Ashley: Before I start this episode with Dr. Amanda Savage Brown I just wanna let everybody know that at the time of recording, I was three weeks post explant. So I had my breast implants removed from underneath my muscle, I had a breast lift and side boob lipo. I hope that you enjoy our conversation about breast implants today. Joining me is Dr. Amanda Savage Brown. She’s a scientist turned women self-acceptance therapist and coach. In 2018 she removed her breast implants and recovered from undiagnosed breast implant illness. Thank you so much for joining me today.

Dr. Amanda: I’m excited to be here with you.

A: Can you tell us a little bit about your first of its kind science-based self-help book?

D: Oh yes, that was born of my own personal experience going through my breast implant removal journey. It’s not a memoir, it’s a self-help book because when I went through explant and I started connecting with other women going through it, I saw all of it through the eyes of a former public health scientist and a clinical psychotherapist. I just saw so much inner suffering just so much mental, emotional, and social impacts from breast implant removal, no matter why you’re removing them. I just saw that it had way farther reaching impacts on women than the surgery. I just took all the evidence-based approaches that I use in my private practice, I translated them to the psychosocial challenges that we go through when we’re going to remove our breast implants, whether it’s by choice or not, there’s challenges that are pretty predictably experienced. Not by everybody, but there’s definitely a journey, an inner journey. I created this inner healing program and then I wrote Busting Free to give that program to any woman whose life journey includes breast implants. I’d never set out to like write that particular book, but it just became apparent to me, some women spend five figures on those surgeries to remove their breast implants, I thought having a self-help book that was at that price point was probably the best way to get meaningful help to as many people on these journeys as possible.

WE REPEAT WHAT WE DON’T REPAIR

A: I think that any resource available is so beneficial because I feel like breast implant illness has been around probably for decades, but it really is something that more people have been talking about, I want to say in the last three to five years, and there isn’t a lot of research there isn’t a lot of information. So anything that can be tangible that somebody can say this will help me along the way I think is so needed.

D: Yes. I have this personal mantra that I’ve observed over time which is we repeat what we don’t repair. I see explant, that’s the term for breast implant removal without replacement, I see explant as an opportunity for women to fully repair their relationship with their self and the way that they’ve been socially conditioned to relate to their body and to solve inner pain. A lot of us solve how we feel on the inside by fixing how we look on the outside. I really see these journeys as opportunities to do long overdue healing and to really fully reclaim yourself so that you don’t keep living that life with that agenda pushing you around because you removed temporary, problem prone, inappropriately studied, breast implants from your body. It doesn’t mean that you have ejected those original beliefs that led you to the implant table in the first place, you know?

A: Well and that is a really important point because we wouldn’t have put them in our body in the first place if there wasn’t some sort of body dysmorphia or something that we thought that they would fix about ourselves, that a lot of people, I think once they do have to remove them, if it isn’t a personal choice and it is health-related that they worry about what that’s going to look like or what that’s going to feel like afterwards. So I do think it’s really important to realize that there is going to be that healing or potentially that need to go back and basically start from square one on day one of why you got them and rework that whole journey so that you don’t feel bad or you don’t have regret, or you don’t want to, reimplant something that was making you sick in the first place.

D: Or something that you can’t afford to keep up. You have to have reoperations or something that as you’re aging, maybe it’s not safe for you to continue having operations, so there’s just so many reasons that I think it’s important to put women just squarely in charge of that decision, because anyone who has breast implants inevitably has to choose to replace or remove. My book puts women in charge of that decision, not society. Not those socially conditioned beliefs. I just want to loop back to something you said, I tend to see, that women who choose for breast implants, we get them for all kinds of reasons. As a psychotherapist, I’m highly sensitive to and resistant to like psychopathologing women who opt for breast implants and saying that it’s body dysmorphia or that it’s some kind of body image disorder.  I think it’s just a very natural response to our innate desire to belong and so I really am trying to get messaging out there that there’s no shame in choosing to get them. There’s no change and opting to augment restore, or if you’ve had breast cancer to reconstruct your breasts. Of course your mind is going to consider that as an option it’s offered. I don’t know about you, but every now and then I like mostly for my research for my book I’ll go to Google and I’ll type in breast implants. I’ll just look at the messaging and the messaging around them is that is going to make you whole complete, better confidence, sexy, powerful, you’re going to fill out your clothes. It’s all these things. That’s just a normal part of being a human is you want to look your best. You want to belong. That’s just part of being who we are and so that’s why with my book, I’m trying to help women kind of recognize that that messaging realize they have a choice over whether or not they follow it and take care of themselves no matter what decision they choose. If you go down that route, it really does need to be that you’ve thought it through, you know the risks you can afford to take care of the inevitable reoperations and you’ve got the health that maybe can withstand inevitable systemic decline.

