The Dr. Hyman Show - Breast Implants Are Making Women Sick—Here's What's Happening | Dr. Jonathan Kanevsky

Episode Date: April 1, 2026

Breast implants may have become increasingly common—but for some women, the experience doesn’t always unfold the way they expected. On this episode of The Dr. Hyman Show, I sit down with Dr. Jonathan Kanevsky, a board-certified plastic surgeon who made the decision to stop performing breast implant procedures after years of listening closely to his patients. We explore what he started seeing, how to approach this decision, and what alternatives are now available. Watch the full conversation on YouTube, or listen wherever you get your podcasts. You’ll learn: • How to tell if your symptoms may be connected to breast implants • What to consider before deciding to remove them • Why recovery after explant looks different for everyone • What safer, more natural alternatives are available today • How to support your body before and after surgery for better recovery This is a complex and deeply personal decision. My hope is that understanding the full picture helps you make a more informed one. View Show Notes From This Episode Get Free Weekly Health Tips from Dr. Hyman https://drhyman.com/pages/picks?utm_campaign=shownotes&utm_medium=banner&utm_source=podcast Sign Up for Dr. Hyman’s Weekly Longevity Journal https://drhyman.com/pages/longevity?utm_campaign=shownotes&utm_medium=banner&utm_source=podcast Join the 10-Day Detox to Reset Your Health https://drhyman.com/pages/10-day-detox Join the Hyman Hive for Expert Support and Real Results https://drhyman.com/pages/hyman-hive This episode is brought to you by Maui Nui, Pique, Perfect Amino, BIOptimizers, Korrus and Made In Cookware. Go to mauinuivenison.com/hyman to claim your free 6-pack of their Wild Axis Venison Jerky Sticks. Secure 20% off your order plus a free starter kit at piquelife.com/hyman. Go to bodyhealth.com and use code HYMAN20 to get 20% off your first order. Head to bioptimizers.com/hyman and use promo code HYMAN at checkout to save 15%. Visit Korrus.com/DrHyman for 15% off their newest product OIO Sphere with code HYMANSPHERE15. Visit MadeInCookware.com and use code HYMAN10 for 10% off your order. (0:00) Breast implants, health concerns, and medical profession perspectives (0:58) Introduction of Dr. Jonathan Kanevsky and personal stories (2:31) Correlation between breast implants, illness, and safety concerns (4:06) Breast implant-associated cancer, FDA warnings, and patient symptoms (6:29) Gaslighting in medicine and types of complications (8:02) Autoimmune reactions and explant surgery (13:15) Challenges and outcomes of explant surgery (16:57) Understanding toxins, metabolic, and cognitive effects of implants (18:36) The future of safe breast augmentation surgery (20:32) Introduction and history of fat grafting (23:14) Fat grafting techniques, results, and risks (28:50) New technologies in fat transfer and critique of new implants (33:10) Banking, growing, and sharing your own fat (36:27) Addressing ongoing concerns about implants’ health impacts (40:23) Surgery as ceremony: concept, history, and protocols (49:42) Post-surgery care, recovery, and dietary recommendations (55:10) Whole food, plant-based diets and nutritional interventions (57:29) Integrating alternative therapies and new surgical technologies (58:06) Where to find Dr. Jonathan Kanevsky and closing remarks (59:20) Disclaimer and final notes

Women are being gaslight by the medical profession about breast implants. The gaslighting is essentially saying to women, these symptoms are all in your head or take some Prozac, you'll be fine. I have seen many cases of women with severe illness correlated with their implants. What's even more impressive is when they take them out, they get better. Silicon comes from petroleum. So this is a petrochemical industrial product. We have not changed the fundamental laws of biology,

which is you put in a foreign object, it is going to have a reaction. Until I could predict who's going to have an adverse reaction to breast implants, it seemed completely unethical to be putting implants in for an elective procedure. The old paradigm of surgeons just cutting and leaving, I think it's done. You call it surgery a ceremony. I'd love you to unpack that. There is an altered state of consciousness, which is the medication that's using surgery. You know, body keeps a score.

It's trying to make sense of what's going on. For example, one patient, her mantra was, like, I want to come home to my body. I work with a great team of lymphatic therapist that will help you land back in your body as you're integrating everything. Today on the podcast, I'm joined by Dr. Jonathan Kenevsky. He is a board-certified plastic surgeon in Los Angeles and a data scientist who advises Google and neurolog. He is a leading voice in the treatment of breast implant illness, pioneering a transformative framework he calls surgery as ceremony. So the big vision is that nobody puts an implant in ever again. This is the only place an implant should be, which is outside the body.

More and more research is coming out on the importance of maintaining muscle as we age. And muscle is essential for longevity, metabolism, and healthy aging. In fact, in my January conversation with Dr. Gabriel Lyon, we took a deep dive into this topic, highlighting the importance of prioritizing high-quality bioavailable protein. But not all protein is created equal. And one of the most nutrient-dense sources I've found is wild venison. These wild access deer roam and grays freely in Hawaii on nearly 200 different plants growing in volcanic soil, which produces meat that's incredibly rich in nutrients, truly embodying food as medicine in its purest form.

And what matters isn't just about the grams of protein, it's what your body can actually absorb and use. Venison is naturally high in bioavailable heem iron, B12, zinc, and complete amino acids, including leucine, which helps trigger muscle protein synthesis. It's also naturally lean and incredibly pure. And if you're like me, you want to avoid a lot of the things that show up in typical snack foods like seed oils, soy protein isolates, added sugars, and artificial ingredients. This is why I've been incorporating Maui Nui's wild venison jerky sticks into my routine, whether it's after a workout on a busy day of travel or even on weekends when I want something quick but nutrient dense on the go. They are made with just three simple ingredients, wild venison,

water, and spices. And it's not just great for me. Active kids, athletes, and parents all benefit from real nutrient-dense protein like this. Right now, Maui-Nui is offering my listeners a free six-pack of their venison jerky sticks with your first order. Just go to Maui-Nui-Venicen to claim your free starter pack. That's M-A-U-N-U-U-I-Venisin.com slash hymen. A lot of people pour a drink at the end of the day to unwind or be social. And as a doctor, I get asked all the time, is alcohol really that bad for me? And while it works in the moment, even moderate alcohol, as little as one drink can disrupt sleep, leaving you groggy the next morning. And it puts stress on your body in ways most people don't realize. On top of that, the World Health Organization classifies alcohol

as a group one carcinogen, meaning there's solid evidence connecting it to cancers like breast and colon. So while the occasional drink isn't catastrophic, alcohol isn't really supporting your health either. And if what you're actually looking for is relaxation, connection, or that subtle evening lift, it's worth asking, could there be a gentler, smarter way to get there? That's where Vesper from Peak comes in. Vesper is a non-alcoholic, adaptogenic aperitif designed to give you a mindful alternative to your usual drink without the sleep disruption or next day fog. Ingredients like L. Thionine and Lemonbaum help your body relax.

While Genshin root adds a subtle, uplifting effect, you feel calm, bright, and present, not sedated. I've been paying close attention to this category, and Vesper is the most thoughtfully formulated option I've come across. If you're ready to rethink your evening ritual, Vesper is a thoughtful, healthier option. And get up to 20% off for life at peaklife.com slash hymen. That's P-I-Q-U-E-Life.com slash Hyman.

John, welcome to podcasts. Thank you. You know, we've been friends for quite a while and talked a lot about regenerative medicine and health and functional medicine. But you come from the perspective of a surgeon. I deal more with the kind of biology stuff. Well, you do two, but in a different way.

We've had many conversations about the topic of breast implants. And as a doctor, seeing patients for now close to 40 years, I mean, if you include medical school, it's, I don't know what the math is 43 years. I would say that I have seen many, many, many cases of women with severe illness, chronic disease who've had breast implants. And it seems to be correlated, can't say caused, but correlates. with their implants. And what's even more impressive is when they take them out,

they get better. And there's something in medicine called doctor years, which is like how many years of medical practices to take to see X, Y, or Z condition? Like, we both learned about a feo-chromositoma in medical school, which is a rare adrenal tumor.

