Nova Scotia

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

Sarah Gray of Middle Sackville, N.S., has struggled for years with pain she believes is caused by her breast implants. After being bounced between doctors and undergoing multiple tests, the 34-year-old has found a Montreal surgeon who's willing to remove her implants.

Sarah Gray says she spent years trying to find a surgeon to take her concerns seriously

Sarah Gray has struggled to get a proper diagnosis for what's been causing her health to deteriorate over the past five years. (Phoebe Malone Photography)

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

Shrugging it off, Sarah Gray of Middle Sackville, N.S., thought it was a normal side effect after having children.

But as the pain persisted and worsened, Gray wondered 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, is convinced she is experiencing symptoms of breast implant illness, but persuading doctors to believe her concerns has only caused more distress.

Breast implant illness refers to a wide range of symptoms similar to autoimmune or connective tissue disorders that develop after undergoing breast implant surgery. It has been connected to various types of implants, include saline and textured surface.

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

Gray has had textured implants for the past nine years. Textured implants have an exterior like sandpaper that keeps them from moving around in the surrounding breast tissue. Scar tissue, also called a capsule, naturally forms around the implant, something that happens with all implants.

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

Trouble convincing doctors

The first time she went to see a plastic surgeon in Halifax to talk about removing the implants in 2019, Gray said she was talked out of it.

The surgeon told 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.

Gray, pictured here with her daughter, says she doesn't want anyone to go through what she has. (Submitted by Sarah Gray)

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 condition until a few years back. His opinion began to change when more and more people with breast implants started appearing at his office asking for removals. 

Some exhibited 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 request an en bloc capsulectomy — a procedure that removes not only the implant, but the capsule and scar tissue as well. 

To date, Nicolaidis has completed over 400 of these "explants." 

Symptoms escalated for Gray two years agoThe 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, Gray knew it was her implants.

Search for a surgeon

For the past two years. Gray has researched breast implant illness and completed medical 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, the MRI may have missed it if it's behind the implant and against her ribs.

A plastic surgeon holds a breast implant in this file photo. (Craig Chivers/CBC)

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 MSI if 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 out in Nova Scotia. She was told a sample of the scar tissue would be removed first and tested for breast implant-associated anaplastic large cell lymphoma, a serious but rare type of non-Hodgkin lymphoma currently being studied by Health Canada.

Online group leads to Montreal

A Facebook support group for people with breast implant illness eventually led Gray to 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 clinic will set her 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. And I couldn't find anybody here," she said. 

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

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