SOCIETIES IDEAL VS OUR OWN

A: That is a really fair point because I do think, and especially somebody who was born in the eighties grew up in the nineties our version of that very sexy, feminine was very much the Pamela Anderson, the pinup version, which was the blonde hair, the big boobs. So then society really convinced us this is what the perfect ideal female body or the feminine view is. So it really is that that’s what we were programmed to believe was the ideal.

D: Yes. And then we measure ourselves against it. If we come up short that gives us inner pain and we want to get relief from that, so even for the non Pamela Anderson influenced people, you can look at women who have had breast cancer and they’re facing breast loss and their mind just like every other mind that grows up in a appearance oriented society. All of our minds hold this rule that women have breasts. And so for them, getting breast implants, there’s a lot more to it than the Pamela Anderson influence, and some women opt for breast implants because there’s an idealized breast shape and perhaps they have tuberous breast deformity or they have asymmetrical breasts or their breasts just naturally have like a ski slope shape, but it’s all the same behind the scenes inner process that we all are kind of carrying around inside us that is preyed upon.

A: It definitely is I know with me, I got mine at 23, I’m 37 now. I always had a really small breasts and then I got pregnant. My breasts, like ballooned, and I breastfed for a year. At that point I was a single mom I literally had like fried egg looking boobs. At 23, that’s not what I wanted going forward. So I know for me, it was sort of in my mind fixing what I had to get back to, what I perceived as a normal or desirable shape. So it wasn’t necessarily I want big boobs to look sexy. It really was that society had told me that fried egg boobs weren’t where it was at and wanting to fix it. They just didn’t really have the conversation back then on what the side effects could be. The only thing that they warned back then about was scar tissue, which is still funny because every single implant gets scar tissue to some degree, but that was legitimately the only thing they told me about if I knew even half of it, I just I would like to tell my 23 year old self that she probably wouldn’t have gone through with it, even though I knew that I would have to get additional surgeries, they aren’t even really necessarily clear on what that looks like. Whether it’s every four years, whether it’s every seven years, whether it’s every 10 years, like there really isn’t even information about that part.

D: I know. That’s the other thing that happens, once we get it into our mind that our breasts are threatening to us in some way, so fried egg appearance, or the loss of them or whatever, once we get that in our mind, when we start looking at before and after pictures of augmented or restored or reconstructed breasts that shifts everything in our mind and breast implants become very appetite of, and it’s almost like you might know that there’s some things that could happen. I could get capsular contraction and it could be distorted and painful. That probably won’t happen to me. Look at these pictures and you move forward because it’s so strong inside us to move toward that kind of relief and to see them as these panacea of positivity, and it can be a slow grind for a women to come to terms with, those early disappointments. These aren’t comfortable or they’re bigger than I wanted or I feel self-conscious with them or there’s rippling or they’re cold or I do have capsular contraction. Suddenly it’s challenging that just a few years ago these promised devices that we’re going to deliver you to the ultimate womanhood, you know? So you’ve moved through this whole change process with breast implants. We all move through that at a different rate, like you were saying some people’s breast implants start giving them problems very quickly, and then we all know those women who have had breast implants for 40 years and never attribute any problem to them so it is a confusing journey for sure.

BRITE PROGRAM

A: Now you had touched on that you have a program, I believe it’s called a BRIGHT. Can you explain what that is?

D: Yeah. First it’s an acronym for breast implant through explant, so BRIGHT. I liked that because I view moving through explant and breast implant loss as an opportunity to really put your best into inner healing and really reclaim not just your body, but your mind and your heart as well. So I kind of think about kintsugi pottery repair, the Japanese pottery repair, where you use gold instead of a glue, and then you get these beautiful pieces where the fractures are still very obvious, but they’re more radiant and they’re stronger. I like it calling it BRIGHT Inner Healing because of that symbolism behind it. I’m an acceptance and commitment therapy practitioner. It translates the very researched evidence-based strategies from acceptance and commitment therapy specifically to these journeys. It helps a woman start to get a lot more flexible on the inside with how she sees herself relative to her breasts. I call that your breast related self-concept it helps women step back from all the social rules that we have about breasts and our body needs to be this proportioned and it helps women in this is probably my favorite part. It helps women learn to companion their inner pain when we inevitably feel less than, or not good enough, or like we don’t measure up or many women I work with, I now specialize in this. Many women who are post explant, who are working on their inner healing, they all struggle with post explant intimacy. Maybe they still have internalized breast shame because having breast implants does not address your internalized breast shame. It just temporarily quiets it. When you remove them, there it is and if you happen to have wrinkled or dented post explant breasts, or if you’re a mastectomy patient who’s explanted to flat, then post explant intimacy, it can be difficult. So I really liked that process of learning to be with that instead of trying to get rid of it and fix it, like really be able to show up for yourself and these aren’t like woo wooey concepts, the book is literally teaches women how to do these things as like verbs, like actions that they can take instead of something to conceptualize and agree with. I think this is also very important when you grow up in an appearance oriented society, it helps women know what matters to them, deep down underneath all of this, because we’ve grown up, like you were saying,  if you’re a kid of the eighties or the nineties, you’re used to external vigil, you’re used to knowing what needs to matter to you on the outside. You can disconnect from really knowing the kind of woman that you want to be, what do you want to take a stand for? What do you want to be about? It helps women reconnect with that and then it helps them do what they want to do. So it’s a whole process. It’s a mindfulness based behavior life changing inner healing program. It just happens to be packaged for women with breast implants or whoever had them. The thing I like most about it is that once you go through BRIGHT Inner Healing and you acquire those strategies, they are known to be translatable to really any kind of suffering or challenge that you can experience moving forward.