I've never seen one in 40 years. I'm assuming you've never seen one. It's always on the differential, but I've never seen one. And it's basically, I've got rare tumors. So it means, like, it doesn't happen around it. But if you see something, over and over and I'm just one doctor and I see it over and over and over. In fact, I'm dealing

with a patient right now with a really severe autoimmune disease that's really resistant to treatment. We've tried everything. I don't start with removing your breast implants, but I'm like, listen, if everything else works that we do in functional medicine and we can't get you better, then we've got to assume there's something that's toxic that's affecting you. And we know that the silicone in breast implants is definitely linked to adverse health outcomes. So you've spent your life, you know, training as a plastic surgeon, you went to McGill, you trained in California for your fellowship, you really are an expert in this field. And you're kind of a heretic because you're going against the orthodoxy of plastic and aesthetic surgery. We'll talk about the difference there.

But you're basically saying that women are being gassed by the medical profession about breast implants. Can you kind of unpack that for us? So thank you, first of all, for having me on so we can talk about this. It's such an important topic. and the way that you dive into it's going to be just so helpful. So this journey into questioning implants started about a decade ago. A plastic surgeon by the name of Gary Brody was, I remember still, I think it might have been 2010, so even more than 10 years ago.

He presented on something called B-I-A-A-L-C-L, breast implant associated, antoplastic, large cell lymphoma. And I saw that for the first time in a conference in Vancouver. And that's basically an immune tumor cancer. It's a cancer that's associated with the implant. And so this very rare type of cancer associated with implants was the first thing that sparked my curiosity. It was like there's something potentially wrong with these implants that patients are reporting. Very rare.

Turns out it's more common now associated with implants. And fast forward a few more years, implants still are not banned or, you know, there's no major warnings about them as this information is coming out. I mean, the FDA still approves them. It still approves them now with a black box warning on all implants about a specific type of implant. But fast forward to, I'm finishing, I'm in the last year of my fellowship. And in one day I had three patients that came in all saying, I'm concerned about my implants making me sick. I think my implants are making me sick.

And I just heard that over and over again. Yeah. And up until that point, the medical community, or the postura community, by and large, just saying, you know, these symptoms are so vague. They're kind of this constellation of autoimmune symptoms, like everything from fatigue to hair loss to joint pain, dry eyes, is really fitting the constellation of autoimmune symptoms, but with no specific, easily diagnosable symptoms.

Rashes. Even nervous system symptoms. Oh, just everywhere. I mean, there's anxiety, depression, you know, just the constellation symptoms are so large and at times vague that it's hard to say, oh, yeah, this is for sure. They call DII, right? Correct. Breast implant illness. But there's so much more than that. Yeah. And it's,

even before that, it was Asia. It was auto-adjuvant silicon-associated autoimmune problem. And then it's since been recategorized SSPI. Systemic syndrome associated with breast implants. Anyway, a bunch of acronyms, but the etiology is the same. Something about the implant is causing a physical problem. I decided at that point, until I could predict accurately who's going to have an adverse reaction to breast implants, it seemed completely nonsensical. it seems unethical to be putting implants in for an elective procedure that have potentially up to a 30% chance of a complication. Yeah, not like you're getting a heart transplant because you need a heart. Yeah, so it's just like, this is strange until I can predict who's going to have these problems and why,

I'm just going to stop using breast implants and focus on a safer alternative. And that's, that was what launched me into this exploration of no more implants. Let's remove the implants and focus on a safer natural alternative like fat grafting. So there's more to talk about an unpack about this, but the gas lighting is essentially saying to women, don't worry about it, or these symptoms are all in your head, or take some Prozac, you'll be fine. And it's beyond just, you know, I kind of looked it up, and I was preparing for the podcast, but up to 10 to 25% of women have some type of complication. That's one in 10 to 1 and 4 women have a complication, and it's everything from caps or

contracture, right? And so, and you can talk about that to, to autoimmune and inflammatory issues you mentioned to this the ASIA that you talked about, it's autoimmune inflammatory thing, the breast implant illness, and the cancer issue mentioned, this lymphoma, even just local, you know, sort of endocrine effects as the silicone migrates and neurologic effects, cognitive effects, psychological effects. So can you kind of unpack a lot of that and just kind of talk us through each one of those? Because it's a lot of stuff, and it's not just one thing that it causes. The complication rate is actually higher. If you look at all of the potential complications associated with implants, it's closer to 30%.

So 30% of women after breast implants will either have a complication such as capsule contracture, breast implant illness, or the more rare side effect is the cancer, ALCL, associated with breast implants. Plus, of course, you know, less common complications, but hematoma, like bleeding, infection, things like that. But the three big ones that are known and make up most at 30% is capsule contractor, BIAI, and the ALCL.

capsule contractor is essential. But the autoimmune or that's the cancer? But what about the autoimmune? That's the biggest category, but the one that's hardest to diagnose. It's really a diagnosis of exclusion. So the other two have very clear, we know why they happen and they're very easily diagnosed. So capsule is basically the capsule that forms around the implant. So a foreign body, any tighter.

Yeah, yeah. There you go. Tell us about here you go. So this is a fourth or fifth generation. For those listening, we're showing a silicone breast implant, which you can't see if you're driving. But anyway. This is the only place any implant should be,

which is outside the body. This is a newer generation of implant. Even if it's newer generation, it's essentially the same technology repeated with slight variation. So silicone shell with a silicone gel inside. It's a silicone gel polymer. If I was to cut this open,

it wouldn't leak out like liquid. It's a gummy bear. Just to be clear, silicon comes from petroleum, right? So this is a petrochemical industrial product. And we know that these petrochemicals have massive effects on human health, like any other, quote, toxins, they affect endocrine function or endocrine disruptors. They can cause autoimmunity. They can cause obesity. They can cause cancer.

I mean, there's a range of effects of toxins. It's huge. And this is a, you know, when you say polymer, that doesn't sound like something should be in your body. And silicone is one of hundreds of ingredients that are usually used in the process of making implants. I brought one that's smooth. The ones that are really causing their problem are textured implants. And there's a whole science behind why they're textured, but basically some sort of abrasive chemical process is used to rough up the implant, so it doesn't spin or move around as much in the body, and it prevents capsule contractor. So capsular contractor, this foreign body goes inside. The same exact thing happens if you accidentally get a piece of lead in your fingertip or a thorn from a bush, the body

encapsulates it. It's going to make that fibroblast covering around. It's going to cover it with scar tissue. This is a really, this is a fairly large surface area of something to be covered in, you know, immune reactive tissue trying to wall it off from the body. And so when a capsular contractor occurs, the body makes this little jail around the implant of immune cells. And if you look at the pathology, like up close, the histopothology of these capsules, it's got four layers, and they're rich in immune cells. It's got all these white blood cells that are reacting to the implant.

And in some cases, nothing happens. And that's great. The body's not having a super strong reaction to it. In other cases, the capsule will continuously contract, like any scar that contracts, it'll contract on the implant and it'll get really hard. And that's what caps are considered. So they're like hard balls, like a baseball. Yeah.

And so at that point, the capsule needs to be removed and adjusted. But it's not considered medically dangerous. It's just it can be very painful for the patient and look uncomfortable. So that's capsule conjecture. The other bucket is ALCL, the cancer associated with the implants. And that's also caused by the immune reaction continuously. It's a type of lymphoma. And then the third category is BII, breast implant illness.

Which is way more common than the cancer. Way more common, harder to die. It's the diagnosis of exclusion. And there can be autoimmune illnesses like Shogran syndrome, rheumatritis, systemic sclerosis, mixed connecticitis, Hashimoto's. I mean, one in five women have hypothyroidism. That's 20% of women.

