for knees for pain control, and we're starting to use it a lot in plastic surgery and it's really been a paradigm shift in our pain control.

Speaker 1: 35:10

Speaking of paradigm shifts, do you think that that's what's going on right now in the world? I'm just seeing so many women get explants, whether they have issues or not.

Speaker 2: 35:30

Like there's something changing in that women are owning it, owning what they have, who they are. Yeah, I agree there is a push to be more natural. The bigger breasts are not in as much as they were in the days of Baywatch and those types of shows, so smaller breasts are more fashionable to a lot of women and they want to be back to their natural self. There's a lot of women, you know, just taking care of their self holistically and this is kind of part of that process and I think a lot of it has been education and allowing women to know that this could be part of their holistic problem, you know, could be their implants contributing to some of the problems that they're having. So I think knowledge and education has been really key in this development.

Speaker 1: 36:12

What do you recommend for a woman after she has explant? In terms of more of the holistic side, do you have practitioners that you recommend they go and work with if they had complications? Let's say they had a lot of you know. Of course, as a surgeon, you're going to clean up what you can, but the fact is is that if toxins are leaching in your body for many, many years, it's not maybe as easy to clean up. What are your thoughts on that?

Speaker 2: 36:44

A lot of my patients go on and do just full, extensive blood panels, full physical examination, and if there's problems in the blood or other medical issues that can be treated, then that's what we do. I think the explant is kind of part one which makes a lot of people feel better right away and enables them to continue on their health journey when they're feeling better, less fatigued, less anxiety, depression and just feeling better overall.

Speaker 1: 37:17

Interesting. Is that a symptom that you see with women?

Speaker 2: 37:21

I do, yeah, I do Quite often, yeah, yeah.

Speaker 1: 37:25

Oh, that's interesting. And age, is it from all ages that you see that those symptoms? From all ages of patient or implants or Patients that come to you with symptoms, who have implants and are thinking or want to have them explanted want to have them explanted.

Speaker 2: 37:52

I mean, in my demographic is from 20s to 80s, implants that have been in a year, implants that have been in 40 years. So I see all types of patients, all types of implant durations, absolutely.

Speaker 1: 38:02

Wow, and I wonder. You mentioned anxiety, depression. Those are symptoms that you see.

Speaker 2: 38:09

I see that a lot in my patients. Um, you know, you have to be kind of cautious with lumping everything into breast implant illness. That's really still being defined. I can only say what I see in my patient population, um, but um, you know, you know there is a big laundry list of symptoms that women are self-proclaiming to experience and I do see many of these things go away after expense.

Speaker 1: 38:36

Wow, that is really fascinating that this is coming about more and more and actually I'm going to say I don't think it's a bad thing. I don't think it's a bad thing because I feel like we're coming into this world where women can age gracefully women who have breastfed children, women who have. You know, like the fact is is that aging doesn't necessarily have to be an ugly thing and you're trying to mask it, and having implants is kind of something that happens, where women feel like they breastfed children and they're not what they used to be, so they're trying to maintain that youthfulness.

Speaker 2: 39:21

Yeah, I mean, everybody wants to look better, wants to feel better, but I do think a lot of my patients that explanted really learned to love their body, love their naturalness, and it's a progression for sure, psychologically. You know, having implants for long periods of time and then you know you get the complete opposite after. So it's definitely a journey, but I agree with you it after. So it's definitely a journey, but I agree with you. I think that there is much more of a push for women to embrace themselves, embrace aging. There's not as much pressure, although there still is pressure on women of course it's easing, hopefully a little bit.

Speaker 1: 39:58

Yeah, there is. There's definitely pressure, but you know, women like myself were in this this world of health, span and longevity and really it's more about what's going on inside of you than outside of you. And I'm not saying I don't fall into the aesthetic side of wanting to age slower, but I think this is an important conversation to say you know, is it worth your health?

Speaker 2: 40:27

Yeah, exactly, and I think that knowing the risks and the benefits, alternatives, potential complications going into your surgery is really important. I think many women in the past were told implants are going to be fine, they're going to be lifetime devices, you're never going to have any issues. But we know that's not 100% true. So having those points in your head makes you make a more informed consent. Some women may say you know what? Maybe this isn't for me.

Speaker 1: 40:53

Hmm, so if you were to knowing and seeing what you've seen, what is your advice, as an expert in this area, to a woman who is either considering implants or considering explants?

Speaker 2: 41:15

You know I, I have two young daughters and, um, they know what I do and I I hope that they never get implants because I've seen the problems that they can cause in some women and I think it's taking an unnecessary chance. I would never demean a woman for getting implants. We all have our life and choices to make. As far as explanting, I think that if you're having issues that we talked about, with recurring capsular contractures, ruptures, infections, or you developed a lot of strange symptoms that you can't figure out, those are the women's that should explant. I think again, if you're doing fine and feeling good and everything's going good, it's just monitoring and working with your plastic surgeon and hoping things don't take a turn for the worse.

Speaker 1: 42:08

What are the complications that can happen after explant?

Speaker 2: 42:13

It's generally a very safe procedure. There's risks of bleeding. We call it hematoma. In my practice it's 1%, so I do five 600 explants a year. I get five or six hematomas. It's a trip back to the operating room. Infection is rare but it does happen, Usually treated with antibiotics. Complication, you could say, is aesthetics right. Everyone doesn't turn out perfect, so those are patients you really have to work with. I always try and come up with a plan of. Sometimes there's small revisions, Sometimes there's fat crafting. So those are really the major things that I see in my practice that are concerning Out of all of your patients.

