147: Could Breast Implant Illness Be Your Rash Trigger? w/ Dr. Anthony Youn

Today's episode is focused on breast implant illness, and its possible link to skin rashes. My guest will explain exactly what breast implant illness is, and why women may experience it.

Or, listen on your favorite app: iTunes (Apple Podcasts) | Spotify | Stitcher | TuneIn | Subscribe on Android

My guest today, Anthony Youn, M.D. F.A.C.S, is known as America's Holistic Beauty Doc. He is a nationally-recognized, board-certified plastic surgeon.

Recognized as a leader in his field, Dr. Youn is the author of the best-selling books The Age Fix: A Leading Plastic Surgeon Reveals How To Really Look Ten Years Younger and In Stitches: A Memoir.

His public television special, The Age Fix with Dr. Anthony Youn, has been viewed by millions. Dr. Youn also hosts the popular podcast, The Holistic Plastic Surgery Show.

His new book, Playing God: The Evolution of a Modern Surgeon, details his humorous, heartwarming, and often harrowing journey to become a leading plastic surgeon. He is an Assistant Professor of Surgery at Oakland University / William Beaumont School of Medicine.

Join us as we talk about breast implant illness, and whether it could be a factor in skin rashes.

Have you experienced symptoms of breast implant illness? Let me know in the comments!

In this episode:

  • What is breast implant illness?
  • What causes breast implant illness?
  • Is it normal to react to silicone?
  • Do women who have had breast implants removed see a difference in their symptoms?
  • How would a skin rash present itself?

Quotes

“Inside the silicone rubber implant is either saline or salt water or is a silicone gel. We don't know what it is that you react to. Most likely it's the fact that it's silicone that's inside your body that you're reacting to because you shouldn't react to saline.” [4:41]

“There are a lot of reasons you get rashes, and people get rashes and they don't have breast implants. But if you get to that point where you say, “I am sick, and we can't figure out what's going on with me,” and you have breast implants, then that's something to definitely look into.” [13:31]

Links

Resources on Topical Steroid Withdrawal

Find Dr. Youn online

Jennifer's appearance on Dr. Youn's podcast, The Holistic Plastic Surgery Show – Episode 136: The Healthy Skin Diet

Healthy Skin Show episode 033: Tackling Scars And How To Support Sensitive Skin w/ Dr. Anthony Youn

Playing God: The Evolution of a Modern Surgeon

Youn Beauty Brightening Cream

Follow Dr. Youn on Instagram | Facebook

147: Could Breast Implant Illness Be Your Rash Trigger? w/ Dr. Anthony Youn FULL TRANSCRIPT

Jennifer: All right, Dr. Youn, thank you so much for being back. I really appreciate it, and I felt like you were the best person for me to talk to about this particular topic today. And in fact, you already kind of schooled me on it. I thought it was breast implant illness syndrome, and you're like, “I don't really think it's a syndrome.” For those who are listening to this who have considered getting breast implants or maybe have them and have heard through the grapevine or the webosphere that maybe your breast implants are causing a problem with your health, what exactly is breast implant illness?

Dr. Youn: Good question. Breast implant illness is something that has been making more and more news over the last couple years, and it is a constellation of symptoms that some women have, symptoms ranging from fatigue to muscle aches, to rashes, to joint pain, to hair loss, and many, many more that have been attributed to their breast implants. Now, if you were to have asked me as little as five years ago whether there was any proof that breast implant illness exists, the answer is that there actually really wasn't a whole lot. At least that's what we, plastic surgeons, have told ourselves. If you look at the actual plastic surgery scientific literature, there is very little information there to support the actual existence of breast implant illness, that women get sick from their breast implants.

Dr. Youn: But over the last several years, and if you really, really do look heavily into the literature, there are some studies, especially recently, not in the plastic surgery literature, not in the stuff that we plastic surgeons read, but in the rheumatologic literature showing that there is a possible connection between breast implant illness and silicone breast implants. And there isn't a lot out there. Unfortunately, the studies are fairly small. There was a recent study that basically it was a study that took a bunch of other studies and put them together, analyzed them together, and did find a higher risk of certain autoimmune diseases like Sjogren's syndrome in women who have silicone breast implants versus women who don't.

