I Have Heard That Enbloc is the Way to Go? Anyone Have This Proceedure?

asked 1 year ago by Suss in Spokane, WA
Latest answer by Sepehr Egrari, MD
Question viewed 321 times
Tags: female, scar tissue

for breast implant explant there is a proceedure called enbloc, which removes tissues around the implant as well, it makes sure there is no scar tissue etc. is how i understand it to be the gold star way to remove them?

10 answers to I Have Heard That Enbloc is the Way to Go? Anyone Have This Proceedure?

En bloc removal of silicone and capsule in breast surgery

It is possible to remove the silicone shell, ruptured implant and scar tissue in one piece, or en bloc. This is a relatively easy procedure for most board certified plastic surgeons to perform. The incision for en bloc removal is a bit longer since after all the entire old implant plus scar tissue must be removed through that incision.

Brent Moelleken, MD
Beverly Hills Plastic Surgeon

Enbloc Implant and Capsule Removal

Capsular contracture which is one of the most common complications of breast implants can be a frustrating result. Many different methods of dealing with contracture has been described. It is widely accepted today that the best method to treat an established contracture is to remove the implant and the capsule around it. This is perhaps what is being called an "en bloc" removal. Furthermore replacement with a new implant is another important element of success. So, a... more

Sepehr Egrari, MD
Seattle Plastic Surgeon

www.egrari.com

It's Not the Gold Standard

If your surgery is being done for treatment of capsular contracture or a leaking silicone implant, an "en bloc" resection is usually not the best choice. It involves total removal of the capsule and implant which increases the risk of postoperative bleeding which leads to a higher risk of capsular contracture. A partial removal of the capsule with the implant, or removal of the implant combined with placement of a new implant in a different location, usually works better... more

George Sanders, MD
Los Angeles Plastic Surgeon

Breast implant removal may require removal of the capsule

When silicone gel breast implants are in place for a very long time, a leak into the capsule can cause a contracture and calcification of the capsule. When this happens, it is necessary to remove the capsule completely with the old implant to give a fresh start for the new implant. Some will call this 'enbloc' a rather fancy term for 'in one piece'. The capsule and implant are removed together. This is not a gold standard or only way to go, as often the capsule can be... more

Peter E. Johnson, MD
Chicago Plastic Surgeon

www.peterejohnsonmd.com

Using a sledgehammer when a flyswatter will suffice: enbloc vs neopectoral pocket

Using a sledgehammer when a flyswatter will suffice is not always a good idea even if it accomplishes the job. IF you have an intact silicone implant with a capsular contracture, a neopectoral pocket is a perfectly reasonable alternative without radical and unnecesary resection of the capsule, surrouding breast tissue, muscle, etc which could result in an increased risk of secondary problems. There are no data to suggest the superiority of this technique in... more

Otto Joseph Placik, MD
Chicago Plastic Surgeon

Enbloc technique

The enbloc technique is really more for cancer resection to remove all the tumor and some surrounding normal tissue. This prevent tumors cells from going into healthy tissue. What I think you are talking about is a total capsulectomy which is removal the all the capsule with the implant still in it. The reason this is done is to try to avoid silicone from going into the tissue if the implant is ruptured. It does NOT cause any disease, but is messy to deal with.... more

Steven Schuster, MD
Boca Raton Plastic Surgeon

www.schusterplasticsurgery.com

En bloc capsule removal

Nothing new here but usually not practical. Even with ruptured gel implants, the only way to do an en bloc removal is with a pretty long scar.

Richard P. Rand, MD, FACS
Seattle Plastic Surgeon

Removal of implant plus capsule is called "en bloc"

The term "en bloc" refers to any surgical procedure where something is removed in one piece. If there is a problem with the implant that has affected the scar capsule then it is a good idea. It's not anything unique, just a matter of terminology. The more important question is what to do if new implants are to be put in, since en bloc removal leaves less of your own tissue to cover and support the new implant. This is something you should discuss with your plastic surgeon.... more

Richard Baxter, MD
Seattle Plastic Surgeon

Implant and capusle removal

Removing the capsule and implant as one unit is often attempted when a silicone implant has ruptured but the contents have leaked and stayed within the capsule.

Steven Wallach, MD
Manhattan Plastic Surgeon

Removal of Breast Implants

When removing breast implants, if there is an easily removed capsule, my preference is to remove it (open capsulectomy). If the capsule surrounds ruptured gel implants and harbors silicone, indications for capsulectomy are more exigent. Dr. Pat Maxwell of Nashville has popularized a procedure for implant removal and replacement in a new pocket without capsulectomy, and in my experience, this is another good approach. In any case, if the capsule or a very large part of... more