A: It is really great having somebody run a program like this that would relate to the people going through your own journey as well. In a lot of cases, like you said, growing up in the eighties and nineties, everything was about the image. It was the birth of Photoshop and us being told just be pretty and everything else will fall in line. Nobody really ever considered check in with yourself, ask yourself what even matters to you versus you being told what should matter to you. That is such a valuable tool and is such a fantastic conversation that really needs to take place. Everything isn’t always going to be sunshine and rainbows going through a program like that so it is really important to understand that it is a journey. It is a process because unfortunately to like say going back, even to my story, fried egg boob me, then there’s big boob implant me. I don’t get to go back to those pre-boobs. It is falling in love with the new shape. There is scarring, there is a different appearance, there’s so many different things. So I do think that that’s such an important step for people to realize going through it, that you’re going to have to essentially fall in love with yourself, or again come up with some body neutrality towards yourself and what your appearance will look like.

D: In my book, I point out the myth of emotion control. Rather than setting a goal of like falling in love with yourself, which is a feeling, of course, that’s great to set that as something that you want to do. I advocate and recommend that we set a different goal, which is to be loving to ourselves, which is very different. That’s legitimately under your control and that’s an action that you can take and something you can give yourself. I have distorted post explant breasts, and I am more loving to myself than I’ve ever been in my whole life. It’s a practice and it’s something that I can actually do. I don’t love the way they look, but I can be loving to myself for damn sure. I am really committed to that because I feel bad for what my poor chest has gone through. I feel bad my poor body was just going about its life and then one day I put it in the car and drove it to get a surgery that it never even consented to, and then I put these two invaders inside of me and my poor body, literally 24/7 it’s job was to just keep working that barrier between me and the implant. Just keep working that barrier. Thank God it did because I ended up having really low quality, gummy bear implants, one of them ruptured and thank God my body was working 24/7 to keep me protected from it. Now I practice gratitude for that. Girl, I’m never going to do you wrong again.

A: I think that is an important thing to know that self love is a fleeting emotion, just like happiness or suffering or all of that, but to really connect with yourself and say we’re not going to go through this we’re as team and actually physically connecting your brain into your body, I think is a very, very important step.

CAPSULAR CONTRACTION, RUPTURE AND MORE

A: Can you tell us a little bit about your experience with breast implant illness before your implant ruptured? Did you know what that phrase was or had you heard it before?

D: No, I was at that point in time, I was a therapist in private practice. I didn’t have any social media. I had been trained in a different mindset, which was that, social media and therapy didn’t go together and so I didn’t have social media. I didn’t know that breast implant illness was a thing I literally had never heard of it. I had breast implants for about 12 years. I started having local problems with the implants that were obvious implant problems pretty quickly after I got them. I started having capsular contraction and minor pain and started having some nerve pain, just all in the breast area. And then I would say over the next decade, I experienced significant impacts on my health that I never once considered could be related to my breast implants. I didn’t know to consider that, none of my health providers did either. My hormones were tanked and it was way too early from an age perspective for that to be happening. And my GYN who was just a rock star said she’d never seen someone my age with those numbers. She never thought to attribute it to my implants either. I just started having all kinds of inflammation, chronic body pain. I was struggling with a lot of infections and I never made the connection. I just thought I was unlucky. I was like wow I’m not aging at all like my mom, who’s super healthy and it looks amazing and I’m not aging at all like my neighbor, who’s 20 years older than me who can go kick ass all day in her yard and do whatever she wants to do. I couldn’t do any of it. I just thought wel, that’s it. This is the lot I got given in life. I had been wanting to remove my breast implants for several reasons. One was I changed. My life evolved. I went back to grad school. I became a therapist. I really practice what I preach and I just didn’t want them anymore. My sister got breast cancer and my implants were interfering with my mammograms. I have naturally dense breast tissue, which already reduces your mammogram efficacy. I also, if I’m being honest with you, I felt a little fraudulent like sitting behind two breast implants that I didn’t want. They weren’t comfortable to me while I was working with women on building the life they want, living life on their terms and practicing self-acceptance. I was like really being a wimp about this surgery. I just didn’t want to get put back to sleep. Didn’t want those drains. I didn’t want any of it. Eventually I had a mammogram and then I noticed that one of my breasts looked crazy. It was just suddenly shaped really weird. I knew that one had ruptured and I just let that catalyze me. I was like let’s just get these things out. Let’s just get brave. Let’s face this surgery, which I was terrified of. That’s when I found out about breast implant illness, it was when I went on explant consults and the doctors started gaslighting me. They were like you can’t believe everything you read on social media. I was like, dude, I don’t even have social media, you know? And they were like you’re not going to feel better just because you explant. Of course, I’m going to feel better. They’re really uncomfortable. There’s a lot of nerve pain. Of course I’m going to feel better. What are you talking about? So then I looked into breast implant illness and like a lot of women, that is a powerful and painful moment. When you look at all that and you come to terms with what have I done? What’s happened? I didn’t know there could be systemic effects from breast implants. What does this really mean to my long term health? There’s a lot of emotions that come up with that moment, you probably have them too.

