Struggling with pain for years, N.S. woman heads to Montreal for breast implant removal

It all started fiveyears ago, with minor pain in her breasts.

Shrugging it off, Sarah Grayof Middle Sackville, N.S., thought itwas a normal side effect after having children.

But as the painpersisted and worsened, Graywondered if the breast implants she had received years earlier were to blame, and set out to have them removed as soon as possible.

"I can't even play with my kids. I can't cook, and some nights I can't even brush my teeth on my own," Gray, 34, said in a recent interview. "That's why I'm not waiting."

Breast implant illness

Gray, who is scheduled for a removal surgery Tuesday at a private Montreal clinic,isconvinced she is experiencing symptoms ofbreast implantillness, but persuading doctors to believe her concernshas only caused more distress.

Breast implant illnessrefers to a wide range of symptoms similar to autoimmune or connective tissue disordersthat develop after undergoing breast implant surgery.Ithas been connected to various types of implants, include saline and textured surface.

It is also a poorly understood conditionthathas not been extensively studied and isnot yet recognized as an official medical diagnosis, according to Breastcancer.org, a U.S.-based non-profit.

Grayhas had textured implants for the past nine years.Textured implants have an exterior like sandpaper thatkeeps them from moving around in the surrounding breast tissue. Scar tissue,also called a capsule,naturally forms aroundthe implant, something thathappens with all implants.

Gray's are placed "under the muscle," which meansthey rest underthe natural breast tissueinstead of on top of it.The texture keeps them in place, right against her rib cage.

Trouble convincing doctors

The first time shewent to see a plastic surgeon in Halifax to talk about removing the implantsin 2019, Gray said shewas talked out of it.

The surgeontold her there was no way her implants were making her sick, and she "would have to be kicked in the chest by a horse" for the implants to burst, Gray recalled.

That reaction doesn't surprise Dr. Stephen Nicolaidis, a plastic surgeon at Contour Clinic in Montreal who has studied breast implant illness and has agreed to perform Gray's surgery.

He didn't believe in the conditionuntil a few years back. His opinion began to change when more and more people with breast implantsstarted appearing at his office asking for removals.

Someexhibited symptoms of breast implant illness, which can include joint and muscle pain, fatigue, trouble concentrating, breathing problems, rash, headaches and depression.

"To hear about colleagues who are just telling their patients,'This is just in your head,'really infuriates me," said Nicolaidis.

More than 400 procedures

He no longer performs breast implant surgeries. He only focuses on removals,and listening when patients requestan en bloc capsulectomy a procedure that removes not only the implant, but the capsule and scar tissueas well.

To date, Nicolaidishas completed over 400 of these "explants."

Symptoms escalated for Gray two years ago.The pain in her breasts increased and her hands began to go numb, followed by intense pain shooting up her arms.

"It was just on my right. But now it's starting to happen on my left and now it's like progressing to my feet," she said.

She also began having intense allergic reactions without any known cause.After a test result came back saying she had a new silicone sensitivity, Grayknew it was her implants.

Search for a surgeon

For the past two years. Gray has researchedbreast implant illness and completedmedical tests in hopes of finding answers, including an MRI that did not find a rupture.

But ruptures of textured implants are almost impossible to recognize without removing them, and even MRIs can fail to detect them.Unlike saline implants, they can retain their shape even if they have burst because they slowly leak over time.

Gray said if she did have a rupture, theMRI may have missed it if it's behind the implant and against her ribs.

Determined to have her implants removed,Gray began inquiring about en bloc surgery in her home province. But she said her concerns were repeatedly dismissed and she was discouraged from going ahead with the procedure or told that certain surgeons did not perform it.

Implant removal can be covered under MSIif there's evidence the implants are causing pain or disfigurement. In Gray's case,surgery would be considered esthetic and she would have to pay out of pocket.

With her pain intensifying, Gray said she was concerned about how long it could take to have the implants and capsules taken outin Nova Scotia. She was told a sample of the scar tissue would be removed first and tested forbreast implant-associated anaplastic large cell lymphoma, a serious butrare type of non-Hodgkin lymphoma currently being studied by Health Canada.

Online group leads to Montreal

A Facebook support groupfor people with breast implant illness eventually led Grayto Nicolaidis, who is experienced in en bloc surgeries and could perform the surgery with little delay. Perhaps most importantly, he believed Gray's concerns from the start.

Though the surgery at a private clinicwill sether back $15,000,Gray said it's worth the cost.

"I have to find someone that will take the scar tissue capsule with the implant. AndI couldn't find anybody here," she said.

"That's why I'm going to Montreal. To get them out."