Dr. Youn: And so more and more now there is this movement that is basically created by women who have had breast implants or who have them who have these symptoms and they're bringing it out into the forefront. And finally, plastic surgeons and the major plastic surgery societies have responded. And the FDA is also now responding and saying, “This is a real, real thing.”

Jennifer: Yeah, and I saw the notice on the FDA's website, which I was pleasantly surprised actually to see. I was like, “Wow, they're actually on top of this much more quickly than I would have thought.” But that said, you mentioned silicone breast implants, but I feel like aren't there different types like saline or something? Is it a specific type where you really have to worry, or is it just all breast implants in general?

Dr. Youn: If you actually look at the studies, the studies all look pretty much at silicone breast implants, and those are the studies that do appear to show a potential connection between silicone breast implants and those symptoms of breast implant illness. But if you actually look at patients and you talk to patients and you get their stories, there are a lot of women with saline breast implants who have the same type of issues. So I don't think that saline implants can protect you from breast implant illness. And unfortunately, it does appear that you can get it with both. There aren't studies on saline implants that are out there. It's just more anecdotal.

Dr. Youn: But I do think from what I've seen and the numbers I've seen and talked to other plastic surgeons and reading these patients' stories and talking to my patients, it does appear to be… It doesn't matter whether you have saline or silicone.

Jennifer: Okay. And do they have to maybe have a leak in them in order to cause this issue?

Dr. Youn: No, definitely not. A lot of women who do have breast implant illness do have implants that are completely intact. Why is it if you've got an intact implant that this can create these issues? Well, the outer part of the implant is made of silicone. It's silicone rubber. Inside the silicone rubber implant is either saline or saltwater or is a silicone gel. We don't know what it is that you react to. Most likely it's the fact that it's silicone that's inside your body that you're reacting to because you shouldn't react to saline. I mean, it's just saltwater. I mean, we put it in IVs millions of times a day and people do fine. We think that there probably is something to do with the silicone outer shell.

Dr. Youn: There are some people who hypothesized that maybe it's heavy metals and other substances that could be inside the shell, as well as the internal gel. But no, you do not have to have a broken implant to have these symptoms.

Jennifer: And was there a reason why maybe silicone was the substance of choice to create that outer housing? Is that a normal thing for us to react to silicone? Is that normal?

Dr. Youn: Yeah. Silicone is used for medical purposes in a lot of different things. Because as far as we know, it's as inert of a substance to our body as we know of. For example, there are silicone implants that are put inside hands. If you've got, let's say, a bone of your hand that is removed because it had a fracture or at necrosed, then there are implants that are basically made of silicone that are used. More and more often now they're going more towards things like titanium and those types of things. And so the reason why silicone is used, same thing as like titanium, is the body doesn't appear to react as aggressively to that as if you put something in that was made of a different substance that the body could react very aggressively to.

Jennifer: Interesting. Wow. Theoretically then, this might even be beyond breast implants. Somebody who says they had an implant or some other type that has silicone could also have potentially, we don't know, but could potentially have an issue as well with the silicone if they never thought of it before.

Dr. Youn: Yeah. There is actually a term called ASIA, A-S-I-A, and it's autoimmune disease stimulated by like adjuvants. I'm blanking on the exact name, but basically what it is is that people who develop autoimmune symptoms due to a foreign substance in their body. And silicone breast implants being the big one, I suppose people put in butt implants, I put in shin implants in people who are made of solid silicone, those numbers though are fairly small when you compare those numbers to numbers of women with breast implants. It's possible that there's risks with these other types of implants as well, but maybe we just aren't seeing the numbers because there just aren't enough people to create this kind of this large movement.

Dr. Youn: When you've got millions of women with breast implants and you have tens of thousands of them or more joining these Facebook groups, I mean, you need to have those numbers obviously to get that. I mean, I think what we have to keep in mind is that with any cosmetic treatment or any medical treatment at all, we have to understand bio-individuality. And the fact that just because your neighbor has breast implants and feels great and looks great and had a great result and no issues with their health, that doesn't mean that's going to happen to you. There are even people talking about Botox, and we do Botox. That's the most common cosmetic procedure in the world. Five million people have it done here in the United States every year.

Dr. Youn: Yet there are a number of people who believe that they have systemic and chronic symptoms, health issues even due to injections of that. I don't see any of that in our literature. I've never had a patient with an issue like that that I know of, but I mean, these are things that we have to always pay attention to.