A: Oh yeah, it’s terrifying because it is all of the different things. Like with me, it was migraines while I had a history of migraines in my family. So I’m like it’s just this. Or I had gone through a very long contentious, custody battle. So I assumed, oh it’s stress. I had gaslit myself to think, oh it’s because I’m a woman. It’s my age. It’s all these things. It wasn’t until three years ago, I saw somebody on my social media talking about breast implant illness that I really started looking into it. It’s horrifying to know that something that you thought your only risk would be scar tissue really can rob you of your health.

D: And your youth and your comfort. I mean so much. I’ve had my implants out for four years and constantly thinking what does this really mean to me moving forward. I have them in my body for 12 years. How disruptive was that on a cellular level? Like what has happened from an aging perspective, a total wellbeing perspective, what are the downstream effects? I know and all the other women that have gone through it, there’s no answers.

BREAST IMPLANT ILLNESS IS REAL

A: No. Which is the most frustrating part because breast implant illness, they do just want to kind of shove it off as just some women. It’s a psychological problem. It makes me so mad because so many of us have such similar symptoms that it’s like, I could see if there was like a vast difference then okay maybe it’s that we’ve invented it. But when so many of us have the exact same symptoms and once there removed a chunk of those symptoms go away. It’s the implants.

D: Yeah. There’s photographic proof. This isn’t placebo and that’s part of why I like my story, I went into explant because of a rupture and breast cancer screening and impacts and discomfort, local discomfort. But within three months of my explant, my body completely reversed a disability. I was diagnosed with peripheral neuropathy in my upper body. I had lost the ability to do, I don’t want to be hyperbolic, but it was impacting. Gosh, over 90% of what I did with my upper body was impacted by this experience. I never once, even as I was being put to sleep for that surgery, I never once thought I hope this goes away. But three months later, you can see me right now. I’m fine. You know, and I had the best care to try to take care of that to try to improve that, to rehab that, and it was resistant to everything and doctors, occupational therapists, they were just shaking their head and how my body could not improve. I explanted and I feel like after my body recovered from the surgical trauma, it was free from that 24/7 battle against the bags. It didn’t have to do that anymore. And then it was like what’s going on with the upper body here. It fixed it. Like my body went back to healing, and functioning. So that’s not placebo. But when a woman has pictures of her skin with lesions and welts and all kinds of stuff, or other neurological, shaking or whatever, and then she explants and those symptoms improve that’s not placebo.

A: No, not at all. It’s frustrating that every level within the medical industry, that they don’t have the training, that they don’t have the education that there should be in this day and age. There should be more available to them. I even had issues with my eyes that they tried to tell me was because more people were working at home. But then when I go and I did the research and actually again was a symptom of breast implant illness. I had such bad inflammation throughout my whole entire body. I started noticing it about 34-35. I could barely walk up my stairs. I felt like I was like 95 years old and all of that inflammation, again, as soon as my breast implants, were out the pain in my joints is so much different. I unfortunately have a cyst in my back that again, only like 5% of women have and is linked to inflammation. So probably a sub result of my implants. Same thing with my teeth. My teeth have such bad inflammation. I will probably need to have my teeth removed because of it. And all of those things that like dentist, optometrist, your GP, nobody has the knowledge or the ability to tell you because it isn’t linked to an actual medical condition. It is so frustrating when I was looking for an explant doctor because of COVID and pandemic things there was about a two year wait list because all surgeries had halted. It took forever to get them out. So I was calling other doctors and other doctors were telling me that I should take them out and reimplant with something else. And that it absolutely isn’t this well, there’s a black box warning now on them, I think back to 2019 or 2020. You can’t say that anymore that it’s absolutely not that. It is really frustrating that profit over people’s health is prioritized in a lot of these industries.

