MTHFR Gene - Should I decide to move forward based on this testing or proceed with my wish to have a breast augmentation?

Dear Kbrow272,

it is hard to tell for sure without an examination. If you are considering surgery, I would suggest you consult a board-certified plastic surgeon. Only after a thorough examination, you will get more information and recommendations.

Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

You should see a hematologist to confirm safety, but after speaking with a few myself, they dont consider MTHFR a hypercoaguable condition, meaning it doesn't put you at higher risk for venous thromboembolism (DVT/PE) post-operatively. Plus, breast augmentation has a very low incidence for venous thromboembolism (DVT/PE). If you are otherwise healthy and at a good BMI, you are likely safe to proceed, but obviously the surgeon has to review your full medical history and examine you before confirming that.

The MTHFR gene is not specific. I am not sure it would predict whether you have breast implant illness. However, you state that you have had 2 pregnancies with breast feeding. Unfortunately, you have not provided photographs or told us your bra size. Often times, after 2 pregnancies with breast feeding, women need a breast lift. The lift technique I recommend is The Bellesoma Method. This will reshape your breast tissue creating upper pole fullness without implants, elevate them higher on the chest wall and more medial to increase your cleavage. Vertical scars are avoided, nipple sensation (in 95%) and the ability to breast feed are maintained. Later, fat transfers can be performed if additional volume is desired.

Best Wishes,

Gary Horndeski, M.D.

I have no personal experience with this but from my understanding this can be managed with proper medical care. Therefore one could assume you would be ok for breast augmentation. Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author. RealSelf Distinguished Hall of Fame Inductee. Philadelphia, Pa., USA

This surgeon sounds misguided and not necessarily a gas-lighting misogynist out for financial gain through exploitation of women's fear. BII, or more aptly SSBI (systemic symptoms from breast implants), has been whittled down to no identifiable pathophysiologic process. Virtually no stone has been left unturned, and that includes this non-sense MTHFR gene. The whole concept that there is something in the silicone elastomer, the material of the outer shell of both silicone and saline filled implants, that gets shed from the device and enters the body has been completely disproven by very thoughtful clinical studies showing that people 'get better' whether all the capsule is removed or NONE of the capsule gets removed. Further, the same material is in dozens of permanent implantable medical devices in millions of people around the world, none of whom have a mysterious symptoms. The real problem all along is not what breast implants are made of, but instead it is what they do: they make women's breast bigger. Proof in point is the testicular implant. These devices were the very first cosmetic prosthetic devices ever implanted, starting in the 1940's. They are made of.... silicone elastomer. Millions of men all around the world have been implanted over the last 80 years and no one has testicular implant illness. if you need more info, please read these two relative short books on Amazon: Silicone On Trial by Jack Fisher, and Science On Trial by Marcia Angell. Yes, very similar titles. Very illuminating. Madam, this whole thing has been a sham. Get your breast implants and live life!

It does not seem that there is any direct connection between positive test and increased risks of surgery. However, genetic counseling may help you to make right decision. Good luck.

Thank you for your question. After 2 pregnancies and breast feeding, it sounds like you may be an ideal candidate for breast augmentation. One of the downsides to genetic testing is what to do with the results. The key ones to look out for are the genes that predispose to breast cancer and ones that may increase your chances of a blood clot, i.e. DVT or PE. Unfortunately, there is no "true" genetic test to predict breast implant illness, as research is ongoing. It sounds like you are doing the right thing and seeing multiple consultations to see which surgeon is most compatible with you. A thorough discussion will help narrow your choices. Good luck on your journey!

I understand how frustrating it must be to have spent all of that time doing your research and frustrating a surgeon you felt comfortable with, only to have this come out of nowhere and complicate everything. Now your Surgeon is correct, the MTHFR gene had been "linked" to Breast Implant Illness, it is still not well understood, and neither is Breast Implant Illness itself.I personally have performed Breast Augmentation on patients with the MTHFR gene and they have had no issue. I believe it is necessary to have a conversation about the data that we do have, so that the patient is able to make the best informed decision. As to whether you should have the surgery or not, that decision is a personal one and there's no way anyone can predict your specific risk. The one thing I would definitely advise would be to not push the surgeon that already said he would not offer a Breast Augmentation to you, to do it. The last thing you ever want to do is ask a surgeon to do something that they are not comfortable with, even if you are. I hope this helps, and I wish you luck in your journey.

You should always fill out your medical history, accurately and disclose all known medical conditions.
Withholding important medical information is inappropriate.
It is ultimately up to each plastic surgeon who they deem appropriate for surgery.
If your internist gives you clearance, there may be plastic surgeons willing to do your procedure.
Best,
Mats Hagstrom MD