To direct one’s hopes or ambitions toward achieving something.
Dr. Lee has been placing breast implants since the early 1990s and counsels patients/partners about the risks and benefits. While any surgery carries risks of bleeding, infection, anesthesia and wound healing, breast implants have specific inherent possibilities. These include malposition, capsular contracture and rupture, among a few.
In the last few years, several new health issues have surfaced in regards to breast implants: Breast Implant Associated Anaplastic Large Cell Lymphoma (BIA-ALCL), Breast Implant Associated Squamous Cell Carcinoma (BIA-SCC) and Breast Implant Illness (BII).
Breast Implant Associate ALCL
BIA-ALCL is primarily associated with textured breast implants in which a significant amount of fluid collects around the implant in the scar capsule. It is a diagnosable condition that can be identified and demonstrated with lab tests and fluid collection. This is different than Breast Implant Illness, which is broader and less well-defined. This is a demonstrable condition diagnosed by specific findings and lab tests. This is the same for BIA-SCC.
BII does not have a uniform presentation or definitive tests to document. It is much more subjective which leads to the controversy of its existence. The symptoms usually start months to years after implantation with chronic fatigue, then “brain fog” (inability to focus, concentrate, think clearly or being forgetful). Other symptoms reported are anxiety, joint and muscle aches, skin rashes, thinning hair, vision, hearing and GI issues. There is no unique pattern of symptoms or specific test to determine if the implants are the issue. In fact, most testing for underlying known diseases (Lupus, Lyme disease, thyroid, adrenal and auto immune issues) are usually negative. BII is a diagnosis of exclusion.
The scar capsule that forms around the breast implant may cause localized symptoms of tightness, pain, pressure or inability to take a deep breath. This is more of a physical and mechanical issue from the capsule pulling on surrounding tissue and may be improved with capsulectomy (removal of the scar capsule). This is a localized phenomenon not specific to BII. The symptoms of BII seem to be more systemic and possibly metabolic in origin.
Breast Implant Illness
Rather than a single diagnosable condition, Breast Implant Illness (BII) is a collection of symptoms people experience after a few months or years after having breast implant surgery. Common symptoms reported include chronic fatigue, “brain fog” (inability to focus, concentrate, or think clearly and being forgetful), rashes, joint and/or muscle aches, thinning hair, hearing problems, and gastrointestinal issues. To date, there are no identifiable patterns to these reported issues, making the correlation with breast implants a subjective conclusion rather than a known diagnosis.
BII is known as a “diagnosis of exclusion” when testing and examination rule out many other known diseases, such as thyroid problems, Lupus, Lyme Disease, and other conditions. So while it is a medical diagnosis, it does not follow the typical pattern when you think of a diagnosed condition.
Dr. Brian Lee
Double Board-Certified Plastic Surgeon
Dr. Brian Lee has been in practice for over 2 decades, serving the Fort Wayne community for all their aesthetic and cosmetic needs. He is proud to work alongside his talented team and looks forward to seeing new and returning patients in his office.
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Why Use Breast Implants with These Risks?
While Dr. Lee acknowledges the reality of BII and will explain its risk factors during a consultation, it’s important to weigh both the risks and the benefits of breast augmentation for many people. People experience changes in their bodies due to life events such as aging and pregnancy that can negatively affect the way they see their bodies. For these and other aesthetic reasons, the benefits of enhancing a person’s self-worth are often worth the risks, especially for those Dr. Lee has identified may not be as at high risk for BII due to his discovery of a simple test that can identify a key risk factor.
Why Some and Not Others?
Dr. Lee’s working theory is that subsets of the patients who get breast implants are genetically predisposed to develop BII. There is a certain detoxification process that your body performs billions a times a second that can lead to body-wide symptoms like those mentioned with BII. Some people carry defects to this process that make them more likely to have a weakened detoxification ability, meaning that after a surgery like breast augmentation, their body begins building up toxicities that affect their nervous system (brain fog), metabolism, (fatigue), and other body systems.
There is a “Methylation Detoxification” pathway that is so ubiquitous that it is estimated to occur a billion times a second in the human body. If there were inherited defects in the genes of this pathway, it may help explain why some people get some illnesses and others don’t. Perhaps this may be true with breast implants as well. Cell Science Systems has a simple cheek swab test that will show three of the major steps in this pathway and if there are inherited defects. The women usually seen with BII who have elected to do this test have had positive inherited genes.