D: Yeah. The brain injuries were first starting to be linked with the professional football players. It was met with derision. It was met with anger. It was shot down. There was a very big, powerful pushback against that, because look at everything that’s at stake. It took some time for the findings to translate into more and more research and then more and more prevention. I feel like we are all living this again with breast implants because it happened in the nineties, and I don’t know if you’ve ever gone down that painful path, but when you watch women from the nineties, the recording of women from the nineties talking. So you, if you really ever want to get good and mad, go watch Oprah, go watch Jenny Jones. There’s a Connie Chung deep investigative report that she did. You will not believe how you feel on the inside. It is really unbelievable. It’s the exact same words. It’s the exact same struggle and hurt and dismissiveness. Here we are, the big difference is that now women are very different. We do have different opportunities and different things that we can do. We can connect in very different ways and we can amplify our voices together, and they did their level best back then. They did some amazing things, but I know people that were involved in that and it felt like David and Goliath, and so that’s hard to maintain. The silicone breast implants got banned and then everything just kind of got quiet and then they just kind of slipped back in the market in the mid 2000’s. That’s when I got mine. I was in a clinical study, for the re-introduction of silicone breast implants in the USA but I was totally ignorant. I just thought if US doctors are putting them in women’s bodies, then these have to be appropriately studied and they gotta be good.

A: I thought the same, who would have thought that they would have put stuff inside of us that would kill us faster and make us sick. It never even would have occurred to me.

MORE MEDICAL DISCUSSIONS ARE NEEDED

D: Yeah. I never vilify doctors because I think back to my doctor and I know he believed what he was saying to me. He had been given data, he’d been shown stuff and he believed what he was told and then absolutely thought that he was helping a woman restore her post-pregnancy and nursing breasts. He thought that he was and he knew I was very afraid of surgery and being put under I’m just one of those kinds of people. He knew that was a really big concern of mine. He was really happy to be able to assure me that I could keep those for life, that they were the new gummy bear kind and that even if they ruptured, they would behave like a gummy bear and they would always hold their shape. He was really happy to be able to knock that out of the park for me, with that new option that was on the market. We know that none of that has panned out. It doesn’t behave in the human body, the way that it behaves outside of the human body. They liquefy, they do rupture. They don’t keep their shape, mine was dripping liquid silicone.

A: I do definitely agree with that. I believe that doctors take an oath to do their best. So I think, especially we both got ours around the same time. I want to believe that they really did think that capsule conjecture were the only really risk to them or rupture or things like that, I do believe back then that they didn’t have the knowledge about breast implants or all the risks that come with it. Now I haven’t sat in a plastic surgeon’s office, obviously to discuss reimplantation so I’m hoping for anybody who is considering getting breast implants, that they just know that this is a possibility, and I’m really hoping that their doctors walks them through everything that potentially could come through. Even if breast implant illness, isn’t recognized in their office to say, hey do your research and at least have that. But if any doctors telling you that your only risk is capsule conjecture please get a second opinion. Please ask elsewhere and do your research because. As far as I’m aware, there isn’t a lot of studies or a lot of knowledge on why some people do end up with side effects from it and some people don’t seem to have side effects. In Canada I think the percentage is that 60% of people end up having breast implant illness symptoms. And so again, it could be whether it’s silicone, whether it’s saline, because even saline breast implants would have a silicone base.

D: I’m sure it’s a complex multifactorial thing that involves many different things interacting within that woman. The other thing that we have to always be sensitive to is how long of a window are people being tracked? I don’t know about you, but I was in a clinical study and it was just abruptly ended very, very early. It was supposed to be a multi-year study longitudinal that was going to track women that had those new gummy bear implants in their body. It just abruptly ended. The data is used and talked about as if it’s definitive. It’s not definitive to study women with breast implants for six months, nine months, three years. It is not definitive to study women with breast implants for five years and say this is what you can expect it, because as you said, wisely when we first got on the call, some breast implants wear down in a few years and some implants last longer, and there’s variation in the device. There’s variation in the woman. You put those two things together and then you have to also consider other external things. The woman’s context if she’s in an environment that’s supportive and loving and safe versus one, that’s toxic and really difficult for her, all those things, come together and impact us. I think it’s really complex and that it is very important that women know just let us go into this with our eyes wide open. That’s what we need. You, and I both know, like we talked about, when you’re in the office and you’ve had your little fun where they give you the in office things and you stuff your bra, and you see how you look for the first time. At that point, they know it, the deal is pretty sealed. So they can give you a lot of information, you get your informed consent, but your mind is prone to dismissing that it says 50% of women get this. So that means 50% don’t you know what I mean? And so for me, we need to honor that and give women with breast implants real tangible ways that they can stay informed that they can watch for things in their body, that they can be stewards, extra careful stewards of their health and their wellbeing while breast implants are in their body. You know, rather than well no, they’re all safe. That is just an unreasonable approach.

