Breast Implant Removal Questions and Answers
En Bloc refers to the removal of a breast implant and the surrounding breast capsule in one whole piece. A capsule is a person’s reaction to a foreign body (e.g. breast implant). It forms 360 degrees around an implant. Capsulectomy refers to removal of a capsule; while en bloc specifies that the capsule and implant are removed together and intact.
En Bloc surgery is usually performed using an incision in the inframammary fold of the breast. The breast and muscle (if implant under the muscle) are carefully taken off the top of the capsule/implant. Posteriorly the capsule is carefully peeled off the chest wall while protecting the underlying structures. Once released, they are removed together.
Both terms ultimately refer to removal of the breast implant and ALL of the capsule. The difference is that En Bloc removal is the technique when they are removed intact with the capsule still surrounding the implant. Total capsulectomy can be performed by first removing the implant, followed by the capsule.
Occasionally an en bloc cannot be performed either due to safety or the characteristic of the capsule. In that situation a total capsulectomy is performed instead. In either case, ALL of the capsule is removed.
Breast implant removal with a breast lift Is the most common combination of surgery performed and can be done in one surgery and hence only one recovery.
A breast lift can be performed if the breast skin has been stretched or sagged, this excess breast skin will be excised/removed and the breast tissue tightened to provide better support. Areolas can be resized to better fit the new shape of the breasts. Lastly the nipple can be positioned to a higher and more youthful level.
Yes, in most circumstances, drains are placed after surgery. They are usually removed on the first post-operative visit.
It depends where your breast implants were placed in the original surgery. In most cases, breast implants are placed under the muscle. In that case the insertion of the pectoralis muscle into your chest wall was cut and released. We always recommend repair of that muscle after implant removal. That will prevent an animation deformity from forming and return your anatomy as close to pre-breast implant state as possible.
En bloc is not covered by your insurance company. In some occasions, a documented ruptured silicone implant may get covered for simple implant removal. In those cases, a MRI must be performed to prove the implants are both ruptured and silicone (not saline).