I have 18 year old breast implants placed behind the muscle wall. I want the implants removed. I do not want replacement of implants. Is the en bloc method of removal best for my case?
En Bloc Breast Implant Removal?
Doctor Answers (4)
Options for en bloc implant removal
En bloc removal of your breast implants may not be necessary. It would depend on what your goals are. If your implants are saline, there would not be any need to do an en bloc removal as the scar tissue/capsule around your implant will shrink and eventually be resorbed once the implant is removed. Taking the additional time to remove the capsule off the back of the muscle and the front of the ribs would needlessly add cost and prolong your recovery with no benefit.
For silicone implants it may be a different story. All silicone implants have microscopic amounts of "gel bleed" meaning microscopic amounts of silicone leak across the shell and some of this is trapped in the scar tissue/capsule surrounding the implant. Although the best studies to date do not show any problems with this, some patients wish not only the implant removed but "as much of the silicone as possible" removed.
An en bloc removal would remove both the implant and the scar tissue/capsule around it. If the silicone implant is already ruptured inside the capsule, en bloc removal would prevent spillage of the silicone during removal. Again this is not an issue with saline implants.
En bloc removal of breast implants
En bloc removal can be an easy procedure or an exceptionally complex procedure that may make if very difficult and nearly impossible to remove the entire capsule. This is especially true where the implants have been placed under the muscle and the posterior wall is adherent and contiguous with the ribs.
If after 18 years you no longer want your implants, they certainly can be removed. En bloc removal is questionable. Removing the implants with or without the surrounding capsule is usually recommended.
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I don't perform en bloc removal in most cases
If the implants are ruptured silicone gel, with evidence on MRI that the gel has moved beyond the capsule, then there may be a reason to do so. My opinion is that the en bloc resection can remove too much breast tissue.
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.
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