Unmasking Breast Implant Illness with Dr. Robert Whitfield | Ep 55

Welcome to the Libido Lounge

Dr. Diane: Welcome to the Libido Lounge where we focus on all things love, lust, and libido. We believe that fabulous sex is just as important to your health as exercise and good food.

Everybody, welcome back to another episode of the Libido Lounge. I’m your host, libido expert Dr. Diane, and I’m so excited about the conversation we’re going to have today. This is with board-certified plastic surgeon Dr. Rob Whitfield, and it’s an important one.

I’ve seen this so many times in my practice—people are sick for a long time, their libido is gone, their relationships are struggling, they’re fatigued, foggy, and have no idea what’s wrong. One of the key components I’ve found is breast implant illness. That’s why I had to bring Dr. Rob on today to talk to you all.

What Is Breast Implant Illness?

Dr. Diane: Rob, let’s start here. Do people even know what breast implant illness is? Are people aware of this?

Dr. Rob: Thank you for having me. I’ve spent about seven years on this journey helping patients. I just saw someone who had been told they were a hypochondriac, that nothing was wrong with them.

I consider breast implant illness to be a chronic inflammatory process. Some people develop chronic symptoms while having a breast implant. About 30% of the time, we find the implant has a bacterial contaminant—like Cutibacterium acnes or Staph epidermidis. That bacterial presence can trigger a cascade of symptoms like fatigue, hormonal disruption, and more.

We also have to factor in environmental exposures—like phthalates from plastic bottles. Yes, stop drinking from plastic bottles, everyone. Those things can really affect your endocrine system. Thyroid goes off first, then we see sex hormone imbalances.

How Hormones Play a Role

Dr. Diane: A lot of women in my audience are peri- or post-menopausal. They’re already dealing with hormonal abnormalities. What are the signs that breast implants might be contributing to their symptoms?

Dr. Rob: If a man comes in with low libido and fatigue, the first thing we look at is testosterone. But for women, we don’t do that nearly enough. Women only need about 1/12th of the testosterone men do, but it’s still critical. I ask women: Do you have a libido? Can you work out? Do you have energy?

One woman recently told me she didn’t have the energy to play with her 7-year-old. That’s heartbreaking. In those cases, I check both total and free testosterone. I typically recommend pellet therapy—though not pushing one therapy over another, it’s just what works in the context of surgical recovery.

Testing and Optimization Before Surgery

Dr. Diane: What kind of testing are you doing to determine all this?

Dr. Rob: We use serum (blood) testing to dose hormone therapy. For breast implant illness specifically, we’ve stuck to a core group of tests:

• DNA saliva testing for estrogen metabolism, vitamin D metabolism, detox pathways, glutathione, and antioxidants
• Gut microbiome testing
• Urine tox tests for mold (mycotoxins), heavy metals, and phthalates
• Food sensitivity testing through serum

We’re also starting to use metabolomics, but not for every patient just yet.

The Treatment Process for Breast Implant Illness

Dr. Diane: So once someone is diagnosed with breast implant illness, what does the treatment process look like?

Dr. Rob: Treatment involves explant surgery (removal of the implants) and detoxing the body. We use a group of functional practitioners—both in-clinic and remote. Our detox protocol uses CellCore supplements, but everything starts with thorough testing.

People’s detox needs vary depending on things like where they grew up or what toxins they were exposed to—environmental, occupational, etc.

Breast Implant Leakage and Lymphatic Concerns

Dr. Diane: What about implant leakage or issues with the lymphatic system?

Dr. Rob: Yes, we definitely see lymphatic congestion pre- and post-op. We use devices like Fesso and lymphatic massage for that.

As for leakage—rupture rates vary. After 8 to 10 years, there’s about a 0.5% per year rupture rate. I assume any implant that’s 10 years old is ruptured unless proven otherwise. A dedicated breast MRI or QT imaging (like what Dr. Jen Simmons offers) is often required to see a rupture clearly.

Detox Before Removal: Step-by-Step Strategy

Dr. Diane: Do you recommend detoxing before implant removal? What’s the typical order of operations?

Dr. Rob: Absolutely. If someone has clear toxicity—mold, metals, gut issues—we want them to start detoxing before surgery. Most people are booked out a few months, so it gives us time to get started.

If they’re also interested in a fat transfer, we need to know their baseline toxicity, because toxins are stored in fat. I’ve done thousands of fat transfers, and while we have the technical part down, optimizing the patient is key. Most of my patients are out of balance to start with.

When Fat Transfer Might Not Be the Right Choice

Dr. Diane: So is there ever a concern about fat transfer mobilizing too many toxins?

Dr. Rob: Yes. That’s why we shift the conversation to balance. We help patients optimize their detox ability—good air, clean water, clean food, the right supplements.

Everyone has some toxic burden. I’ve never seen a clean tox panel. We all get exposed.

What About Double Mastectomy Patients?

Dr. Diane: For people who’ve had double mastectomies, is there ever a situation where implants are still recommended?

Dr. Rob: When I was doing cancer reconstruction, patients had multiple options: aesthetic flat closure, implant-based reconstruction, or autologous (own tissue). I specialized in autologous using the DIEP flap.

Sometimes, patients insisted on implants—but I always leaned toward using their own tissue, especially if they had underlying autoimmune issues. With autologous reconstruction, there’s zero chance of rejection since it’s their own tissue. Technically challenging, yes, but very high success rates.

Informed Choice and Other Options

Dr. Diane: So what I’m hearing—and what I want our listeners to know—is that you’re not saying implants are never an option, but that there are other options people need to be informed about. Is that fair?

Dr. Rob: Exactly. It’s all about informed decision-making. For augmentation patients, I always talked about fat transfer as an option—whether to add a cup size or gradually increase volume over a few years.

Cosmetic versus reconstructive needs vary, but patients deserve to know they have choices. I’ve taken care of complications in every kind of implant—breast, knee, dental, cardiac, spinal. Every implant has the potential for issues.

Final Thoughts

Dr. Diane: I love this conversation so much because we’re opening eyes and empowering people to ask deeper questions about their health and their options.

Dr. Rob: Thank you for letting me share this. The more people know, the better they can care for themselves.

Dr. Diane: Thank you, Dr. Rob, for being here. And to all of you listening, if you loved this episode, please like, comment, and subscribe. Share it with a friend who needs to hear this.

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