With the growing cultural focus on youth, longevity and physical attractiveness, it is perhaps unsurprising that the growing trend in plastic surgery continues to rise each year. Among the top categories, liposuction holds first place followed by breast augmentation. In 2023, the American Society of Plastic Surgeons reported in its National Plastic Surgery Statistics that a total of 304,181 breast augmentations were performed. A less publicized but increasingly common trend was also reported in 2023 by the Aesthetic Plastic Surgery Society—74,326 women had their implants removed (explanted) and not replaced. 

The marked increase in surgeries implanting these Class III “high risk” medical devices includes many women that undergo procedures to replace old implants that have broken or caused other problems. In the past, an estimated 40,000 U.S. women a year have the surgery to remove the implants entirely. These “explants” stem from a variety of issues, including rupture, delayed wound healing, broken implants causing breast pain, capsule contracture, spontaneous deflation, breast lesions, infection, wrinkling/scalloping and necrosis.

Another reason for removal is the growing concern about the reported incidence of breast implant-associated anaplastic large cell lymphoma (BIA-ALCL), a treatable T-cell lymphoma, and breast implant illness (BII) associated with silicone and saline implants. The FDA first raised concerns about the rare lymphoma in 2011, linking it to implants with textured, Velcro-like outer shells. Later, it issued a letter to healthcare providers seeking to increase awareness “about an association between all breast implants, regardless of filling or texture,” and BIA-ALCL. 

Three local women are part of the growing trend to have implants removed and not replaced. Doreen DeStefano, APRN owner of Root Causes in Fort Myers, Root Causes Clinical Director, Sandra Hoskins, and Nadia Barsamian, owner of HerbaLuxe Organic Skincare, in Naples, courageously shared their stories with Natural Awakenings hoping to enlighten others regarding the surgery. 

Doreen DeStefano, whose office focuses on integrative and investigative medicine, estimates that 12 patients in her practice have decided to have their implants removed and not replaced. “It might seem silly that one of the questions I ask on my intake form is, ‘Do you have anything in your body that you weren’t born with? It’s necessary for me to know this when I take on a new patient because when a woman starts presenting systemic symptoms such as fatigue, joint and muscle pain, memory and concentration problems, depression, anxiety, skin problems and hair loss, she may not logically think those symptoms point to breast implant illness (BII) because she wasn’t informed of the potential problem by her surgeon. Depending on how long she has had them, it may not occur to her because she wasn’t aware that she’d previously had a problem. There is no official medical diagnosis for BII, and while there aren’t a lot of doctors that are familiar with the condition, I am because I had to have my implants removed,” she says.

BII is an empiric diagnosis based on exclusion, which means DeStefano needs to run lab tests on her patients to eliminate each possibility. “To convince a woman, including me, to have her implants out when there’s nothing on paper that indicates BII, and no lab results because there are no lab tests for it, is nearly impossible,” says DeStefano

Recalling how exhausted she always felt before being explanted, and without a clue as to the cause, she recounts a particular night when she was crawling from her bed to the bathroom, all the while thinking, Am I going to die? “That was the motivation for me getting on my computer and beginning to search for answers. It took me a long time to figure out that it was BII. Even when I knew that I needed to have them removed for the sake of my health, I had to force myself to do it. I was trying to talk myself out of it. I know firsthand how difficult it is for women to admit when their health problems are caused by their breast implants because it’s the agony of the denial that I experienced all the way to the surgeon’s office,” advises DeStefano.

At age 26 Sandra Hoskins had her first implants and was informed that they should be replaced every 10 years. She had them replaced at age 38 and removed at age 51. “I was around 40 when I started noticing the bloating and my distended abdomen. I worked out so it bothered me that I looked like I was pregnant. I changed my diet but eventually suffered from constipation. In my mid mid-40s, I began experiencing muscle pain, fatigue and brain fog. I attributed those symptoms to getting older and not getting enough sleep, stress, and spending too much time multi-tasking. My hair fell out. I had dark circles under my eyes. My weight was down to 98 pounds, and I didn’t have the energy to drive my car. I was always finding reasons that had nothing to do with my implants,” says Hoskins.

