How Should You Prepare Your Body Before Explant Surgery?
(Based on a recent interview with Violet Odeh, NP discussing breast implant illness, explant surgery preparation, and postoperative recovery - https://www.youtube.com/watch?v=QBpZGwSlhXk)
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When women reach out about explant surgery, the conversation tends to center on the operation itself: when it can happen, how long recovery takes, what the incision will look like. Dr. Robert Whitfield's practice has found that the months before surgery, and the internal environment a patient brings into the operating room, matter just as much.
That idea came through clearly in a recent conversation with Violet Odeh, a nurse practitioner who now leads the practice's postoperative surgical program remotely from New York. Violet spent time working in Austin, went through her own explant surgery as a patient of the practice, and now brings both a clinical and personal understanding of what preparation actually requires.
Preparation is a phrase we use a lot in this practice, and it can sound like a soft word next to something as significant as surgery. In practice, it means specific, measurable steps: bloodwork, a toxin burden panel, nutrition changes, sleep habits, and a realistic look at what the body will be asked to do in recovery. Violet's story is a useful window into why we treat that preparation window as seriously as the surgery itself.
## A Nurse Practitioner Who Didn't Know BII Was on the Table
Before joining the practice, Violet worked for about three years with a facial plastic surgeon in New York City, surrounded by a community of nurses and nurse practitioners who worked with body plastic surgeons across the Park Avenue area. She had breast implants herself, placed at age 20, and had been considering having them removed. Breast implant illness, she said, simply was not part of the conversation in that professional community.
"I had had symptoms that I didn't know were related to BII until I specifically started getting started with Dr. Whitfield," she said, describing years of dermatology visits where her symptoms were attributed to genetics.
It was only after she began working at the practice, and started learning about the connection between implants and systemic symptoms, that she decided to pursue her own explant surgery.
## Why Preparation Starts Months Before the Operating Room
Dr. Whitfield described a pattern he sees often: once a patient decides to move forward with surgery, there is a strong pull to schedule it as quickly as possible. He is careful not to discourage that motivation, but he also wants patients to understand what is happening physiologically once that decision is made.
"Every time you have surgery, it's a very big deal for your body and how you respond to and cope with surgical stress and cortisol release," he explained. The practice's approach to preparation, built around sleep, nutrition, and targeted supplementation in addition to standard pre-surgical workups, is designed to reduce that surgical stress response before it happens.
For patients able to plan ahead, that preparation window is typically about three months. Some arrive already living in a way that supports it: gluten-free, dairy-free, having already reduced synthetic products in their home. Others are just starting to learn what that means.
## What a Toxin Burden Assessment Actually Reveals
A central part of that preparation process is a comprehensive toxin burden assessment, which gives the surgical team a clearer picture of a patient's internal environment before a major operation, beyond what standard bloodwork typically shows.
Dr. Whitfield shared findings from an internal audit of more than 500 of these tests: the most frequently identified environmental exposure was BPA from plastics, followed by glyphosate, the herbicide commonly known as Roundup, and then mycotoxins from mold. Heavy metals also appear frequently. He referenced two patients discussed previously on the show as examples: Lauren Bostic, whose results showed significant heavy metal exposure, and Ashley Curts, a lifelong golfer whose testing reflected a heavy herbicide and pesticide burden that was not apparent from her health history alone.
"I never know what a test is going to show," Dr. Whitfield said. "If you had spoken to Ashley Curts, you would have never guessed in a million years she had a whole page full of herbicides."
The practice has moved away from leaning on standard bloodwork for this kind of preparation, since most patients arrive with labs already within normal range. A toxin burden assessment is intended to surface information routine testing tends to miss, giving both patient and provider a starting point for what to address before surgery:
https://www.drrobssolutions.com/products/total-tox-burden-test
## The First Six Weeks Are Harder Than Most People Expect
Violet was candid that, despite a year spent caring for patients through this exact recovery process, she was not fully prepared for her own experience. She described the first six weeks after her surgery as unexpectedly difficult, with disrupted sleep, irritability, and emotional swings.