Jennifer: And I think it's important for people to know. You both put in breast implants and you also remove them, and you do all sorts of different procedures. This is something that you're actively… This is your world. This is your wheelhouse essentially. Do you have both women who come to you? I assume there's still women now that want to have breast implants done. Do they also have the concern that they could have a reaction, or most women are usually not concerned about that?

Dr. Youn: More and more people are becoming more aware of it, and I think that's the most important thing. And so all of my patients who I see now, that is something I bring up with them. And I tell them, “Look, we don't have the studies to give you definitive answers and percentages,” because people ask, “What's the chance that this is going to happen to me?” And my answer is I don't know. There are two small studies that do show that if you do have a history of autoimmune disease, one of study looked at that, another study looked at if you have a history of severe allergies that you may be at higher risk for breast implant illness, but these are small studies.

Dr. Youn: And so that is something that I do tell them, “Hey, if you've got a history of autoimmune disease, you need to be aware of this. If you've got a history of severe allergies, you really need to be aware of this. And you really have to make sure that this is a decision that you feel is right for you because you may be at higher risk.”

Jennifer: And then you, on the other side, have women that come to you that maybe have had them put in, maybe even not by you per se, and are like, “Look, I would like to have these removed.” Is the reason they tend to want to have them removed because they are having symptoms?

Dr. Youn: It's both, some people who are having symptoms and some people who are afraid. You know what? I think the tough thing in my specialty and something that we as plastic surgeons should be ashamed of is that there are still plastic surgeons out there, and there have been a lot in the past, where they have poo-pooed women's symptoms with this. For example, I had a patient who I actually did breast augmentation on about 10 years ago, went to a different plastic surgeon about a year ago in my region, in the Metro Detroit area, and said, “Hey, I had these breast implants put in 10 years ago, and I think I'm having these types of symptoms. My hair is kind of getting thin and this and that.” And she was there with her husband who was actually there for a consultation.

Dr. Youn: And so she asked this plastic surgeon as an aside like, “Hey, just wanting to bend your ear on this while we have you here.” He is an older doctor and somebody who's been here for quite a while. Guess what he told her? He said, “You need to see a psychiatrist,” is what he told her. That was his response to her. And then a couple of months later, she came to see me and she said, “Look, I've got this. And I saw this other plastic surgeon and he said I need to see a psychiatrist.” I mean, I was dumbfounded. I mean, appalled that somebody would have as a physician, I mean, mind you, would have that type of an attitude.

Dr. Youn: But this is also a doctor that I have heard from my patients that when a woman comes in thinking about breast implants, oftentimes he doesn't talk to the patient. He talks to her husband.

Jennifer: Right. There's a pattern there. Sure.

Dr. Youn: Yeah. It baffles me that somebody could be in this type of business with 90% of your patients are women and this is how you treat them?

Jennifer: That's not really right. But in your case, I know that you take a lot of time with patients. You listen to them, and you really talk to them. It's one of the things I really appreciate about you as a person, but also the fact that we could have this conversation, which is I would say to some degree a bit still controversial.

Dr. Youn: Mm-hmm (affirmative).

Jennifer: I didn't want to have some like, oh my gosh, it's going to kill you. It's going to make you sick. I don't think that that's really a practical conversation to have in this day and age. I think people need to have information so they can start to either do some research on their own, but ultimately you got to make the best decision for yourself in conjunction with your physician, right? I assume when women come in and have these concerns, you guys sit down and kind of hash things out.

Dr. Youn: Oh yeah. If you're thinking about breast implants and let's say you're listening to this podcast, the first thing you want to think about is, can I be happy in my life, completely happy, and not have breast implants? And if the answer is yes, then reconsider, because there are complications that can occur with breast implants. You know? I mean, when you look at breast implants, yes, the satisfaction rate is extremely high amongst people who have it done, like 97%, but there are definitely issues that can develop. You know? You will likely have multiple more operations throughout your lifetime. There are complications that can happen, and obviously breast implant illness is something that you have to always keep in mind.