What's been noticed is if you have a predisposition to any kind of autoimmune illness, any family history, personal history, there's a higher likelihood that getting a silicone implant or a silicone gel or shell implant is going to be what could push you over the end. to go from no symptoms to symptoms. So if your immune system's already kind of of upregated and wired, something like that

acts as an adjuvant and it'll upregulate the immune. And it's impressive that the FDA actually finally recognize this as a real thing. They acknowledge a breast implant illness in 2020 as a real condition, and it's not in women's heads. What's really interesting, maybe you talk about this, is what happens, and you've done a lot of this, because you do what we call ex-plant surgery,

which is different than an implant, right? It's a taking out them. Yeah. breast implant, what happens after women do that? Do they get better? How much do they get better? So in my experience, the majority of women do get better. But there is, it's important to acknowledge how much the mind and body is connected in this experience,

that there's a very clear physiology that we know that there's something that's causing this in the body, but there's also the way the mind associates to it. And I believe that's part of the reason why not everybody gets better. Some of the symptoms that patients feel, they'll get better right after the implants are or shortly thereafter, especially if they follow certain protocols, but not everybody gets better. And that's a question, you know, there's an incredibly large growing body of research in this field. And before I said, you know, the plastic surgery community felt like it was kind of gaslighting women over the years. But since then, the attention has really turned inward.

There's a lot more research being done, good high-quality research to understand the effects of what's actually going on. So removing the implant with or without the capsule can improve symptoms. The majority of women who seem to be experiencing better symptom relief, it may have to do with a capsule removal. The most recent studies showed that removing the capsule or not, it doesn't dramatically change the difference, but there is a strong psychological association and relationship to what it means to have a capsule in the implant remain.

So it's important. Why would the capsule remain? Why do you take the whole thing out? Because it's stuck? It's a dangerous surgery. It's not easy. Because it's stuck in it. It's stuck, yeah.

There's a risk of pneumothorax, so you could puncture the lung while removing it because the implants now live, the implants that were placed between the peck muscle and the chest wall. So it's, and there's this, you know,

the technique that was developed, that the surgeon was doing for all is called on block capsulectomy. So it's like trying to remove this implant with its capsule as a whole without, without rupturing the implant or the capsule. So it's technically challenging because you're operating in a small space, trying to get all the way around it, 360 degrees,

and then deliver the implant hole with the implant intact, with the capsule intact. Sometimes it's easy. Other times it can be very challenging, especially the capsule stuck to the chest wall. You can get into a place that it shouldn't be like a lungs. Yeah. Yeah.

So it's a much more technically challenging surgery. And for that reason, unless there's a very clear indication to remove the capsule, I'll remove as much of it as I can, but not all the time. It's risk, risk benefit, harm. We just do no harm. And you don't think the capsule remaining

still has silicone in it that's going to cause issues? It's still reactive inflammatory tissue. So anytime it can remove the capsule safely, I do. If I think it's going to potentially, put the patient at more risk, obviously I wouldn't remove it. And it all has to do with, I screen the patient to see what are the symptoms you're experiencing. You know, if the patient says, I don't have symptoms, I just want the implants out. We won't go there.

As we get older, especially once we hit our 40s and beyond, our bodies actually become less efficient at using protein. And in functional medicine, we sometimes call this anabolic resistance. It basically means the same amount of protein that worked for you at 25 might not support your muscles the same way at age 50. And that matters because muscle is one of the most important predictors of healthy aging. It supports metabolism, balance, strength, and overall resilience as we get older. Of course, I'm a huge believer in getting protein from whole nutrient-dense foods. That's always the foundation. But many people still fall short of the essential amino acids their bodies need to support muscle maintenance and recovery, especially busy moms, juggling careers, families, and everything

else. Are you wondering what essential amino acids are? They are the specific components of protein your body can't make itself, which means they must come from your diet and are important for supporting muscle maintenance, recovery, and normal metabolic function. That's why I like perfect amino. It provides a balanced blend of the essential amino acids your body needs to support muscle protein synthesis, especially when paired with resistance training and a healthy diet. I think of it a bit like a multivitamin for your protein intake. A simple way to help fill in nutritional gaps when life gets busy or your protein intake isn't ideal. If you're focused on healthy aging, strength, and maintaining muscle as you get older, this can be a really helpful addition. You can learn more about perfect

amino at bodyhealth.com and get 20% off your first order with code hymen 20. I know you have heard me talk about the importance of getting enough protein to maintain muscle as we age, but sometimes even when you eat well, meals can leave you feeling heavy, bloated, or sluggish. In some cases, it's not the protein, it's your digestion. And our bodies rely on enzymes to break down protein, fats, and carbohydrates so we can actually use the nutrients we eat. With stress, age, or busy lifestyles, enzyme production can fall short. That's why I recommend mass zimes from bioptimizers. It contains 18 different digestive enzymes, including four times more protease than many other formulas to support the breakdown of protein, fats, and carbs. Supporting digestion can help turn meals into clean fuel so you feel lighter,

more energized, and more comfortable after eating without changing your diet. If your goals this year include eating well and feeling better after meals, mass zimes is a simple way to support healthy digestion. For an exclusive offer, visit bioptimizers.com slash hymen and use promo code hymen to save 15%. Subscribe and you'll get extra discounts, free gifts, and guaranteed monthly supply. That's B-I-O-P-T-I-Z-E-R-S dot com slash Hyman and use code Hyman today. But what's interesting is the X-Pplant studies because, you know, it's one thing to say, well, you know, can you prove by cause and effect? Because they're not going to do like a randomized trial where they, you know, give a thousand women implants and they get up another

thousand or 10,000 women and another 10,000 implants and they follow them for 20 years and you get sick. You know, that's a really tough study to do. But the follow-up studies where they take the implant out and they follow people for a while and they see what happens. The data is pretty compelling. It shows like 50 to 80 percent of women see improvement. I mean, you're removing this thing that's full of silicon that's causing this chronic inflammatory reaction. So I think just from the ideology, it just makes sense. You just take out the thing that's causing the problem and you have less of a reaction. There's a plastic surgeon. Her name is Patricia McGuire. She's done probably the most research on X-plant capsules, things like that. And she,

what she found was that removing the implant helps, but the capsule, removing the capsule doesn't always create improvement symptoms. So I still think the source of the problem is what needs to remove. The implant is prime. Yeah, I mean, that's sort of classic functional medicine. If someone's sick, you take out all the bad stuff until you see what happens. Because you don't know. And the truth is that many people have autoimmune diseases or issues for many reasons.

And so the way I think about toxins is it's sort of like a cup that overflows. Your body can handle it to a certain moment, and then your toxic load gets so high that it tips over into a disease. And so, you know, there may be other factors and other toxins that are affecting you. There may be other things in your microbiome. There may be dietary factors. There may be late infections. So there's a lot of reasons for all those symptoms that relate to immune activation and inflammation and autoimmunity and microbiome issues. Even there's heavy metals, right, in the silicone.

In the things that are used to process the implants, they all sorts of heavy metals. You know, the dose for amount is probably what is the most important question, but they are present. Yeah, it's small. But it's a cumulative effect of all this. And so I think that, you know, we're now in an era we're beginning to understand that, you know, toxins play a role in human health. Doctors have been really notoriously bad at thinking about that or assessing it. And unless you have an acute poisoning, they don't think toxins are a problem because you're body can handle it, you know, they just thinks you're fine. And so what's really unfortunate is that,

you know, doctors, because women wanted this, you know, developed a way to help women, you know, with their body image or get breast implants. But the dark side of it is it's problematic. And it's created a whole string of issues that are concerning and that have, you know, a lot of metabolic effects and cellular effects and cognitive effects. I mean, it's not just the autoimmunity. You can get neuroinflammation and brain fog. You've said some of the, you know, neuropathy's headaches, pots, things like that. So it's a concern.

So I think that what I really kind of want to dive into now is kind of the work you're doing and what you've discovered because, you know, after listening to this, I'm sure many women who are listening, who want breast implants or are disappointed or have implants or are freaked out. Like going, what do I do now? I don't want to get sick. Or if I am sick, do I have to take these things out? And what am I going to do?

because, you know, it's going to affect how I look and how I feel about myself. And, you know, it's a big deal. It's not just like, oh, geez, you know, you've got a wart, take it off, and big deal. Like, you know, because I'm dealing, I deal with this regularly because I treat a lot of patients who have autoimmune disease, who are sick, who have breast implants. And it's always like, it's always the hardest thing for me to say, listen, I think we tried everything. And I think it's time you really explore this because this could be a factor.