A: It makes you distrust the medical industry in a lot of ways because it’s that constant messaging of it’s just in your head or that’s not a thing or it’s probably this, that, or the other. And then having to spend the money and having to spend the time and just feeling at a loss, for words of why things aren’t getting better when there is a really obvious solution that nobody wants to talk about and you potentially just don’t even consider it because of all of those things. That’s really what I would just hope for people as being able to have that knowledge and being able to feel like respected and safe to say, oh it could be this. Not necessarily that breast implant illness is necessarily the cause if you are having something, but it will be just have it listed as a possibility.

D: Yeah, exactly. If you’re going to a doctor and you have a lot of issues, but not any answers, it would be a mazing if you don’t have to do that for five or seven years, accumulating more problems. It’d be so nice if you had breast implants and you start having mysterious declines on your health and you know, much more quickly that maybe it’s my breast implants. Just think of the years, the quality of life that could be saved if breast implant illness were normalized as something to consider, you know? That’s what I feel is very sad and unfortunate about this is that anytime humans engage an all or nothing thinking it can be really unhelpful. So there’s a camp that’s like breast implants are all safe, they don’t cause this kind of systemic stuff, you might get some rippling, you might get this capsular contraction, dah, dah, dah. But other than that, it’s good. Then there’s it’s like they’re not all safe. I just think that women are going to want breast implants. I just do and if they’re offered, rather than try to do that all or nothing kind of thing, or black and white or all good or all bad say, yeah, here you go eyes wide, open move forward. And here’s what you need to be on the lookout for if you start getting more questions than answers, mentally prepare yourself, emotionally prepare yourself that these just may not work out for you. You may need to get them taken out a lot sooner than you would like. Really it’s almost like, there’s like a waiting period in some states when people are wanting to get divorced, and they have to go through like a six or nine month, like period. I hate to bring up this issue, but there is a waiting period if somebody wants to buy a weapon, people have to in some states, not all, but in some states there’s a waiting period. Maybe there should be something like that with breast implants because you get so excited, but maybe it should be like okay we’ve got you sized now take this information, take all of this. Here are different resources and you can’t have this surgery there’s a mandatory waiting period of 30 days or you know what I mean? And just see what happens if those emotions can soften. And if the thinking self can come more online and kind of look at the information that’s available now that wasn’t available to you or me, you know?

FINDING AN EXPLANT DOCTOR

A: Yeah. Just being able to have that really informed consent and that really informed decision-making versus just they’re big and they’re fun and you’ll love them and go bathing suit shopping. Did you find that it was hard finding an explant doctor?

D: I live outside of Chicago, so it wasn’t really hard for me. Not at all. I didn’t know what I know now. Now I know that there’s some explant surgeons around here that I would have loved to have gone to, but I just didn’t know. I just did a Google search and typed in breast implant removal. And then on my own, I explored the different approaches to breast implant removal. I learned about, the enbloc where you can remove it with the scar capsule intact and get it out out of the body or capsulectomy or partial capsulectomy. I made my own decision before I even stepped foot in an explant surgeon’s office. I knew what I wanted because I was convinced that I had a ruptured silicone implant. I went and met with them and I always say to women, this isn’t like getting a tooth pulled, right? So like anyone who goes to dental school, they all get trained and pulling teeth, so if you have a worsening tooth problem, you can kind of go to like the nearest dentist, but with explant, this is an evolving area of women’s health. It can be a complicated and involved surgery, especially if you do the enbloc approach. I really encourage women, you may need to be willing to travel depending on where you live. Don’t just go back to the person who put them in. Don’t just choose somebody because they’re closest to you, really check out is this person, are they double board certified. What’s their skill level? How many of these surgeries have they done? What kind of complications have they seen in their practice? I was given after my explant surgery, my aftercare instructions were the aftercare instructions for breast augmentation patients. I called the office and said, there’s a mistake. I was given the wrong aftercare. And they were like, no it’s pretty much the same surgery in reverse. I was like, really? Cause I’ve had breast implants put in and that was fun. I didn’t have drains hanging out of me and this surgery actually doesn’t feel the same at all. It feels very different and I’m in excruciating pain. I don’t know about you, but how was your surgery relative to implant?