DeStefano ran tests and tried every solution she could think of, including IV therapy, and ozonating Hoskins’ blood and running it through a UV machine. “One day, when a new patient came into our office and I was scribing for Doreen, as the patient described her symptoms, I mentally checked every one she had. That’s when Doreen connected all the dots, and I scheduled my explant surgery,” recalls Hoskins.  

Nadia Barsamian had her implants for 11 years until immediately after her daughter was born. “I started experiencing horrendous symptoms, leaving me unable to take care of my newborn. I had gut issues, was exhausted and would fall asleep anywhere. I suffered from hair loss, raised skin rashes, and was diagnosed with SIBO, Small Intestinal Bacteria Overgrowth. 

“Two weeks after I had the implants removed, I was a completely different person. I find it challenging to believe how uneducated we are about breast implants and the problems they can cause. This is also happening with men who get testicle implants for medical reasons or aesthetic reasons,” she says.

Having her implants removed was a tough decision for Barasamian. She explains, “It was very difficult. No one believed my symptoms were directly correlated to the implants. I saw different specialists and had numerous blood tests and imaging, but nothing showed up. I met with six different surgeons before one agreed to remove the implants without replacements. I had to make the decision without the support of doctors or anyone else.” 

Barsamian questioned herself. “Was my life worth more than my vanity or how I looked. I’d just had a baby that I couldn’t take care of. It felt like such craziness because I was still questioning if removing the implants was the right decision. It took me a few months to internalize all of it and mull it over. It's absurd that it wasn’t an easy decision. My health was at risk, so it should have been a no-brainer. My husband is always my biggest supporter. I could not have gone through the removal without his support.”

This experience has led to an immense lifestyle change for Barsamian and her husband. They are now very conscious of the foods they eat and avoid synthetic ingredients, fragrances, and chemicals. “Herbaluxe Organic Skincare came to fruition from my experience. I hope it will help other women realize the dangers of putting foreign objects and chemicals into their bodies. In the long run, they will make you sick and age faster,” she says.

Facebook.com/groups/HealingBreastImplantIllness has become a sanctuary for more than 150,000 women that report a range of symptoms associated with BII. Nicole Daruda, of Vancouver Island, Canada, says she created the group to support women that visited her website, HealingBreastImplantIllness.com, where she told her personal BII story that began with implant surgery in 2005. “I never anticipated an avalanche of women’s stories about the symptoms that I endured before having my explant surgery in 2015.”

After hearing from other women, Daruda felt affirmed in her suspicions that implants had caused her symptoms. “I also had headaches, recurring infections, swollen lymph nodes, irritable bowel syndrome and problems with thyroid and adrenal glands. I believe that various doctors pigeonholed my symptoms into the category of autoimmune disorders because few general practitioners are aware of BII.”

The National Center for Health Research reports that at the time of explant surgery, approximately three out of five women have had implants and their unhealthy symptoms for 10 years or more. After explant surgery, 89 percent of the women report improvement. However, explant surgery is just the first step in the recovery process. For example, Daruda used chelation and the protocols of Gerson Therapy, a natural treatment that activates the body’s ability to heal itself through an organic, plant-based diet, raw juices, coffee enemas and supplements. It took four years for Daruda to recuperate. 

The lesson Daruda shares today with other women is one embraced by DeStefano, Hoskins and Barsamian—self-love and self-worth are more important than society’s false concepts of beauty. The essence of who we are is not tied to any body part. 

Root Causes, 12734 Kenwood Lane, Ste. 4. For more information, call 239-425-2900 or visit RtCausesMD.com. 

Herbaluxe, 1575 Pine Ridge Rd., Ste.15, Unit 9, in Naples. For more information or to make an appointment, call 239-387-2549 or visit Herbaluxe.us.