Dr. Youn: If, however, let's say you're listening to this and you have breast implants and you say, “Well, geez, I've had breast implants for a few years, and I love how I look. But yeah, I've started noticing that I've gotten these weird rashes, or my hair starting to fall out, or I've got this weird pain,” the first thing you want to do is get a regular workup by your regular physician, because there are a lot of reasons, especially as women get older, that their body changes. And I'm sure you've covered a lot of this stuff. There are a lot of reasons you get rashes, and people get rashes and they don't have breast implants. But if you get to that point where you say, “I am sick, and we can't figure out what's going on with me,” and you have breast implants, then that's something to definitely look into.

Dr. Youn: Unfortunately, there's no test for it. There's no blood test for it. There's no skin test. Really the only test of whether you have breast implant illness is to take your breast implants out and see if you feel better. And that's a big step for a lot of women. That's the challenge we have. I would love if we were to have some type of way we can test somebody and like, “Oh, it's positive. You've got breast implant illness.” Unfortunately, there just isn't, and hopefully someday there will be.

Jennifer: Can I ask you? With the patients who felt that they had a myriad of symptoms and that it might be connected to the breast implants, how long and actually even do they tend to feel a difference after surgery? And if so, is it immediate? Is it like months later, years later? Any thoughts on that?

Dr. Youn: No, it actually can be quite immediate. For example, I had a patient who came to see me. She had had breast implants for many years, and she actually listened to one of my podcasts on breast implant illness. And she said, “You know what?” And initially she said, “You know what? My breasts are bigger than I want them to be. I'm thinking of downsizing.” And then we talked about it. And she listed my podcast actually after we talked initially about downsizing her, and she said, “Maybe I should just take them out.” And as she started doing more research, she's like, “Oh my gosh, I've got all of these symptoms.” I brought her to surgery. I took her implants out. I even removed the capsule, which is the scar tissue surrounding the implants. And within about two weeks…

Dr. Youn: She ended up having… There's a list online of like 40 different symptoms, ones that I mentioned in many others. And I think she ended up starting with like 30 of them. Within two weeks, she dropped down to having 10 of them left. And then about six weeks after that, virtually all of them were gone.

Jennifer: Oh my gosh.

Dr. Youn: This is something that quite often you hear very quickly that they come out and within days they feel much, much better. But unfortunately, it's not everybody, and there are some small studies that have looked at removing breast implants and whether the symptoms get better. The studies do appear to show that if you have a diagnosis and a rip-roaring history of autoimmune disease, if you've got lupus or rheumatoid arthritis and it's been going on for decades and you've had implants for decades, you take those implants out, most likely your symptoms are not going to improve or they're not going to resolve. They don't have this great a chance, unfortunately.

Dr. Youn: But if you have symptoms but not necessarily a diagnosis and your breast implants are removed, anywhere from 50 to 75%, possibly more of them, do achieve resolution of their symptoms.

Jennifer: That is super interesting. I mean, I guess the other thing too to consider is like, if you want to take the more conservative route, you could look at your symptoms from other perspectives and address those from stress management, making sure you're nutritionally replete, looking at gut health, looking at liver function, doing all of that stuff first. And then if you're like, “I still can't get these symptoms to alleviate,” then you kind of like got into like… You're kind of at like, “All right, I guess we can say this might be the case.”

Dr. Youn: It's one of those where if you said, “Well, I don't really want these anyway,” then by all means, take them out. But if you do want them, because yeah, you take implants out and it really changes the appearance significantly, in most cases, then yeah. In general, I encourage my patients, try to make sure that there isn't something else going on. Because the last thing we want to do is take something that you may be very happy with, that may contribute to a positive sense of self and self-image interfere with that and find that you still have symptoms because that wasn't the problem to begin with. Because not everybody with breast implants develops symptoms. I think it's a small percentage in general that do.

Jennifer: I know that you mentioned how rash is a symptom, and I'm thinking to myself, okay, well, is that a rash anywhere on the body? Is it just across the chest and the abdomen where the implants typically are, or maybe if we had a silicone implant or some other device implanted someplace else? Do you have any thoughts on how the rash in general would present itself?

Dr. Youn: In general, it's a patchy rash, but there are no… Unfortunately it doesn't necessarily follow a pattern that everybody gets. That's the issue with breast implant illness is that it is… That's why we call it more of this constellation of symptoms because some people may have one and other people have another, and that's the difficult thing. And unfortunately, there aren't studies, large studies, that have gotten that type of information for us saying, “Okay. 90% of people have a rash. 70% have muscle aches. If you have a rash, it's in this part of your body.” There just aren't studies that I know of that have actually compiled that together.

