“I have breast implants and I have pain Doc.”

As a  plastic surgeon treating breast implant associated deformities and illnesses for over 25 years, I have seen many patients such as Dolly Parton who now complain of pain associated with the breast augmentation. For example, I treated award winning actress Sally Kirkland back in the late 90s for breast implant related pain. I removed her implants and their associated encasing collagen capsules and corrected her resultant “empty breast” via a mastopexy or breast lift in common parlance.

Actual breast pain tends to be more frequent in patients with very large (i.e. heavy) implants. especially in conjunction with thin, stretched-out overlying breast tissue. Indeed, the implant itself becomes the main culprit responsible for the thinning;  essentially, a vicious cycle  develops taking the patient down a one-way street of pain.

Heavy implants especially in delicately framed women can also contribute to cervical, deltoid and upper back pain. Again, this could simply be represent the long term effects of heavy implants upon the upper body. The only way to alleviate this painful ball-and-chain effect is to either reduce the implant size or just remove them completely. A breast lift is often done in conjunction with implant removal to tighten the excess loose skin left behind.

Capsular contracture is another reason for breast pain extending to the shoulder like a vice, limiting one’s range of motion . When implants are placed in a pocket under the breast  a capsule composed of your body‘s natural collagen develops to line the pocket. This capsule can have a mind of its own and decide to shrink down tightly around the implant causing distortion and in some cases significant pain. This can be torturous and removal of the scar tissue is the only way to effectively treat the problem.

Left Baker’s Grade IV breast implant associated capsular contracture
Right mild Baker’s III encapsulation
(Grade I -Normal
Grade II- Hard & stiff, but fairly normal appearance
Grade III- Hard & distorted
Grade IV- Hard, distorted with pain)
Postoperative results after Dr Haworth, a foremost breast implant revision specialist, performed a bilateral total capsulectomy and implant exchange “under the muscle”

Finally,  many patients suffering from breast implant-related pain have attributed their problems to auto immune disease caused by the very implants  themselves. Often times, these patients may complain of other systemic painful symptoms including fibromyalgia and fatigue. Though few doctors question their pain, there has been little  scientific proof that there’s a link between painful auto immune disease such as fibromyalgia and breast implants.

Most women end up loving their breast augmentation  and even accept mild discomfort in order to maintain their new cleavage. However, for the unfortunate minority  who experience severe pain, parting ways with their breast implants may be their only solution. 

Bachelor surgery secrets, how the contestants transformed their looks before the show

They’re known for their natural beauty, but it’s no secret Bachelor contestants have turned to cosmetic surgeons in the past. It has been revealed that several women from the Bachelor Australia have invested in some ‘nip and tuck’ before the show. 

Beverly Hills plastic surgeon Dr. Randal Haworth provided his thoughts on one of these contestants, Blair Thomas. Dr. Randal Haworth claimed it was quite obvious PE teacher Blair Thomas had undergone breast augmentation.

Blair Thomas ‘There is no disputing that Blair had her breasts enhanced, most likely with the help of a plastic surgeon. Her results make quite the statement and leave little to the imagination,’ Dr. Haworth observed. ‘The abrupt edge of her breasts as they transition from her chest wall indicate to me she had breast implants likely placed over her pectoralis major muscle,’ Dr. Haworth claimed.

‘Implants placed over the muscle are more likely to give this “bolt-on” appearance not normally seen in nature. However, when a patient has little body fat or breast tissue, implants placed under the muscle can occasionally give the same appearance.’

Original Article

Elyse Knowles’ fuller bust likely achieved with cohesive silicone gel implants

The Block winner Elyse Knowles has long been known for her stunning figure. Rumors have been circulating that she has surgically enhanced her physique, with whispers she has previously gone under the knife to increase her bust size. Beverly Hills plastic surgeon Dr. Haworth offered his thoughts on Elyse’s appearance. He explained there are several types of surgical breast implants, including ‘spotlight’, ‘rejuvenation’ and ‘balance’. Haworth is under the impression Elyse has undergone the latter procedure.

Elyse Knowles ‘Balance’ breasts are designed to ‘fly under the radar’, so to speak, leaving little evidence of surgical change. According to Dr. Haworth, ‘balance’ breasts are supposed to ‘look, feel and behave naturally’ and, as such, this is the surgery most likely chosen by Elyse. ‘It is obvious to me that Elyse had this balanced type of breast augmentation which is natural and well proportioned with the rest of her body,’ Haworth claimed. ‘This was likely achieved with cohesive silicone gel implants placed under her pectoralis major muscle.’

Original Article

The Importance of Total Capsulectomy in Treating Breast Implant Problems.

I was exchanging breast implants and performing a capsulectomy the other day (to treat a breast encapsulation) when my anesthesia provider expressed surprise at my method. Specifically, she had commented that she has never worked with a breast implant revision specialist, especially one in Beverly Hills or California, who had removed the WHOLE collagenous capsule when treating a breast encapsulation. Apparently she has only seen plastic surgeons either make slits in  capsules (capsulotomy) or only partially remove them.  

Evidently, she was part of a growing support group of women who had their breast implants removed for mainly medical reasons and were firm believers that any associated capsules needed to be removed in their entirety during the same operation. Up to now I had no idea that performing a total capsulectomy is “a thing” and supposedly I am among a minority  who do this par for the course.

  One of the leading theories for breast encapsulation relates to bacteria and their byproduct, biofilm (a type of organic shield, if you will), surrounding the surface of the breast implant itself. One can safely assume that if a breast implant is supposedly contaminated by bacteria so is its associated surrounding capsule. Therefore, it is only logical to remove the collagen capsule in its entirety when removing or exchanging a breast implant, whether it be silicone or saline.   I created this video below to help patients better understand the vexing process of breast encapsulation and methods to treat it. Though breast augmentation​​ is one of the most popular plastic surgical procedures performed today, it is also one of the most capricious or unpredictable because breasts often times have a mind of their own and do not behave in the way we would like them to.​   Dr Haworth 2017