And there's no way to prove it. Although there was a lab in Germany that was actually testing for remuner activity of silicone and other things. So, you know, there are ways of potentially actually doing immunological testing to see. There's, there's, there's ways to check how your, how your white blood cells react to the telecon or your antibodies. So there's two different kinds of immune reactions. One is your white cells fight it, and there's your antibodies fight it. But you can actually start to test that. So I think, you know, until we get better at that, it's going to be hard to know. And the question is, the women who are listening to this in in despair right now,

or husbands who are worried about their wives or partners. what actually is available now? Because you're pioneering a whole new field of surgical interventions around safe and effective breast augmentation surgery that doesn't involve foreign toxic material. So walk us through what you do, what you've been doing, and what's coming. So there's two ways that I think about this. The first is for anybody listening,

if you do have breastland plans and you're concerned, there is an ample amount of ways that you can explore what is safe to be done. The first thing that I noticed among my patients is it takes an average of about three years from the time of thinking or being concerned about your implants to going through the whole journey of X-plants, removing their breast implants. So wherever you're at on that journey, whether you're just curious about it or you think you might actually follow through with it, there's an abundance of support groups and information and ways to think about it. And surgeons are getting better and better at the technique of removing the implant and all the surgery around it. It is a big undertaking, though, because psychologically it's a lot to have undergone a surgery. to change a part of your image to, you know, that might impact your identity to then probably anywhere from five,

10, 15 years later, think about now removing the implants and reclaiming that identity. So it's a lot of the body, but it's also, you know, how do I, how do I accept this new part of myself without implants? What does that look like? So the second category is wanting to change a part of your body, wanting to, whether it's after, you know, cancer, breast reconstruction, or as a primary augmentation, to increase or change the shape and size of the breast,

fat grafting is a safe option. It may not achieve. So what is that? Yeah, so fat grafting is taking fat from one part of your body, processing it, and then using it as a sculpting medium. So literally changing the shape and volume somewhere else. Bellies women nursing. How do I get rid of my belly fat?

Yeah. This is a double, a two for, a two for, right? Two for one experience. So you can shape and sculpt one part of the body and also use it as a medium. And I think it's the most natural way to do something, because the breast tissue itself is a combination of fat and land. And so we're just putting fat where it's supposed to be. Fat grafting has, there's a lot of myth around it over the past, you know, it's been around for a long time, over 100 years.

Did that? Yeah, yeah. Fat grafting has been around for a long time. Amazing. What was he used for? The very first case was a case of liposection that was done in like the 1800s. It did not go well. This is an experimental procedure at the time, but using transplanting a piece of fat actually for breast implant as a breast implant. Wow, wait, wait, in the 1800s, they didn't have anesthesia. No, this was like late 1800s. The stories, it was a, it was a, it was a breast implant. It was a I believe it was a ballerina. I can't remember, but it was exactly, don't quote me in this,

but they actually took like a lipoma and transplanted this lipoma as a breast implant. Uh-huh. Yeah, so a ball of fat put somewhere else. Of course, it didn't survive. We know a lot more about how tissue grows and regenerates now, you can't just take a blob of fat and put it somewhere else in the body, expect to survive.

Oh, what do you do? Well, the technology has gotten a lot better. The myth used to be, well, you transplant fat, it doesn't survive. That's kind of true, but not entirely true. So 50 to 80% of the fat that gets transferred will survive. It's literally like planting stem cells, and you know all about this.

Yeah. You take these little adipose-derived stem cells, you plant them like seeds, and then all these new blood vessels grow in, and then that tissue grafts, and it lives in this new place. There's many things that have been done to improve the fat graft survival and some things I do in my own practice, and everything from red light therapy to treating the fat with something called surfactant. It's like a little soap molecule that will help preserve the fat cells after they've been removed. And it has a lot to do with technique, the way that it's injected. You inject these little micro droplets, so not these big globs of fat, these types of fat, these types of fat, tiny little fats with special tools that is like planting little drops, little seeds in a garden versus just like throwing a big handful of them. So fat grafting became popular around the time

that breast cancer surgery was was really also being developed. So women would have breast cancer, have a mastectomy, have an implant placed, and then have radiotherapy. And radiotherapy would completely just, you know, damage the tissue, would become really thick and tough and leathery because of the radiation therapy. So fat, was used as a way to regenerate the tissue. So fat would be injected. The stem cells in the fat would soften the skin and also have the benefit of creating more of a contour. Ironically, fat grafting became popular because of breast cancer to the breast. And that's what most breast cancer surgeons would do would then. They'll do a combination of an implant because still

if there's, if a lot of breast volumes removed, still in many cases the best option is a breast implant or a bigger surgery called a free flap. So taking like a big block of tissue from one part of the body to sculpt and make the breast. But fat grafting is used throughout as a modality and it's getting better and better. So that's what you do, right? So kind of walk us through, you know, how it works and what women can expect and what kind of different options are in terms of sizes and stuff. Because I think, you know, you kind of think, well, it depends if you have fat or don't have fat. Right. So the process is really three steps. The first is we have to get the fat from somewhere. So harvesting the fat involves the process known as liposuction. So the areas are numbed, and we remove the fat with a combination of

vibration and suction under low pressure, which minimizes the damage to the fat. Once the fat's collected, it's processed and treated, and then it's re-injected back into the body and sculpted. So you just like a needle? Yeah, it's tiny. So everything's done through a little keyhole entry points, so about two to three millimeter incisions, no big cuts, and the entry points are hidden throughout the body so it's it's really meant to be as as aesthetically neutral yeah so you don't you're not seeing big scars anywhere and i i do all of the fat injection through one tiny entry point in the base of the breast it's about the size of a tip of a pen so it just kind of like fills up like a balloon it's it's it's i'm literally sculpting i'm literally sculpting so when the tools go inside i'm it's like i'm

painting with a brush like 3d painting wow and so it's about surgery is art surgery is art Exactly. So I'm able to sculpt the area to make sure that it's not just like a one-and-one-done thing. Everybody's different. So certain parts of the breast need more fat here or there, and it's about sculpting. And the results you get are just like an implant or better? So I would say, well, it depends what the aesthetic as you're going for. So I never try to push it a certain aesthetic on a patient. Most patients that come to see me want the more natural look. They don't want really large over breast with that. What is a giveaway that somebody usually has an implant is there's a lot of fullness in the upper pole, so the top part of the breast is really full. The natural breast doesn't have that shape. It's more of a natural slope and then fullness on the bottom. Right. And that's what fat grafting can achieve. Sometimes it does take more than one round of fat. The reason for that is because unlike an implant, you know, you can put almost any sized implant into somebody. It's pretty traumatic. You're just shoving this large thing in there. Whereas fat, you're limited. It's like a sponge. So if you imagine a sponge filling with a water. It can only fill with so much water before it just flows out. And the fat in the breast is the

same way. You can only put so much fat in before the fat cells don't survive. So the first round of fat grafting, it's like a one-to-one ratio. You can double the volume of the breast. Not all of it will survive. Once that fat heals, the stem cells cause all these new blood vessels to grow in. And then with the second round, you can accommodate even more fat. And so you can get to the same size as an implant, but it may take more than one round of fat grafting. But the aesthetic will be different. it's going to look more like a natural shape breast. Are there any complications or risks or challenges other than just normal surgery, infection, and bleeding? Those are the main ones that we look out for.

So infection, bleeding, it's still surgery. So just like any surgical procedure, those are common things. The things that are more important to look out with fat grafting, there's a risk of something called fat necrosis. So if the fat's not properly injected, they get these big globs, some of it will die. It can create an oil cyst and cause problems. The thing that I see more commonly is the entry points can get to be, um, You can have a bit of scarring around them, and that's hard to predict.

Not everybody scars the same way, but usually scars heal really well. And the question I get asked a lot, and it's super important, is fat grafting doesn't increase the baseline risk of breast cancer. So patients with fat graftingers want to know, is this going to change my future risk of breast cancer?

