I recently joined Dr. Daniel Pompa on The Dr. Pompa Show, which just aired to an audience of more than 327,000 YouTube subscribers and 1.8 million Instagram followers. We had an in-depth, science-forward conversation about breast implants, explant surgery, breast implant illness (BII), and fat transfer as a natural alternative—topics that continue to impact millions of women worldwide.
This discussion wasn't about fear or sensationalism. It was about physiology, immune response, and why so many women struggle for years before their symptoms are properly connected to their implants.
Why Breast Implant Illness Is Often Missed
Breast implant illness rarely presents as a classic infection. Instead, women report a wide range of symptoms including brain fog, fatigue, joint and muscle pain, gut dysfunction, palpitations, anxiety, and shortness of breath. From a conventional medical standpoint, these symptoms appear unrelated.
Clinically, however, I see a consistent pattern: chronic immune activation driven by a foreign device and the body's response to it.
The Capsule and Biofilm: The Missing Link
Whenever a foreign object is placed in the body—whether it's a knee replacement, hernia mesh, dental implant, or breast implant—the body forms a capsule of scar tissue around it.
Last year, my team published research showing that 29% of breast implant capsules tested positive for bacterial biofilm using PCR analysis. These bacteria don't cause an obvious infection. Instead, they form biofilms, allowing pathogens to hide from the immune system and drive low-grade, chronic inflammation.
This is why simply removing the implant alone may not resolve symptoms.
If the capsule is left behind, the immune system can continue reacting.
That is why I perform complete capsulectomy during explant surgery—removing both the implant and the capsule when clinically appropriate.
A New Understanding of Immune Rejection
Emerging molecular research shows that the capsule response is not always a simple foreign-body reaction. Instead of only a T-cell response, newer RNA-expression studies demonstrate increased B-cell and plasma-cell activity, similar to what is seen in organ rejection.
In some patients, the capsule behaves less like scar tissue and more like a chronically rejected graft—explaining why symptoms can persist or worsen over time.
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Why Some Women Have Symptoms—and Others Don't
A common question is: "If implants are a problem, why doesn't everyone get sick?"
The answer is adaptation.
Some immune systems compensate for years or even decades. Genetics, toxic burden, gut health, hormones, stress, and environmental exposures all influence when that compensation fails. Symptoms often appear long after implantation, making the connection difficult to recognize.
Fat Transfer: A Natural Alternative
We also discussed fat transfer for breast enhancement—either after explant surgery or as a primary option. Fat transfer uses a patient's own tissue, avoiding foreign materials altogether.
When done correctly and in the right patient:
- It provides a natural look and feel
- It avoids implant-related immune activation
- It can be a powerful reconstructive and aesthetic option
Success depends on proper patient selection, adequate donor fat, low inflammatory burden, hormonal balance, and precise technique.
Why Preparation and Recovery Matter
Surgery alone is not enough for patients with breast implant illness. That's why I developed the SHARP Method, which focuses on optimizing genetics, detox capacity, gut health, hormones, inflammation, sleep, and nutrition before and after surgery.
Removing the trigger without supporting the immune system limits recovery. A comprehensive approach is essential.
Empowerment Through Education
I've never told a patient they must explant. Women arrive at that decision themselves—often after years of unanswered questions. My role is to provide clarity, data, and a path forward based on science and experience.
Breast implants are not going away. But informed consent must evolve alongside emerging research.
This conversation with Dr. Pompa was one of the most thorough public discussions I've had on breast implant illness, capsulectomy, immune response, and fat transfer. If you're seeking answers—or simply want better information—this episode is an important place to start.