En Bloc Breast Implant Removal


The removal of breast implants are requested for various reasons by women.  Simple exchange may be desired for implant rupture, capsular contracture (scarring around the breast implant), change in size, change of position of the implant (subglandular, submuscualr, or subfascial), or change in type of implant (saline, silicone, or shaped).  Some women also just choose to have her implants removed altogether.


There are various ways in which to have the implant removed.  It is arguably wisest and the best way to explant the breast prosthesis en bloc (removal of implant, all extruded material, and capsule in full as one).  While there are few surgeons who actually perform the capsulectomy and implant removal in this manner, it is the preferred method with us.  This allows complete removal of all of the scar and capsule.  In addition, it affords the overlying breast tissue and/or muscle to return to its anatomic position on the chest wall and fully allow adherence back to this place.  Sometimes a drain is used to promote this adherence and minimize the amount of fluid accumulation, which can further promote a capsule in the potential space that the implant was exchanged or removed.  This en bloc method also produces a better aesthetic result as it creates softer and more supple tissue, having an improved shape overall.


With breast implants, it is common for the overlying tissue to atrophy over the years as well as the normal changes of the breast over time with age, pregnancy/breastfeeding and weight gain/loss – causing breast ptosis (sagging).  Removal of implants will remove the size and fullness of the breast and may have the appearance of significant ptosis.  A breast lift may be required to improve the appearance – an examination would be needed to determine this.  If so, having the lift performed at the same time or at a separate time will be discussed as it may impact the overall viability of the breast/nipple.  The en bloc method has been a popular procedure for us and has significantly made big differences for women with pain, deformity, and issues with her breast implants.  Women from throughout the country and internationally have sought this procedure with us.

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