Dr. Youn: However, there are studies going on now, which I really applaud our plastic surgery society, is they're actually doing these studies now to try to get to the bottom of all of this. And all of this has been spurred by women who would not allow doctors, like this doctor I mentioned earlier, to blow off their symptoms. And they got together and they rose up and they said, “We're going to create a movement here because if we don't do it, nobody else will.” And I admire them because this is information that needs to get out there. This is from a plastic surgeon, and I do breast implants. And I think the majority of women who have breast implants, they're happy with them, they're healthy, but that's not everybody.

Dr. Youn: And people need to be educated and aware if they make this decision that there are potential consequences.

Jennifer: And that is very true. That's why I thought you were the perfect person to talk to about this so that whoever is listening to this, no matter where you are, or say someone who has had breast implants and they are having issues with their health, this could be a great opportunity to share this show with them. That way they can begin to dig a little bit deeper on their own without necessarily feeling like there's some… This isn't life or death. I mean, that I think is an important point to make. It can feel very overwhelming sometimes when we start to dig into websites and research, and you're like, “Oh my gosh, everything feels like an emergency.”

Jennifer: But I do think it's critical that we have a conversation about this in a way that is, I don't know, measured to some degree. Because I always get nervous when people say, “This is the next big thing,” and then everyone believes that that's what they have. And then we're taking very drastic measures, as you pointed out, that may or may not be necessary for you, because what is going on with one person may not be going on with someone else. Any final thoughts that you'd love to convey to anybody out there listening to this going, “Oh my goodness, this sounds like me.”

Dr. Youn: Yeah. I mean, I think the thing to keep in mind is that there are people out there who are saying, “Breast implants are poison. You're putting poison in your body.” And then there are people out there saying, “Breast implants are 100% completely safe, and breast implant illnesses is a farce.” And like probably most things in life, the truth is probably somewhere in between. And if you are having these types of issues, definitely I encourage you to speak to a board certified plastic surgeon who will listen to you and who believes that breast implant illness is real. And if the surgeon does not and they dismiss your symptoms and they dismiss the diagnosis, then find somebody else who will listen to you.

Dr. Youn: And if you need to take your implants out, be careful as far as surgery because obviously those are permanent consequences. Really take time, weigh your options, talk to your physicians, do your research, and in the end, do what you feel is best for you because you know your body better than any of us.

Jennifer: That is so true. That is so true. And I just want to thank you so much for coming on and talking about this. And for everybody listening, in the event that you haven't heard Dr. Youn on the show, this is actually his third appearance, he has his own great website, dryoun.com, but he has a podcast as well. You may find a lot of additional information over on his show that will also help you make a decision. It's called The Holistic Plastic Surgery Show. I've been a guest on there, and we'll link up to that in the show notes, as well as his website. He's over on Instagram. He's even on TikTok. I feel like you're like the funniest doctor over on TikTok and Facebook. You're everywhere.

Dr. Youn: I've discovered that I have a sense of humor of a 14 year old boy, I think, and that's why I've done well.

Jennifer: Well, you do have a very good sense of humor, and you are genuinely a very kind and just… You're really funny, but you're also incredibly kind. And the one thing that I loved about you, when I met you initially, I was like, he's a plastic surgeon. I don't know. And then I just talked to you. And I just want people to understand that I don't just know you from this. We know each other in real life, and I deeply appreciated your care and your willingness to look deeper into what's going on in your respective field. I think most of us just blow people off and saying, “Oh well, they just do this,” and you don't. You are different, and that's why I feel like we've become such… We're good friends.

Jennifer: And I also deeply respect everything that you do and love having you back on the show. For everybody that's looking for more information, Dr. Youn's website is an excellent resource and all of his social media and his podcast are an excellent resource for you to check out. Thank you so much for joining us again.

Dr. Youn: Thank you, Jen. This was fun. I appreciate it.

“Inside the silicone rubber implant is either saline or salt water or is a silicone gel. We don't know what it is that you react to. Most likely it's the fact that it's silicone that's inside your body that you're reacting to because you shouldn't react to saline.”