It’s Wednesday, July 28, 2021. Dr. Bruce Van Natta is five-and-a-half minutes into an eight-minute public discussion with two colleagues.
This joint discussion by an all-male panel of plastic surgeons is in direct response to an “influencer’s” video declaring that breast implant illness is, in fact, real.
The “influencer’s” video has been viewed 4 million times.
The response has been viewed fewer than 125 times, thus the remarks made have evaded public scrutiny.
‘One of The Influencers’
“There was a video on TikTok by one of the influencers, about how he’s a believer in BII and it brought this whole mess up to the surface again.”
With these words, Boca Raton plastic surgeon Dr. Jason Pozner opens the discussion with two of his “good friends:” Dr. Bruce Van Natta from Indianapolis, Indiana, and Dr. Ned Snyder from Austin, Texas, on an episode of “No Spin Live” on The Plastic Surgery Channel.
The “influencer” whose video is under discussion is board-certified plastic surgeon, Dr. Anthony Youn.
Dr. Youn had shared his opinion about breast implant illness on Instagram and, when that went viral, with the New York Post, who ran an article on it under the headline of, “Celeb Plastic Surgeon Breaks Ranks, Says ‘Breast Implant Illness’ Is Real”
The June 8, 2021 Instagram Reel from Dr. Youn is merely a re-post of a video he had filmed and posted to TikTok in January 2020, and again to Instagram in August 2020.
By the time mainstream media picked up the video, it was 17 months old.
@tonyyounmd Symptoms of Bre*st implant illness. Be educated. #plasticsurgeon #implants #plasticsurgery #surgery #todaywelearned #doctor #foryou #fyp
♬ original sound – _ritikaaaa
Citing Science
“He doesn’t cite any science,” says Dr. Van Natta about Dr. Youn’s video and interview with the Post.
Possibly unknown to Van Natta, and thus unmentioned, is a series of articles, podcasts, and videos by Dr. Youn that cite published studies—though the science is far from settled.
“He’s saying that it’s real, but how the hell do you define ‘real’ when we haven’t even defined the entity?” Van Natta continues.
Van Natta makes clear that he and others agree “there is the possibility of a small percentage of patients [who] could have something going on related to their implants,” but adds that that doesn’t mean it’s the implants per se. Instead, one possibility is that it may be bacteria around the implants.
He also says he is sponsoring research into breast implant illness through The Aesthetic Surgery Education and Research Foundation (ASERF).
In May 2021, Dr. Van Natta announced he was elected to an executive role in ASERF and is today listed on the society’s website as its President-Elect.
(Surgical Times reached out to Dr. Van Natta on September 3rd but did not hear back.)
‘Good Science Takes a While’
Van Natta argues that good science takes a while.
“It’s not like we’re blowing this off or discrediting it,” he says.
“What most of us are asking for is good science. Good science takes a while. We’re working on it as you [Dr. Pozner] pointed out.
“It’s going to take a year or two to sort out.”
How can breast implant illness be “real” if it hasn’t been defined?
It’s the same rhetorical question Van Natta asked two years ago—on the same channel and platform.
“One of the issues here is we haven’t defined it,” he says in a June 17, 2019 video. “And you can’t study, learn about something, treat it, if you don’t know what it is.”
“So, at the end of the day, we need to study this. And it’s incumbent upon us, as plastic surgeons, to lead that charge,” he said in 2019.
From what date exactly should the 150,000-plus women in Facebook groups start counting down the “year or two” before studies are complete?
‘This Facebook Group’
“They don’t have the ability to filter and, some of these [Breast Implant Illness] groups, it’s kind of like the anti-vaxxers. It’s a bit of a cult.”
Dr. Bruce Van Natta
“Somebody comes back to this Facebook group and they’re like ‘I had my implants taken out and I still have my symptoms. And they’re like, ‘Well, you haven’t waited long enough, you didn’t go to the right surgeon,” Van Natta continues.
“You know, rather than ever acknowledging—I mean even if you truly believed in the whole concept of BII the way some of these people do, it can’t be all these people, right?”
Van Natta is evidently referring to the same group listed in the Post article.
“Breast Implant Illness and Healing by Nicole,” formed on April 1, 2016, now has more than 150,000 members.
That’s a sizable number, but still half the average number of women who undergo breast augmentation in any given year.