Fortunately, there is a simple cheek-swab genetic test that evaluates a major component of this process to help potential patients understand their risks. Dr. Lee also provides counseling for preparing to remove breast implants for those experiencing symptoms of BII. Diet and lifestyle changes, as well as immune support, has been helpful for many people to prepare for yet another surgery as well as helping the recovery process.
Approach to Explanation
For those seeking explantation for BII, Dr. Lee has found (and personally uses daily) several modalities that seem to help support the body with nutrition, hydration, detoxification, and immune support with dietary and lifestyle suggestions. They are used to help prepare for the explantation surgery, in which the implants and all capsular scar tissue are removed. In some cases, patients begin to feel better even before the explanation, and building the body prior to surgery may help in the recovery. Using a self-reported inflammatory score sheet before surgery, six weeks, six months, and one-year post-surgery, Dr. Lee and his team have noted a consistent reduction of symptoms in EVERY explanted person to date. That is several hundred women with 100% improvement. Some skeptics say it is a placebo, however the placebo effect is only 30-35% of the time, not 100%. However, even if it is just a placebo effect, the women are doing much better.
The surgery is performed under general anesthesia and as an outpatient. Dr. Lee attempts en bloc removal (scar capsule still encased around the implant). Sometimes this is extremely difficult and causes more retraction and tissue damage or a much larger incision, which decreases blood flow to the remaining tissue possibly risking necrosis, particularly if a mastopexy (lift) is indicated. If en bloc is not performed, he instead makes a controlled capsulotomy (opening into the capsule) and removes the implant without any internal contact or spillage. The capsule then collapses and the dissection planes are easily seen without the excessive traction and potential damage to the remaining tissue. Photo and video documentation is done and the patient has a full decision for lab testing and/or keeping her implants.
If a mastopexy is indicated, Dr. Lee has developed a two and sometimes three-level lift of the native tissue to give a better position and shape with minimal undermining to maintain vascularity and blood supply.
The first explanation for BII Dr. Lee performed was in 2015 and he was not sure that the procedure would help, but his patient was insistent, saying in the consultation, “I know you don’t believe Breast Implant Illness is real, but will you please take my implants and capsules out. Nobody else will and I have no other alternatives.” He performed the surgery at her request; however, she struggled for 8-12 weeks before beginning to improve. He realized then that he took a person who was physically, mentally, and emotionally drained and put her through the “controlled trauma” of surgery. Afterward, he now subsequently views any surgery as an athletic event and has offered a protocol of nutrition, hydration and immune support, as well as detoxification prior to the surgery. This seems to have helped tremendously in the early recovery and many start feeling better before the explantation.
I had a tummy tuck and breast augmentation with Dr. Lee and I am grateful to him and his staff for everything they did for me. Dr. Lee answered all my questions thoroughly, and was extremely patient and helpful on the day of surgery. Dr. Lee is amazing, and I’m happy with my results and would recommend Aspire Plastic Surgery to anyone.
- Written By Verified Patient
Dr. Lee is the most amazing doctor I have ever met. He has an awesome bedside manner, professionalism and a caring personality. He really knows what he is doing. The one thing I wanted most when I went to see him for a breast augmentation was to be proportionate. This is exactly what he gave me! The trust you feel when you first meet him and his caring attitude after the surgery is one of a kind. I had some nerve endings that were causing me pain, and he answered my call without any hesitation and said call for absolutely anything. I would recommend him to anyone!
- Written by Jennifer
A common question asked is if Dr. Lee believes in BII, why is he still placing implants? The simple answer is that he believes only a subset of the population may be affected by this process and feels that it is related to the Methylation Detoxification Cycle as mentioned above. By having open discussions regarding the risks, benefits, and alternatives to breast implants as well as BIA-ALCL and BII, the patient has information so they may decide how they wish to proceed. The team at Aspire Plastic Surgery does offer detoxification pathway testing. This is purely a test to evaluate the genetics and NOT a specific test for BII as one does not exist.
Dr. Lee prides himself on patient care. Every patient who walks into the office is immediately part of the Aspire family, and their health and well-being are paramount. If you have questions or need anything from our team, contact our office today by calling or filling out our online form.
“I will continue to see patients, listen to their symptoms and journeys, and provide holistic modalities to build the body as well as explantation surgery. I will also track patient outcomes and hope someday we will be able to unlock the mystery of Breast Implant Illness.”