"I think of myself as someone who's kind of straightforward. I'm not super emotional and crying," she said. "The first six weeks were so hard for me." She acknowledged returning to work four days after surgery, against her own advice to patients, and being sent home as a result.
Dr. Whitfield connected this period to the same surgical stress response discussed earlier. Rest, protein intake, and supportive nutrition in these early weeks can help the body move through the hormonal and metabolic changes that follow any major surgery:
https://drrobssolutions.com/products/inflammation-support-bundle
## Emotional Processing Extends Well Into the First Year
Beyond the physical recovery, Violet described a longer emotional process that many patients move through, often touching on why they got implants in the first place, sometimes decades earlier. Having gotten her own implants at 20 and removed them at 36, she described adjusting to her post-explant body and even relearning how certain clothing fit as part of a longer identity shift she had not anticipated.
"It's almost like turning a chapter in a woman's life," she said.
This is part of why the practice structures follow-up across a full year, with scheduled check-ins at one week, one month, three, six, nine, and twelve months, rather than concluding care after the initial post-op visits common elsewhere in plastic surgery.
## Practical Steps to Prepare Before Surgery
Drawing on her own recovery and her clinical role, Violet offered several concrete suggestions:
Pack loose, front-closing clothing rather than anything that pulls overhead, since patients placed under the muscle are typically asked to avoid overhead reaching for about four weeks. Rearrange frequently used items at home to a lower height in advance. Prepare freezer meals or arrange grocery help, since standing and pushing a cart are harder than expected in the first weeks. Plan for more time off work than seems necessary, ideally a week and a half to two weeks, and start the paperwork process early if a physically demanding job is involved.
Violet works closely with patients whose jobs are physically demanding, including nurses, physical therapists, and factory workers, to help arrange the documentation needed for adequate leave. She described this as a point of emphasis for her personally: patients should not feel that their job has to limit how much recovery time they take.
## Why a Full Year of Follow-Up Matters More Than It Might Seem
Violet pointed out a structural difference between this practice and others she has worked in or trained alongside: the length and consistency of postoperative follow-up. Where she previously saw brief post-op visits that might end after a month or three months, this practice schedules check-ins across a full year, at one week, one month, three, six, nine, and twelve months.
"It's actually at the first appointment not even about cosmetically how they look," she explained. Early visits focus on what is happening internally and emotionally, with photos taken at each milestone to track healing and catch anything that might interfere with recovery early.
Dr. Whitfield noted that this structure, including a functional medicine team working alongside the surgical team, is something he has not seen replicated elsewhere in his training or practice experience, including time at Cambridge in the UK and at Indiana University.
## The Role of a Support System
Both Violet and Dr. Whitfield emphasized that recovery does not happen in isolation. The practice asks patients to have a caregiver present during the recovery week in Austin, and encourages patients to think beyond that short window to who they can lean on in the weeks and months that follow.
"What's your ongoing support?" Dr. Whitfield asked. "How is that going to be at two weeks and six days at the twelfth hour when I'm not feeling right?"
Not every patient arrives with a strong support system already in place, and Violet was clear that this does not exclude anyone from the practice. Local resources in Austin, along with the functional and postoperative teams, are structured in part to help fill that gap.
## How the SHARP Framework Applies to This Discussion
Everything described here, from pre-surgical toxin testing to structured emotional support well past the first month, reflects the SHARP approach this practice was built around: preparing the whole patient ahead of surgery and staying closely involved for the full year that follows.
Buy Dr. Robert Whitfield's book about SHARP:
https://drrobssolutions.com/products/sharp-by-dr-robert-whitfield
For anyone weighing their own timeline for explant surgery, a comprehensive lab assessment can offer more clarity than guesswork about where to start:
https://www.drrobertwhitfield.com/sharp
Disclaimer: The content provided in this article is intended for educational and informational purposes only. It does not constitute medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider before making any changes to your health regimen, supplements, or treatment plan. Results discussed are not guaranteed and individual outcomes will vary.
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