The answer is no. And the second thing is it doesn't obscure mammograms. In the first six months, it can, which is important to be aware of if you have any family history of breast cancer. but onwards, most radiologists are well trained enough to know what calcifications from fat grafting can look like compared to breast cancer eyes. So there's other technologies which show how. So compared to breast implants, I think the risk profile is much lower, but it's still surgery. So got to be careful. But it's not the autoimmune issues and the breast implant illness and the

cancer risk and all that stuff. It's your own tissue. So you're not dealing with any of these autoimmune issues and it's going to heal. So let's say ideally you'd want to be having a little extra body fat and you can use it and then you want to stay at the same weight. But what if you're like, you know, want an implant and then you're a little overweight and then you want to lose 20 pounds? What happens? So the fat that gets transferred is a great question. Fat that gets transferred is just like the fat anywhere else in your bodies. If you lose weight, gain weight, it'll go in the same direction. The fat cells that survive will stay there. It's just their capacity to grow and shrink is what changes as the body weight changes.

Usually I recommend patients, it's not around the time of surgery, is not the time to lose weight. So you want to achieve a weight that you're comfortable with within like, let's say, five to ten pounds, then do the surgery, and then you want to just try and maintain your weight. If you lose a significant amount of weight afterwards, the breast size will decrease. And the same for the opposite, which is if you gain a lot of weight, the breast size will increase. And patients will use that to their benefit all the time. Yeah, but if you're really overweight and you want to take OZMPIC and you have a fat. Yes, so ozempic and fat transfers do not go well together.

So if patients are on any kind of GLP1, I say we've got to stop the, the GLP1. Forever. Not forever. Just reach a plateau that you're comfortable being at. Stop the OZempic or the other GLP1 for four weeks. Let the fat fully heal and then you can restart. But the idea is about maintenance.

It's not about going up or down significantly. And then there's new technologies. This is what's been around. This is what works. This is what you're doing right now. Yeah. But we were chatting a little earlier. You said there's some newer technologies that are available, which are pretty interesting,

which is using other people's fat. But there's an endless supply of that in America right now. It's like, you think people give medicals that used to make money by giving blood donations? It's wild. Or sperm donations? Yeah. You go like, I don't you're going to do fat donations. Do you see, I mean, the OZEPic thing is really taking off.

Apparently, the OZEmpic thing is taken off so much so that airlines are now saving money on fuel. Fuel, of course. Yeah. So we're, maybe not for long. Yeah. Yeah, well, that's good for climate change. Yeah. Wild.

Who knew? Side effects. Yeah. Everybody on Ozepic, right now, no? Yeah. Save the planet. Takeo's epic. In terms of the way it's important, I think,

people understand it's if this is fat tissue and a fluctuates. But these new technologies sort of use an endless supply of fat from other donors. So tell us about what that is, what it's called, how it works, what the risks are. So the big vision is that nobody puts an implant in ever again. I'm putting my stake in the ground, maybe five to ten years ago, hopefully sooner, that we'll just say, you know what, implants are really not it. You want the FDA to go, this is done? Yeah, and they've done it twice.

In the 80s, they said, 80s or early 90s, there's a moratorium place on breasted plants because of these rheumatologists that were saying, I think implants are making people sick, we need to do more investigation. A bunch of research was done, questionable about how the studies were funded and what the outcomes were.

But they said, okay, they're safe, they can come back. And then, again, the resurgence, I think, in 2018, black box warning implants, but they're still out there. And now there's these newer generation implants who are, you know, The whole, like trans fats are now ruled they're not safe to eat by the FDA, but there's still a cool whip in the grocery store. Exactly. Or it's like, hey, don't smoke the regular cigarettes, smoke the skinny ones, which is exactly what's happening now with implants. The implants are getting smaller. There's a whole new design of an implant by certain motiva is the latest one. And they've redesigned this implant for it to be more safe. But it literally, to me, I look at it's like, oh, it's a safer cigarette. I'm like, what are we doing? This is not. Why do they say it's safe and why do you think it's not safe? I've heard about this one. We have not changed the fundamental laws of biology, which is you put in a farm. an object, it is going to have a reaction. If it's less of a reaction, great, but there's still some

percentages of people that are going to have their reaction. They've done a lot of science. They changed the way that the rough surface of the implant is created. It's no longer abrasive chemicals. It's now a 3D printed surface, and it's done even more minimally invasively. But the root cause is still a root cause. People are still smoking. Silicon. There's still silicone in the body. And now I saw recently a surgeon's putting in 100cc implant. That's a third of the size of this. That's small. It's not only just small. you could easily do that with fat. So it just makes even less sense to me.

Yeah, yeah, yeah. So to answer your question, I don't think, so hopefully implants stop altogether, but that won't happen until there's better technologies out there that fully replace them. And the three technologies that I think are making waves and breakthroughs in the world of fat transfer fat grafting, the first is using your own fat, but doing everything possible on the surgery side and recovery side to improve fat graft retention. Yeah, I want to talk about surgery as a ceremony after what you do this, because you're not just a regular surgeon, we're going to get into all that.

So I'm going to save that. But there are ways to use various kinds of therapies and treatments to enhance healing. And I recently, I had a bike accident and I smashed out my face and I recently had to use it. I was sort of amazed at how fast things heal. You look great, Mark. Thank you. So what's the name of this, this, that transfer that you get from other people? Like, what is it called? Aloklae. Basically, Aloklay is the name of the brand right now, Clay like molding. Yeah, aloe clay. And aloe means foreign.

Correct. So allo from somebody else, clay, it's spelled, it's not spelled the same way. It's A-L-L-O-C-L-C-L-C-L-A-E, but the concept or the medical term for is catavericelular lipid or fat. It's basically fat from somebody else that's been processed that you can safely inject. And before that was Renuva, another brand. But the technology has gotten better that you now have this pre-processed fat that can be injected from somebody else. I don't use a ton of it just because I still think the best source is you're own natural fat. But if there's no other option, if you truly are too thin, BMI's too low, there's

not enough fat to harvest to get the result you want. If you're a lay dancer. Yeah, it's a good, it's a good alternative, which is you're not using an implant and you're using this other thing. It can be a little bit pricier at times. And the immune reaction is. It's minimal. Yeah. Sometimes patients can have, like, the body can react and have a bit of redness around it, but it's, it's rare. Now, we also talked about a newer technology that is, it's kind of interesting to me that you say it's only a year or two off. because it involves taking some of your own fat and then growing it in a lab.

So can you talk about that? Sure. And what the promise of that is? So I think this will be big in the future, which is you can, so it's really, I'll go over the four. This is the third one that we talked about. The third technology is banking your own,

taking your own fat, getting the stem cells from there, and growing ex vivo. So outside the body growing fat cells. And I think we'll see that in a few years as a safe alternative. So you could go to your doctor to get like a quick five-minute procedure because you don't need a lot of fat for that.

just take a little bit of fat out, send it to a lab, the lab will grow that fat tissue outside of your body, and then whenever you're ready, you get a notification on your phone and come back into the office and you get the fat transfer. And how long does it take to grow? I mean, fat, like most, and this has been done, this isn't, you know, this is new, but it's been done in many other examples. It's been done for bone, it's been done for skin, it's been done for other tissues, six to eight weeks. Basically, you get a little fat sample taken out. Yeah. And it doesn't Doesn't it be a lot? Yeah.

And then you can, you put in a lab and you cook it, basically. It goes in like a incubator and you grow your own fat cells. Yeah. You can grow as much as you want. Yeah. It'll be, I would say right now it's probably cost prohibitive. It's more experimental. But like with any technology, as it becomes more abundant in scales, the cost goes down.

What's available today and can be done today is you can bank your own fat. So four technology, four things we talked about for fat. The first is improving everything possible in the operating room with your own fat. The second is aloe clay or using somebody. else's fat. The third is banking or growing your own, growing your own fat cells outside your body. And the fourth one, which is available today, is you take your own fat and save it and freeze it and process it for later. And so if somebody's undergoing a procedure and wants to do fat grafting, but doesn't want to have to have liposuction every time, they can store their own fat outside

their body. And that's good for two things. It's good for as a source of stem cells for any number of things in the future. And two as a volume filler. But ultimately, you wouldn't even do the banking if you could just... Yeah, if you can just grow it, great. But right now, that's not a It's not commercially available, and it would be extremely expensive. It's kind of like, you know, with impossible meat and all the lab-grown meat, like lab-grown meat's a thing today, but it's $800 burger. I don't know how much it costs now, but it's expensive. It's less.

