Emergency Explant Surgery & Recovery for Mel Cain
Donation protected
I am asking for support to help cover a medically necessary surgery to explant recalled ruptured and poisonous breast implants from my body.
In the fall of 2022, my health took a drastic turn downwards, I started feeling very ill, struggled with chronic fatigue, extreme anxiety and depression and flu symptoms. There were several days I couldn’t get out of bed and my joints and body started aching as if every day I was walking around with Covid. I was prompted to get blood work and see my primary for further testing and it was discovered I had developed an autoimmune disease called Lupus. In December, I started experiencing strange neurological symptoms and started to develop Raynaud's Disease which affects the circulatory system resulting in blue hands and feet from poor circulation. I also started noticing pain and burning in my chest area. Lupus is a common symptom or side effect of Breast Implant Illness which is a newly recognized set of manifestations of disease related to women who have breast implants. This is something that I was researching and that had come into my awareness several months back. Explant surgery is something I knew was in my future as they are not lifetime devices and a lot of the unresolved sexual trauma and psychological reasons behind deciding to implant in the first time had been recognized and resolved to a degree. At the time I was contemplating explanting, but it was more for spiritual reasons. With the newly developed Lupus, I knew my body was asking me to dig deeper and make a drastic change soon, as my health was deteriorating.
On New Year's day 2023, I woke up to a rash and pain in my right breast and armpit and aching lymph nodes on my right side. I also had flu symptoms, numbness and tingling in my limbs and shocking nerve pain running through my body. That day I looked up my insurance policy and read over the coverage details for a mammogram and called and requested a mammogram from my primary Dr. to rule out any issues with my implants and also started researching the recommendations for screening for issues, ruptures and policy coverage for defects. During this time, I discovered by implants (Allegra brand- Model SRF Natrelle Inspira 415cc) Were Recalled by the FDA. I was never notified by the manufacturer or the Dr's office . ( There isn’t a shared registry or board that tracks this information for consumers evidently).
The recall is specific to textured Allegra Implants for its direct association with a breast implant-induced immune system cancer called BIA-ALCL. Breast implant-associated anaplastic large cell lymphoma.
After reading the information on the recall by the manufacturer I read a small print section that recommends that “Symptomatic patients get MRI or Ultrasound screening because the risk of exacerbated symptoms or rupture during the procedure is common. over 60% of patients that get a mammogram end up with a rupture from the procedure or exacerbated symptoms from the procedure when they had an undetected slow leak.
My insurance wouldn’t pay for an MRI without a preauthorization and letter of medical necessity so I combed through the policy exclusions and wrote one that my Drs office could fill in. They accepted and I was able to get an MRI and have insurance cover it by quoting the recommendation on the FDA and manufacturer website in regards to MRI over Mammogram.
My breast MRI came back clear at first, then 2 weeks passed and I received an addendum and follow-up call that there were suspicious spots on the left side and I was recommended for a biopsy. I found a support group for women with Breast Implant Illness and an approved explant surgeons list where other women were navigating the same issues all over the world. I found Dr. Ramen Mahibir of Tuscon Plastic Surgery for a consult for biopsy and explant. He is a skilled microsurgeon and expert in treating Breast Implant Illness and has been fighting in WA D.C. for Breast Implant Illness to be recognized as a medical condition so that insurance will start to cover testing and procedures related to treatment and complications. He worked to pass a bill that requires surgeons to do screenings and provide informed consent about the danger of implants before moving forward with surgery. He supports and believes in Breast-Implant-Illness and related diseases and works hard to provide his patients holistic care pre and post-surgery.
I was able to see him for a consult on March 3rd, 2023. At the consult during the initial breast exam, he used ultrasound which is an alternative way to detect leaks or ruptures and it was discovered via ultrasound that my left breast implant had a small leak and that the right side was ruptured and there was “Milky and snow storming seen on the scan which is indicative of rupture”. This was not picked up on the MRI.
BIA-ALC usually forms in the capsule and the scar tissue that forms around the breast implant. My right side has pain and swelling at the bottom right side of the capsule and scar tissue. Total Capsulectomy or En Bloc is the recommended treatment for ALCL along with extensive testing of the fluid and the tissues in the capsule post-surgery. If any disease progression is found by pathology the next step would be to meet with an oncologist for further treatment recommendations and disease staging.
Explant surgery is not usually covered by insurance if the implant was originally placed for cosmetic purposes. However, some insurance policies will cover if the surgery is deemed medically necessary due to disease progression or rupture. In this case, the liability would first fall back on the manufacturer. Currently, Allegra, the implant manufacturer is only offering to pay for and REPLACE the defective implants. That isn’t helpful if the implants are killing you. I can join the class action lawsuit against the manufacturer and hope for a settlement someday or I can hire a private attorney to take on my case. If you suspect cancer or any other disease you are left to pay for your own testing and follow-up treatment including chemotherapy and radiation for cancer treatment worst-case scenario. The medical system doesn’t currently recognize BII as a diagnosis code so a lot of the legislation and advocacy work that needs to be done with the insurance and manufacture comes down to reporting, case studies and direct evidence and most women fighting this are so sick they just suffer in silence or go into debt to pay for the treatment they need. Not all women catch and treat in time. The FDA filed a
I'm currently paying out of pocket for this surgery and testing. Prepayment is required to even book with a specialist surgeon and is required at the time of Pre-Op. For me, that is April 10th, 2023. Because the medical system doesn’t currently recognized BII as a medical condition, there currently is no diagnosis code that can be used for billing insurance. To create an electronic bill there has to be a diagnosis code and a treatment code that goes hand in hand together. Therefore, treatment codes for billing are denied if they aren’t coded right and that correct code then has prior approval or authorization. It is quite the process and is part of the reason, documentation and researching all this information is important. My best option is to document my case and then prove medical necessity and get reimbursed for treatment after which has worked for many other women suffering from BII.
My short-term goal is to safely explant and start a detoxing protocol with a licensed naturopath in Sedona focusing on heavy metals then parasites and candida. I will need money to help cover testing and supplementation to detox and recover and to send labs to pathology for cancer testing.
For pain relief, I was able to get a medical marijuana card through the state last week. My surgeon recommends using cannabis for pain management over narcotics. Unfortunately, a card doesn't cover the cost of medication but you don't have to pay tax.
The total cost of my surgery is $12,950:
Bilateral Capsulectomy:$7500
Operating Room Fee $3200
Anesthesia $1500
Exparel Suspension $750 -This is a nerve pain block recommended to decrease the
I am allocating another $5000 for:
Testing and lab fees
Hotel and travel to and from Tuscon
Post-operative rehab Myofascial Therapy, Red Light and Cryotherapy as well as mental health support.
For a total of $17950
My long-term goal is to use my case study to further support the legislation and development of resources and funds to aid women in fighting this disease.
Here are some links and info regarding some of the information I have shared. Please reach out with any questions. Thanks for all the love, prayers and support.
With appreciation,
Melanie
Organizer
Melanie Cain
Organizer
Sedona, AZ