En-bloc Breast Implant Removal
En-bloc capsulectomy is a specific technique for permanent removal of breast implants. The procedure is usually performed through an incision in the inframammary fold area, and consists of removing the implant and the surrounding breast capsule-scar as an entire unit.
En-bloc capsulectomy includes taking a small cuff of the surrounding tissues such that the entire prosthetic capsule is removed. In this way, the patient can be reassured that all of the implant and surrounding breast capsule, which has ever been in contact with the implant, is removed completely. .
The Best Candidates for En-bloc Breast Implant Removal
This particular technique is used by patients who present with Breast Implant Illness(BII) symptoms, and is also the preferred technique for patients who have textured breast implants, to reduce the risk of ALCL (acute large cell lymphoma).
Planning Your Surgery
Once the implants are removed, there is often a very significant souffle/collapsed deformity that will persist. Patients have options of immediate reconstruction with techniques such as deep plane mastopexy-lifting or small canula fat grafting.
En-bloc removal is an outpatient procedure. The patient will have a full general anesthesia so the muscles can adequately relax.
After Your Surgery
En-bloc technique can be very painful. To minimize pain, increase safety, and enhance the postoperative experience, I always use intraoperative Experal with this surgery. This provides effective numbing-anesthesia to the treated areas for approximately 2-3 days, and has dramatically decreased pain and helped with recovery from this surgery. I include Experal with all of my en-bloc implant removals.
Patients should expect the first 2-3 days of recovery to be at home. Everyone recovers differently and at different rates, but suction drains will be utilized to help collapse the pocket so there is no fluid collection and reformation of a capsule. Drains will stay in approximately 7 days.
Major landmarks of recovery are approximately 10-14 days before patients can safely drive, and then gentle activity only until 4 weeks after surgery.
After 4 weeks, the tissues have regained appropriate strength, and patients are released for unrestricted/athletic activities.