A: I was lucky in the sense that the surgeon that I had came recommended and was local to me. So I was able to have it in the hospital versus their surgical center, which is most common, but same thing I was given a chest surgery as if it was potentially like an open chest surgery versus an actual explant. The hospital had no knowledge (of explant specific aftercare). And that’s the only sort of negative I would say about my surgeon is his aftercare has been super confusing to the point that I didn’t know when to take the tape off. I didn’t know exactly like how much it could move my arms. What I’m supposed to do when I went into his office again. You forget all of your questions because you’re in this fog of being a medicated and being in pain that it was like to ask those questions or those follow-ups. There wasn’t a lot of information. Granted, I was lucky in the sense that he believed in breast implant illness, even though he couldn’t confirm its existence that he had done, I think about 600 of the surgeries. He said there was only 60 patients out of 600 that didn’t have any relief from their breast implant illness. So he was knowledgeable on that scope of things, but yeah the aftercare part, it definitely left me feeling confused. I will say I have a very high pain tolerance and I was very worried about the drains and just being in excruciating pain. I would say within the first two weeks of being post op, I maybe had two really bad days, where I was in say pain higher than a seven, but overall I was fortunate enough that it wasn’t as bad as I was picturing in my head. The drains I almost thought psychologically the idea of having some in me, it was going to bother me. And I accidentally pulled half of my drain out the day I left from the hospital, not to the point that they had to do anything with it, but to the point that it then made it a little bit more painful to remove, but he only kept the drains in me for two days, but based on the information from the chest surgery, I was still draining on one side, way more than they recommended. So it was also like, should you be taking this out, but even things to watch for it, as far as like swelling, I don’t know what’s normal. As far as like, any of that kind of stuff, like say after you get your implants and they tell you to like massage things, to be moving things around, I literally don’t know what I’m supposed to do post-op that it’s, it’s a very confusing and scary because again, the surgeries are not the same. I had implant under the muscle. I had a little scar underneath both of my breasts. Now, in this case I have from my mid ribs all the way over it to maybe like an inch in between my I guess my cleavage, all scars that it’s a much more invasive. It’s a much harder surgery and the recovery, I would say for getting implants in, I was back to work maybe two weeks after I put them in and I have six weeks off and I’m not even sure that it’s going to be enough time.

D: Oh, wow. I mean and you’re raising so many really good points that this is like I said, it’s an evolving area of women’s health. It gets extra confusing because women go into all the different social media groups. And each doctor has different approaches that work in his or her practice or that they just really believe in. So a woman in practice A will get completely different directions than a woman in practice B. This is what I say I noticed this from a public health scientist perspective and a clinical psychotherapist, what happens is that the destresses that activates your nervous system, you don’t feel safe. You’re confused. You’re wondering should I have drains, should I not have drains? This doctor never uses drains. This doctor makes you have them for 14 days. What is best for me? You described your scars. My scars are tiny, and even to this point, I’m like did he really take them out that way? Like, I mean, we just, our minds are really powerful on this journey because we are kind of forging this information as we’re moving forward, and there isn’t this huge body of knowledge yet. So this isn’t like tooth extraction, and I think it just really comes down to being able to communicate with your surgeon having somebody that’s accessible to you and listens to you and that you can meet with afterwards, if you’re having any complications, but like you, I mean I was told I could shower, like the next day. I never had anything on the incisions, not at all. Just like a little bit of gauze underneath the surgical bra. I see other women and the scar, care’s like a really big deal at the practice that they were at it’s so interesting and it’s just confusing to us and not good for our poor fried nervous systems.

A: I hope for it going forward is that again, we’re almost like the testers. For the next wave of people that do end up getting implants or explants that hopefully collectively the doctors will get on the same page and the people will have more information so that they will feel safer in this journey, even if we didn’t get that opportunity.

HELPING WOMEN FEEL CONFIDENT TO HAVE THE CONVERSATION

D: Yeah, exactly. And just like us having this conversation right now, and it has been much more normalized for people to be able to talk about personal things for people to be able to talk about medical things, surgical things. I mean, you and I have said the word breasts so many times in this episode and that’s different than it was before. I don’t think that there should be any stigma around the fact that a woman had breast implants, for whatever reason, if she wants to talk about the experience of her journey with them, her decision to remove them or her need to remove them. I think it’s fabulous that we’re able to do that so that other women can hear this. And, if they feel overwhelmed if they’re at a different place in their journey than we are, being able to point them in the right direction help them kind of find their way through this evolving area of women’s health.

A: I really do like that too. I don’t think there does need to be any stigma. I really hope with more people talking about breast implants and breast implant illness that we just bring awareness to it because of whether somebody chooses to get them, or they decide after hearing about it that they don’t. I just really hope that everybody, like we’ve talked about just has all of the information to feel confident and be able to trust that they’re making the right decisions for themselves. So that they aren’t stuck in this wave of not knowing what the repercussions are, what the costs are involved, because I don’t know about you, but getting the implants. I got them through a medical school. So I was basically some guys final project. I paid about $4,000 to put them in. I paid 15,000 to get them out because again, the benefit to the medical industry in some ways at this point is because it isn’t recognized as a condition that it isn’t covered by any sort of insurance practice, at least here in Canada.