It's not $800. How far off is this growing your own fat technology for women? I don't want to put an exact number up, I'd say at least two to five years. It's like not right around the corner. In five years, in terms of the interesting in the volume, because we're talking about, you know, fat transfer, if you're thin, it's hard. But if you have a lot of fat, would you be able to have bigger breasts? Yeah.

And when I do fat transcers, I like to have at least three to 400 Cs of fat per side. And just for a reference, this is a 250-c-in implant. So like double that almost. Yeah, and a can have soda is about 330 Cs or something like that. So it's a good amount, knowing that not all of it's going to survive. And that's per side. So usually, like in the best case scenario, you'd harvest about a liter of fat, which is doable if you treat multiple areas in the body. As people are listening to this and wondering, you know, okay, this house sounds like promising.

There's actually this aloe clay now, which you can do. You can do if you're underweight. If you're, if you have plenty of body fat, you can use your own fat. How do you kind of coach women and explain to women when they're talking about their breast implants and worried about them and taking them out? Because that's a big deal. Like I think it's, I just want to sort of spend a minute on the psychology of that, how you handle that. Because I deal with this and I feel uncomfortable, to be honest, uncomfortable. Like I'm like, God, you know, this is a very personal thing.

You know, I think as a doctor, this is affecting your health adversely. if you want to not have this autoimmune disease, you know, I have this woman who's got breast implants and her platelets are like 10, and I'm like, everything is just not moving the needle. And I'm just like, listen, this is the thing. I think it's causing it. But, you know, what's the threshold that you kind of say,

okay, you've got to do this? The first place is like you're doing, it just comes from a place of compassion saying, like, you know, this is a procedure that you have that may be impacting your health. And also medically, it is a diagnosis of exclusion. So let's check, let's do every other possible workup

to make sure that it's not something like Lyme disease or your thyroid or this or that. Once everything else is ruled out, we've arrived at the final destination, which is, I think it could be the implants. And it's important to do everything else medically. Well, that's what I do. I deep dive on every possible other cause

from a functional medicine perspective of what could be gauzing it, and I get rid of that. And if they're still not better. And the latest research shows that it's actually more of a neuroimmunology, probably something closer to fibromyalgia, the way that it's approached and handled.

And so, I mean, imagine all the patients that suffer from my fibromyalgia, if you could say, I think it's this physical thing that's causing it. We've ruled out everything else. Let's remove it and see what happens. So the coaching or the counseling comes from first compassion. The second, where are you in the implant journey? Because if patient says, like, I heard about this yesterday and I think our breast implant list, I don't think it's a good time to have surgery within a week. It's, there's a lot of understanding that needs to happen and about the risks and the benefits of X-plant,

also the identity of who you're going to be on the other side because you've become this avatar of yourself over the past however long the implants are there, and it's a lot to dramatically change your appearance if you're not fully sure that the symptoms are caused by the implant or where you're out psychologically to prepare for it. So that process takes time. Usually I recommend patients wait at least six months to a year.

Many patients that come to see me, I've been thinking about this for years. They've been on message boards. They've talked to other patients. They've really done a lot of their own research to understand what it's going to be like on the other side and they're ready for it. A big mistake is to do a surgery too soon just because a patient feels like they're ready and then they're unhappy. And there have been situations where it's rare, but once or twice patients, one patient stands out in mind. She had her ex-plant, even though I felt like she was ready for it, she felt like she was ready for it.

And then months, about eight months later, she's like, you know what, I feel better, but I can't handle the way that I I look and I really want that look back. And that's part of the journey. So for me, it's more about doing everything I can from what I know and hearing what the patient's saying to say, like, you're really ready for this journey and it takes time. Also preparing before and after, there are protocols, things that help healing. And, you know, that's everything from preparing psychologically for it to physically. The amount of modalities out there is amazing to detoxify afterwards. So how long after women get an explet surgery, do they have to do they have to do?

wait before they do some kind of other procedure like a fat transfer. I usually recommend waiting three months. And I always stage it. I don't do the explet and the fat crafting the same time. It's like demolishing and building a house at the same time. It doesn't make sense. So let everything heal, adapt, get comfortable in your body, and then we can talk about the next step.

And that can be done. That next surgery could be done either awake or asleep. And I think awake is important because less general anesthesia, less risks of all those heavy medications. I think for everybody listening, you know, I can say as a, as a practicing physician, that this is a real phenomenon. The FDA thinks this is a real phenomenon that it can cause a range of symptoms from sort of mild, you know, fatigue and cognitive dysfunction,

all the way to full-blown autoimmune disease and cancer. And it's not to be taking it lightly, and it's a serious subject because a lot of women have this, about 5% of women in the country have breast implants, so it's just a big number. Many people are thinking of having implants, so I hope you could listen to this and understand the risks and kind of wait a minute and pause

and wait, maybe wait for these new technologies, use one of these other possible transfer transfer techniques. You're also thinking about how to really take care of women in a way that's safe and effective, but your thinking goes far beyond that. And you're one of the few surgeons that I've ever met that's thinking holistically about surgery, its impact on, and I've had surgery many times, and it's a very scary thing. There's not a lot of psychological support, and there's not a lot of ritual around it. There's not a lot of understanding of how it affects you.

I mean, I had massive surgeries, like about a year ago, and it was a lot, you know. I have a pretty good constitution and a pretty stable mind, so, but I remember, like, I mean, for mine, it was, you know, it was a very severe thing, and I couldn't have died, and, and I remember going into the operating room, and, you know, it's just, you know, you're kind of in the hospital, you're in a sterile environment, you're getting wheeled into the operating room, they kind of stick the needle in you, they go, okay, you're going to sleep, out, you know. And I remember this could be my last breath.

This is my last moment of consciousness, you know. And it was kind of scary. And you've been in the operating room for thousands of hours probably, and you understand what the normal approach is. And you've created this whole other framework. You call it surgery a ceremony. And I love that. So I'd love you to unpack that.

What is that? And what do you do this different? And why do you do it like that? So I know this might sound woo-woo and a bit out there, but I believe that we've removed a lot of the ceremony from many parts of our lives, the intention behind why we do things, the protocol behind it, the process, the ritual.

And I heard once this, it was a U.S. general I was giving a talk. He said, what is a protocol but a process, a process but a ritual, and a ritual but a ceremony? And it stuck out to me as, how many things do we do regularly in our life that are ceremonial nature,

but we treat them as a protocol. Think about flying. You know, there's the FAA checklist, which turns into flight school, which turns into the ritual of boarding an airplane. But the ceremony is like travel. Travel's amazing experience. But we've removed a lot of that.

And surgery is no different. We've taken what used to be, you know, it started, you were there in Egypt. We were in Egypt, and I was looking at the walls of, I think it was like, I can't remember raw or cop. Yeah, one of the gods.

Yeah. But they had all these hieroglyphs of surgery and pharmacy and things like that. And I was like, wow, even... And psychedelic mushrooms. Yeah, of course. It's got part of the experience. So 5,000 years ago, there were these elements of medicine and surgery that were very ritualistic, very ceremonial. You know, they didn't have a sterile, clean operating room.

They had these altars and things like that. And then if you really break down the nuts and bolts of surgery through a different lens. and I'm not the very first person to think about and talk about it like this. Maybe to operationalize it in a way that it's used in my practice, that might be new. When I was in residency, one of the surgeons used to play the Grateful Dead in the operating rooms, that was kind of like a ceremony. Music, and I'll talk about this, music is a huge part of it. Did you know that circadian disruption affects all of us,

and that most modern lighting misalines our internal clocks and quietly doses us with junk light, signaling the brain to stay alert long after our biology is preparing to rest? I felt this myself for years, that vague sense of being off even when everything else in my routine was dialed in. Chorus, the makers of Oyo, created a smarter solution. Their circadian lighting shifts gradually throughout the day to support your natural rhythm. And in the evening, it removes blue wavelengths so your body can do what it was designed to do, rest and recover. They didn't just build a new bulb. They spent years decoding how to bring the sun indoors.