Speaker 1: 42:54

What would you say? The percentages of the women who are happy once it's done?

Speaker 2: 43:00

Probably 95%.

Speaker 1: 43:02

Wow, that's, that's pretty big, that's pretty big, that's pretty big.

Speaker 2: 43:07

It's a big satisfaction.

Speaker 1: 43:10

I would love for you to, because I've heard you have quite the wait list. Is that true?

Speaker 2: 43:17

I do, yeah, I do.

Speaker 1: 43:19

And there's only one, Dr Rankin right?

Speaker 2: 43:24

Yeah, I do. I always tell my patients that book your date. If you want to try and move up, get on the cancellation list because I have a lot of movement in my schedule. Patients get pregnant, patients can't travel, patients get sick. So we always try and move people up to their dates that they are trying, know are trying to achieve.

Speaker 1: 43:46

And here's another question If you were going to kind of give me a rough breakdown, what?

Speaker 2: 44:01

percentage of your patients are over 45 and what percent are the younger women? You know I haven't really done the math on the numbers, but I would say average patient in my practice is probably right around there about 45. You know, I do have patients in their 20s not very many. I did a patient yesterday. Implants were in for, I think, 45 years, so I've done patients in their eighties.

Speaker 1: 44:31

Um, it just it's kind of all over the board. And here's. Here's another thing that I always kind of I've. I've heard from women who have had implants. Their biggest thing is they're like okay, well, I'm, you know, over 50 now and am I going to keep getting these and I'll be like 70 and it'll be time for me to change my implants. So I think, you know, the longevity aspect is huge.

Speaker 2: 44:58

Yeah, I see a ton of that Patients that say specifically what you said. I'm 50, I'm healthy, I feel great. I don't want to have surgery when I'm 70. You know, I want to do this now and be proactive. Again, that goes back again with silicone versus saline. You're more apt to consider that if you have a silicone implant, you really don't want a ruptured silicone implant that causes a complication later down the road.

Speaker 1: 45:25

And here's the other thing that I always see. Obviously, you know, as we age, we are a little bit more sensitive to any assaults that come our way. As we're aging, we're just not as resilient and we have to do a little bit more. So that, I've heard, is another consideration that women have they're like well I'm healthy now, but you know that women have they're like well, I'm healthy now, but you know, in 10 years from now, what if something comes my way, even high stress, like we all know, there's that factor and there are things in our lives that you know we really don't necessarily have control over. So why add another thing to the mix that could potentially increase or exacerbate other issues that are going on?

Speaker 2: 46:09

Yeah, a hundred percent. There's definitely more risk to undergoing anesthesia when you're in your seventies than in your fifties and, like you said, you'll have other comorbidities that can be confounding when you go to do surgery down the road also. So for those patients they like to do surgery down the road also, so, um, for those patients they like to do something a little, a little sooner while they're, while they're healthy, this has been such a great conversation.

Speaker 1: 46:34

Is there anything that we missed? We kind of ran through it pretty quickly, maybe because it's, you know, almost six o'clock dinner time.

Speaker 2: 46:41

No, I think, um, I think we really covered all the major points. I think it's important to state that if you do elect to have an explant, you choose a board-certified plastic surgeon American Board of Plastic Surgery and someone that does it all the time. So, like anything in life, experience is key. It's not the simplest surgery in the world.

Speaker 1: 47:04

You want somebody with experience, so that that, I think, is a really good talking point okay and do a lot of surgeons do mostly explants, because I haven't heard of a ton of them there's more and more, you know.

Speaker 2: 47:20

As more women are wanting to have this done, more plastic surgeons are stepping forward to accommodate them, I think you should find a doctor that does believe in breast implant. Illness also Makes sense. That's important In my practice. I don't put in implants, I just explant. Not necessarily that is something that you have to look for, but doctors that just focus on explanting and trying to do the best in that regard, I think is someone maybe to look for.

Speaker 1: 47:52

Okay, and you can find them across the United States, canada.

Speaker 2: 48:00

Yeah, absolutely of social media groups that are, it's just all women talking about explanting and breast implants and a lot of those groups are pretty good because you can ask other women their experience that they've had and it's good to have a referral from someone that's been through the process and been to a doctor that has done a lot of these.

Speaker 1: 48:19

Yes, I've heard your name a few times, so that obviously means something, because I'm in this whole world of holistic wellness and people are talking about you, dr Rankin, so that's a good thing.

Speaker 2: 48:32

It's awesome.

Speaker 1: 48:33

Yeah, so where can we find you?

Speaker 2: 48:36

So on Instagram I'm DavidRankinMD and that's really my main source of information. I also have a website at DavidRrankinmdcom as well.

Speaker 1: 48:50

Okay, that is perfect. Thank you so much for your time today. I know you're a very busy man. I really appreciate you coming and speaking with us.

Speaker 2: 48:59

It's my pleasure and keep doing the great work. Thank you, keep doing the great work.

Speaker 1: 49:05

Thank you. I hope you enjoyed this episode. Be sure to share it with someone you know might benefit and always remember when you rate, review, subscribe, you help to support my content and help me to keep going and bringing these conversations to you each and every week. Join me next week for a new topic, new guest, new exciting conversations to help you live your best life.