But public sentiment toward breast implants may be changing.
Despite doctors who deny that breast implant illness even exists, plenty of other board-certified plastic surgeons see something to it, and awareness of the condition is increasing.
In 2020, breast augmentation plunged from its perch of popularity.
For the first time in 15 years, it wasn’t the nation’s most popular procedure.
Of the nearly 30 different plastic surgery procedures tracked by the American Society of Plastic Surgeons, breast augmentation saw the greatest dip in procedures performed, while breast implant removals (explant surgeries) saw the largest uptick.
Social Media’s Place in Science
For an illness that evidently affects so many women—who, for a sense of shared understanding and community have congregated on social media—one wonders if the ability to so easily reach out to them and conduct any sort of study could be capitalized on.
Aspects of social media and its influence on patient’s desires to have plastic surgery have been the subject of numerous studies.
“Since the internet is a key source of information and action regarding female genital cosmetic surgery, comments on social media sites were important data sources for my research.”
Lindy McDougall, “The Perfect Vagina; Cosmetic Surgery in the Twenty-First Century” (2021)
Lindy McDougall, author of “The Perfect Vagina; Cosmetic Surgery in the Twenty-First Century” (2021, Indiana University Press) writes that, “Since the internet is a key source of information and action regarding female genital cosmetic surgery, comments on social media sites were important data sources for my research.”
McDougall, who spent years studying the rise, rhyme, and reason behind FGCS, goes so far as to say the subject “cannot usefully be understood without examining social media.”
Apropos to Dr. Van Natta’s cult comment—an in direct contradiction of it—McDougall also argues that plastic surgery acts as both a ritual and sacrifice, submitting the self to pain with the promise of transformation.
“Cosmetic surgery has a powerful ritualistic component,” “involves sacrifice,” and “is also a rite of passage,” she writes.
‘Suckered Into’ an En Bloc Capsulectomy
Van Natta and Pozner believe the solution to breast implant illness as frequently requested by patients is built on a foundation of “misinformation.”
They believe that the procedure, called en bloc capsulectomy, can actually be dangerous.
“People get suckered in,” Van Natta said, “because, well, let’s face it, they’ve got symptoms, they’re frustrated, they’re desperate.”
“And then they’ve got someone that tells them, ‘Okay, you’ve got breast implant illness and the ONLY treatment is this capsulectomy thing.’ And they’re vulnerable, and I think that’s unfortunate in a lot of people getting surgery they don’t need.”
Dr. Snyder adds that “only a percentage of them get better when we take implants out anyway.”
‘Significant Improvement’ After En Bloc Capsulectomy
But a different video on the same channel features yet another board-certified plastic surgeon, Dr. Robert Whitfield, who says his BII patients have seen significant improvements after an en bloc capsulectomy.
“In this small subset of patients who feel like their breast implants are making them sick, I’ve offered them en bloc capsulectomy, where we remove the entire capsule and the implant… and for the most part, we’ve had a significant improvement in their overall state of well-being after implant removal….” says Dr. Whitfield.
“We’ve really seen our patients really do well afterward.”
‘Virtually Every Explant Patient’ Reports Improvement
Dr. Van Natta has said as much himself.
In the video mentioned earlier, he says, “My partner, Dr. Christine Kelley…has a whole routine of removing the capsule, the implant, washing out the pocket with three liters of saline each side.
“She tells me that virtually every one of the patients comes back and reports some improvement in their symptoms.”
Adding Fuel to the Fire
For a video that began with the apparent goal of providing a reasoned counterargument to Dr. Anthony Youn, we certainly went from “breast implant illness isn’t real,” to disparaging generalizations very quickly.
Is it any wonder, then, that members of this community choose to think for themselves and share information amongst each other?
Doctor, these comments have meaning.
Jason Pozner, MD: “I think Tony added fuel to the fire with this.”
Bruce Van Natta, MD: “I agree. I was disappointed.”
Ned Snyder IV, MD: “Well totally, I think that you can’t just make comments that have [meaning]—if you’re out there as some sort of authority, even if it’s you’re a social media authority but you’ve got followers like he does—and you make comments about things, those comments have meaning at least to a certain percentage of your followers…. you kind of have to be careful about what that conveys.”
Doctor, these comments have meaning.