D: Yeah. Some women in the US are having more success and getting it covered. But again, it’s highly variable. You can have two women with the same insurance and one of them manages to get it done and a hundred others can’t, and that is another thing that is really, really frustrating that the idea that, and I’m speaking from the women who opt to augment or restore, the idea that well you elected this and so you’re totally on the hook to pay to get these things out of your body, even though you’re getting them out because they’ve caused XYZ issues. You know, and I naively thought that women were breast cancer were always in a different category because legally any further surgeries that involve their breast or breast implants or reconstruction is supposed to be covered by their health insurance. But I’ve recently learned firsthand from a woman with breast cancer that was really not her experience at all.

A: Or the people that end up with the implants that get recalled. I’m not sure about in the states, but in Canada and unless they are recalled and to the point that you do have a rupture that’s causing you like deadly harm or have given you breast cancer, they won’t take them up for you. You’re a hundred percent on the hook, even though you have devices in you that have been medically recalled.

EXPLANTS AREN’T JUST BECAUSE OF BREAST IMPLANT ILLNESS

D: Yeah. It’s really disturbing. I think it’s also important in these conversations for us to, speak to women who don’t identify with breast implant illness, but who are considering removing their breast implants for other reasons. I think it’s important that we not equate explant with breast implant illness, because there’s so many other reasons that women will choose to remove. I’m always concerned about those women may be feeling marginalized or like they don’t really have a place where they can connect with other women around explant. That’s why I made my Facebook group. It’s open to anyone whose life journey includes breast implants. And you’re welcome there if you’re considering them or you have them and you love them, but you’re scared about all this stuff. Or maybe you have them and you don’t love them, or maybe you’re taking them out or you’ve taken them out. So it’s a pretty cool little diverse group of women. It’s really there to be like a place to connect with other women on the inner journey, the emotional and mental and social, the relationship impacts, the I don’t want my partner to see me after afterwards, or I don’t want to be seen, I don’t want to go to the pool. I’m dreading seeing my in-laws, oh my gosh. I lied to my daughters they had no idea I had breast implants and now I have to have this surgery and I don’t know how to talk about it. The focus of the group is different than the other groups, but if any of your listeners have breast implants and they’re considering what they want to do with it, and they don’t identify with breast implant illness, they’re just considering it for the reasons, they’re welcome in that group. And just for them to know that they’re not alone, that women remove breast implants for all different kinds of reasons. I know women who removed them because their lifestyle changed and they are doing organic clean living and it’s a values violation for them to have those bags filled with chemicals inside their body, or some religious women are like I feel like I corrected God, you know? And just all different reasons that women remove. Like, I really missed hugs. Like all of my hugs were just completely compromised, but like I said it took that obvious shape change for me to finally act on my behalf. So I always wanna like pull in other women who maybe are in that early stage of considering and just let them be around women who have gone through the journey so that it’s not as scary because you and I are, we’re doing fine.

A: I do think that is important. I do think that people that want them out for other reasons, do end up kind of getting pushed aside or marginalized. It’s like there’s no wrong or right reason to want explant. Whatever is the right choice for you and your body is completely valid. I know as somebody who went from having small breasts and big breasts, they also get in the way like if there is a lot of like nice benefits of just having them gone from the hugs or when my daughter is young enough to cuddle, like she couldn’t cuddle in the same like little nook because that nook wasn’t there. Whatever reason, whatever choice you make for your body is the right one. If people are trying to look for your group or want to work with you, where can they do that?

D: Probably the very easiest thing is to just go to my website, which is my name so it’s AmandaSavageBrown.com. Once you’re on my website, there’s free resources for women going through this journey. So there’s an ebook that you can download that teaches you five science-based ways to steady your nervous system when you’re feeling overwhelmed, which is so important before, during and after breast implant removal. That’s why I made that resource free. There’s also my blog, which I’m working on. It has maybe 10 or 11 articles at this point take a very different and unique perspective on all of this, because it does focus on the psychosocial aspect, which is deeply felt, but often overlooked. And then you can sign up for, I have something called the Bright Insiders. I do not spam. I do not funnel none of that stuff. It’s if you want to connect with me, if you want to keep abreast of my forthcoming book, that’s a good way to do it. I’m also going to start sharing with the Bright Insiders, like advanced copies, guided audios that I’m making for women who were on these journeys that they can listen to as they’re moving through. They can also find the link to join that Facebook group. It’s called Breast Implant Through Explant Inner Companions and it’s a small little group. I just started it last fall but it’s an agenda free, safe space. So I think that’s that’s best. They can follow me on Instagram at Dr. Amanda Savage Brown. I love to connect with women. I’m actually pretty active in all of these things and I just had a woman the other day reach out and was like where should I go in California? I just like connecting women to resources and helping women out on these journeys.

A: Perfect. I really appreciate you having this conversation with me and I love that people can connect with you and actually get that science-based theory and actually get to the root of having them be healed. So thank you so much for taking the time to have this conversation with us today.

D: Yeah. Thank you so much. I was excited to connect with you because of your recent experiences. So I’m glad we connected and I appreciate your time.