And I've seen how the right light can transform how you feel. When people fix their light, everything shifts. mood, focus, sleep, and resilience. You can make the switch to lighting that works with your biology today and learn more about their newest product, OyoSphere, at KORS.com, S-P-H-H-E-R-E, and enjoy 15% off with code Heimonsphere 15. That's K-O-R-R-U-S dot com slash sphere. I've always believed that one of the most powerful things you can do for your health is cook your own food. Recently, I had some friends over and made some delicious, slow, brazed short ribs, steamed buckchoe, and some red potatoes. The meal was deeply flavorful with simple ingredients.

afterwards, someone said, you're such a great cook. I laughed because I always tell people what my mother told me. If you can read, you can cook. Cooking isn't about being a chef. It's about following simple steps using real food and having the right tools. That's why I love cooking with Maiden. Their cookware heats evenly is beautifully designed and is trusted by professional chefs as well as millions of home cooks. When I'm brazing short ribs or searing wild salmon, I know I'm going to get consistent results. And when cooking feels easier, you actually want to do it. That's how healthy habits stick. If you've been wanting to cook more at home or upgrade the pans you're using every day. This is a great place to start. Visit madeincookware.com and use code hymen 10 for 10% off your order. That's madeein cookware.com.

I know you will love these products as much as I do. If you think about a ceremony, what is this ceremony? Ceremony, it could be meditation, could be a week-long retreat. It could be sometimes plant medicine experience, but you have this desire to undergo a change, whether it's psychological or physical. you're looking for an altered state, again, it could be meditation, quieting the mind, could be some people do it with plant medicine. And then the third thing is you have to go through the journey. You have a guide sometimes that brings you.

And then if you look at surgery through that lens, well, you're wanting to undergo this major transformation, whether it's elective or not. You could have a broken knee or something. You want to be fixed. There is an altered state of consciousness, which is the medication that's using surgery. it's without a doubt 100 million surgeries a year people are having a consciousness altered for that time period.

Your conscience is being implugged, all these medications flood your system. And then you have to go through the journey and meet yourself on the other side. And very rarely is there psychological support after the surgery to say, even before to say like, oh, your body's changed,

but your mind has to catch up with what's happened. And the consensual part of surgery, which is I know I'm going to receive this damage from my surgeon, which, you know, it's very carefully done, but it's still damage. It's the coterie, things are being burned, things are being cut. You're asleep.

The shaman once told me that your body can't tell the difference between a samurai sword and a surgeon's knife. Exactly. And I was like, yeah. It's exactly the thought that led to this, which is surgery is a traumatic experience for the body. And if we're unplugging consciousness just before it happens, even though you knew what you went in for, when your body wakes up, it's still having to, you know, body keeps a score. It's trying to make sense of what's going on inside.

so why not have a system that allows more support for the journey for the experience of surgery? And that can happen before, that can happen during surgery and immediately after. So surgery ceremony is a protocol that has three parts. The first part is having psychological support immediately. It's like, I call it like surgical psychology. So basically, in preparation for your procedure, you meet with a therapist to go over the intentions, desire, fear, and anxiety that you might have around the surgery. The protocol that I use uses ketamine as part of the process, so it's ketamine-assisted psychotherapy.

Not a big dose, it's a very light dose, but it helps kind of drop the ego defenses so you can get into the discussion with the therapist. The therapist then will elicit certain keywords, mantras, and you know Dr. Kat, we've worked out. She helped craft this protocol, amazing therapist to work with. We'll help basically pull out little key phrases, mantras, and things to understand that are unique to that patient that I can then use during. surgery because patients are generally awake during their procedures to coach and talk them through it. And they're also listening to music during that first part. And this is where the Grateful Dead thing is actually pretty important. The music, that sort of like neuroacoustic recall that you hear during this transformative experience where you're dropping into why you're going to surgery,

if that playlist starts playing again during surgery, it's like a warm hug. You've like, I heard this before. I felt pretty good last time. Let me listen to that music again. And then I also have key phrases and words and intentions that I can say back to the patient of why they're doing this as a reminder. For example, one patient, her mantra was like, I want to come home to my body. And I could tell during the surgery as the medication was coming in. I also used ketamine as anesthetic during the surgery. I was able to, I said those phrases back to her. I said, you're coming home to your body and you just smile and it's just like, yeah, yeah, yeah, I'm ready.

So the ceremony of the surgery itself is also very important. So you talked about having surgery, it's this clean, sterile environment, it's loud, it's noisy, it smells weird. It's like nobody wants to go to a party like that. You want the light to be good. You want the music to be good. You want the vibes to be good. Why can't an OR be the same? So the energy of the staff that are in there,

they're here holding a patient's hand, tactile sensation. The release of oxytocin may be the best pain medication we know. So all those things add up. Right music, right lighting, right vibe. Even the bed has to be warm. I use these vibrating pads to help distract patients from the experience, drop them more into a parasympathetic state.

The ceremony of the surgery has a lot of steps to it, but the most important thing is it's about removing the things that are uncomfortable at the typical OR environment. The last thing is actually afterwards, so it's bodywork. It's coming home to your body. I work with a great team of lymphatic therapists that will help you land back in your body as you're integrating everything. And that's just really important.

So three parts. Before surgery with psychotherapy, the actual journey of the surgery itself, and then afterwards with bodywork. And all of those things come together to be. what I call surgery ceremony. Yeah, it's true. You know, I had this massive surgery in my back. And, you know, without the people I brought in to help me after, which was not

recommended by the surgeon, I don't think I would be where I am. You know, I had lots of body work to get back in my body. I had, you know, dry needleing acupuncture. I had physical therapy. I had, you know, I had all these things that helped to move the energy and get my body back. And it's amazing. I mean, my neurosurgeon was like, what are you doing?

Like, we've never seen anybody. recover like you. Like you're an anomaly. I'm like, well, this isn't rocket science. It's just, you know, understanding how the body works. And surgeons are great at like cutting and leaving them. It's like, boom, you're done. Not anymore. And what's really interesting is that, you know, you can ask a surgeon, what do I do after surgery? They almost don't even have an answer for you most the time. And don't list heavy things. It was like, all the don'ts, not what the do's are. Not the do's, but the don'ts. And I was like, wow. you also do other things to advise patients.

You mentioned red light therapy and there's other modalities. What else do you use in terms of helping recovery? So it's things you can do to your body and things you shouldn't do. And the things you can do, it starts with foods that you eat, actual physical things that you can do to your body and some other parts of the protocols. So I generally recommend a whole food, mostly plant-based diet, but having a lot of protein. Because after you have surgery, it's like your body's running a marathon. Yeah.

You need a lot of supplementation. Yeah. The next thing is I'm a big believer in red light therapy. The specifically near infrared and infrared light, 650 nanometers is about the wavelength that really stimulates mitochondria and improves wound healing. Hyperbaric oxygen is amazing. I know you're a big fan of that. Acupuncture and lymphatic therapy is essential.

I recommend it for all of my patients. It's closing that loop between what's happening in my body and what's happening in my mind. So if you're anxious, you're going to feel more pain. And if you're feeling more pain, you're probably going to feel more anxious. And it's just this loop. those kinds of modalities like lymphatic massage, acupuncture, they cut the loop. You're addressing the mind, relax, feel less pain.

It also feels nice to be to held and touched. There's other modalities that I think are great now. More and more I'm recommending peptides to my patients. So TB 500, BPC-157, thymus and alpha. We have a little peptide protocol that I think is more and more important. Up tissue repair regeneration, yeah. And to touch on what you said is, I think the old paradigm of surgeons is just cutting and leaving.

I think it's done. I think the most cutting-edge surgeon or the new way is, what do we do before and after surgery? How do we curate the whole experience for your wellness, not just cut and done? Yeah, and I think this kind of holistic view of surgery ceremony, of preparing patients before,

of how the environment is and how you do it and the post-top care, which is quite different. It's important. But I just want to touch on something I know you know about and I want to dive in because people don't think about this when it comes to surgery. And it's going to sound very crass, and you probably heard this in medical school.

