Best Way to Explant Cohesive Gel Implants 10 Years Later?

I have had small 270cc cohesive gel implants over the muscle for 10 years. I now wish to remove and not replace. I am not symptomatic nor do I believe they have ruptured. Should I insist on enbloc removal? I am in the UK not many surgeons do this procedure. Thank you

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4 Doctor Answers | Asked by dee in uk

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Enbloc removal of breast implants

There is no reason to do an enbloc removal of your implants even if the implants are ruptured. It would require a longer incision and be technically more difficult and risky. There is no real advantage to it either. I typically dissect around the outside of the capsule as far as I can reach before removing the implant. If the implant is ruptured most of it can be pulled out into a bowl and a little more dissection is all that is needed to free the capsule... more

Consider Tradeoffs of Enbloc Removal, Rather than Insist

Enbloc removal of gel implants is the removal of the implants while still in intact capsules: the surgeon dissects the capsule away from the surrounding breast and muscle tissues and removes the capsules without taking the implant out of the capsule. The surgeon tries to do this without penetrating the capsule so that there will be no leakage of gel, if the implant shell has failed (the capsule is now containing the leaky gel and preventing the gel from coming in contact with the... more

En bloc removal not necessary

Unless there is documentation of implant rupture, there is no real reason to remove the capsule surrounding the implant. This can be done with great accuracy using preoperative MRI imaging. If indeed there is a rupture, complete removal of the implant and capsule is the best option.

Implant removal

If implants are ruptured, it is sometimes better to remove them enbloc if the capsule is intact and the tissue are thick enough, so to avoid silicone leakage onto the tissues. While it is inert, it can sometimes be a bit messy to remove all the gel.