But you remember those patients you'd operate it on and their tissues would just fall apart? Like you try to look so-um, and you're in the wound or in the surgical field. Yeah, it's like tissue paper. And it's like, yeah, you can't grab onto it with a needle and a rip. And we had a terrible saying for it. Do you remember what that is? Tell me. Piss-poor protoplasm.

Oh, yeah. Do you remember that? Piss-poor protoplasm, it's terrible. But it's kind of what doctors do to sort of deal with the gruesomeness of all the things they have to do is make jokes. But it's a real thing. And I think it has to do with how your body heals and wounds. And the cause of that, in my belief, is that it's people's overall health and diet and nutritional status. Because, you know, if your tissues are bad and you're malnourished and you're eating tons of sugar and you're inflamed and you have insulin,

which is to some degree over 90% of the population is on the spectrum, not of autism, but on the spectrum of insulin dysregulation and blood sugar issues, you know, you're not going to heal as well, like if your vitamin A is low or your zinc is low or your protein's low, as you said, or you have lower levels of omega-3s or... Even copper, like all these micronutrition are super important, yeah. And so I'm curious, you know, what I really found interesting was as I began to do functional medicine, I started to like, you know, use supplements and things 30 years ago. And one of the only other doctors and two groups of doctors using supplements were plastic surgeons and dermatologists.

And I was like, this is fascinating. And they're recommending stuff for wound healing and repair and recovery. And I actually, they were supplement companies that had like a pre and post-op supplements, which I thought were amazing that I used a lot of my patients. Yeah, I recommend them all the time. What should people do to prepare and what should people do after in terms of their diet and the right supplementation regimen to help them get through. of surgery. Great question. So before, it's kind of like the do's and don't. There's things you should do, things you should definitely not do. So you want to avoid

anything that might thin the blood. So avoiding omega-3s, ginko, ginseng, garlic, usually anything with a G kind of thins the blood. And that's not forever. Vitamin-e. Yeah, so like in the omegas and that category, things that we know thin the blood. Avoid those for at least a week before surgery. Of course, consult your doctor to know for sure. Plus aspirin and ad bill. Yes.

Anything that thins of blood. And it's interesting. N-s-sades, less less so now, the evidence for them that they But is there really evidence about the omega-3s? Like, is it just a... We just know that it's a blood. I'm a huge proponent of the omega-3s, but we know, like, it's the risk... We don't really have any good data during surgery.

It's a problem. We just hypothesize that it... I recommend them afterwards all the time. I just said beforehand, just to stop. Also, with the surgeries I do, the risk of bleeding is so low because there's not really big incisions. So it's less of a risk. But with other surgeries, yeah, for sure. But the things you should do is... So I think protein intake is incredibly important. Creating more and more evidence that it's actually...

important in the wound healing, zinc, copper, vitamin D. And so there are supplements out there that incorporate all those things. And I share a few with my patients. I think they're really helpful before and after surgery. I think the things that get slept on the most are Arnica and bromulane. So Arnica is a plant-derived thing that helps with bruising. And bromelane is a compound from pineapple that helps with swelling. Before surgery, you just want to make sure you're in the best shape possible to undergo the stress of surgery. Afterwards, you want to be doing things that are going to nurse the body. And the diet. Yeah. It's all, oh, diet's the most, I mean, you know, diet's the most, diet's the most important part. Yeah. So having, in general, I think a whole,

whole food, mostly plant-based, but obviously with a good amount of protein can be animal. And the base is good, too. Yeah, we were about to do a study to the head of orthopedics at, or one of the key orthopedics surgeons at Cleveland Clinic, I think. And he wanted to do a study knee transplants, like knee replacements. And he was like, listen, a lot of our patients bounce back because they're, being bounced back, they come back to the hospital with complications, infections, problems. And, you know, these patients who get knee surgery

usually overweight, and they have, that's why they have, you know, bad knees because you're putting massive forces of pressure of weight on your knees, which you're not supposed to. I forget the math on that, but it's like, it's like an exponential amount of force for every pound. And, and they come back with complications. And so we were about to do a study where we put people

on a 30-day program to reduce inflammation, to help them lose weight, improve their metabolic health and nutritional health as a pre-op strategy to reduce post-op complications and then even post-op the same thing. So I think that's really important. And I knew, for my recovery, I just loaded up on protein and inflammatory foods. And you know, you want just the right of inflammation and all the nutritional support you can get. I do, I think in the future, there will be diets that will be specific for certain surgeries. I mean, already sort of exists, but there's these thing called early recovery after surgery protocols, eras protocols,

a lot of hospitals have them. But I think with the more information we get about specific blood work and the type of surgery people are having and what's really good for them and their wound healing. Like if you're having bone surgery, it's probably better to be supplementing things that are going to support joints and collagen and things like that, more push that kind of healing more. If you're having more skin surgery, things that are going to, you know, favor more skin healing, brain. Like, I do think there's, there is a world in which we have more organ specific or surgery specific diets afterwards that are tailored toward your recovery. Absolutely. Yeah. I mean, it definitely wasn't a diet that I got served after my back surgery. So I think, you know,

we don't really have this consciousness in medicine, but we will. And I think your work around understanding, you know, surgery, ceremony, around using all these nutritional and lifestyle modalities and psychological supports and, you know, environment and post-up healing technologies, whether it's, you know, peptides or red light or hyperbarics, lymphatic drainage acupuncture, these are all things that should be used as part of standard of care. Hopefully they will be because they ultimately reduce costs because they reduce complications. they improve recovery.

They basically save money. So, John, thanks for enlightness about the dangers of breast implants, which I think most people need to know about. And also the hope of new technologies that are around, because it's not just all bad news. There's good news. Because that was the problem before. I was like, you know, okay, you need things out,

but like, I'm sorry. Like, there's nothing to do, you know, and now there is, which is really refreshing. And where can people find out about your practice, learn more about you, what you're doing, go see you. Best place is going to be online. My Instagram, it's at Dr.john.k, so D-R-J-O-N-D-K.

And I answer most of the message I get, and I always happy to chat. And what's your website? It's auraesthetica.com. So that's A-U-R-A-O-A-A-E-S-T-H-I-C-A-C-A-C-A-C-A-T-A-C-A-T-A-C-A-O-C-K. Okay, great. Or Aesthetica. We'll put a link in the show notes. I can't always if your book comes out.

I don't know when you're writing it. You better write it. I'm going to need your help. Give me some pointers. Definitely need to write a book on this. I'm thinking busted. Busted? Yeah.

That's a good one. Yeah. Something about breast implants is not being a thing anyway. Anyway, we'll workshop the title. Okay. Okay. Thanks, John, for coming over and doing what you do and being a pioneer and all this and thinking about things differently. I'm so glad to see how well you do.

with all. Yeah, I appreciate you, your friendship, mentorship, and always always good vibes. All right. Thanks. If you love this podcast, please share it with someone else you think would also enjoy it. You can find me on all social media channels at Dr. Mark Hyman. Please reach out. I'd love to hear your comments and questions. Don't forget to rate, review, and subscribe to the Dr. Hyman show wherever you get your podcasts. And don't forget to check out my YouTube channel at Dr. Mark Hyman for video versions of this podcast and more. Thank you so much again for tuning in. We'll see you next time on the Dr. Hyman Show. This podcast is separate from my clinical practice at the Ultra Wellness Center, my work at Cleveland Clinic, and Function Health, where I am chief medical officer. This podcast

represents my opinions and my guest's opinions. Neither myself nor the podcast endorses the views or statements of my guests. This podcast is for educational purposes only and is not a substitute for professional care by a doctor or other qualified medical professional. This podcast is provided with the understanding that it does not constitute medical or other professional advice or services. If you're looking for help in your journey, please seek out a qualified medical practitioner. And if you're looking for a functional medicine practitioner, visit my clinic, the ultra-wellness center at ultra-wellnesscenter.com, and request to become a patient. It's important to have someone in your corner who is a trained, licensed

healthcare practitioner and can help you make changes, especially when it comes to your health. This podcast is free as part of my mission to bring practical ways of improving health to the public, so I'd like to express gratitude to sponsors that made today's podcast possible. Thanks so much again for listening.