Sub Muscular PIP Capsule Removal or En Bloc?

I have Lupas and other auto immune issues. I would like my implants removed and have seen two surgeons in London that will remove and uplift for me. The first will remove part of the capsule and the second will remove all. Neither will do it en bloc. I have read so much on en bloc and is it really necessary to remove in this way Can anyone recommend a good surgeon to explant and uplift without replacing in London?

Doctor Answers (3)

Sub pectoral PIP implant removal

+2

It should be your choice to remove your breast implants but there is no good evidence that this caused your lupus or that it will be made better by removing the implants (PIP or any type). There is also no need to automatically lift the breast when implants are removed. Implants do not lift the breast and removing them does not make them sag. Breasts look lifted in some situations when they are filled out with implants but they are filled out, not up. The same thing happens in reverse. Removing implants can make the breast look as if it sagged but it is an illusion due to the lost volume. 

There is no scientific or established reason to remove any of the capsule unless it is abnormal. There is certainly no support for the concept that an "en bloc" removal is even better. The tissues will not be cleared of microscopic silicone regardless of whether the implant was intact or if the capsule is removed. A plastic surgeon has to use experience and sound medical/scientific judgment for performing procedures and cannot be expected to do whatever the patient says they want for whatever reason. I would remove all visible implant and silicone and only remove the capsule if it was abnormal and I would probably not do a mastopexy at the same time but consider it later as a separate procedure if desired after the implant is out and things settled. 

 


Denver Plastic Surgeon
4.0 out of 5 stars 1 review

My Recommendations fro En Bloc Capsulectomy

+1

Here are My Guidelines for en bloc Capsulectomy for PIP implants:

In general I would follow these recommendations - If there is no evidence of rupture of your silicone gel implants and your breasts are soft, that is no capsular contracture,  then I do not recommend capsulectomy to my patients. However if there is a rupture or what is called "silicone bleed" where there is visible sticky silicone on the outer capsule, especially with PIP implants then I recommend capsulectomy to rid your body of traces of free silicone

Larry S. Nichter, MD, MS, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 41 reviews

Breast implant removal and capsule treatment

+1

If the capsules are soft are not significantly calcified it may not mbe necesary to remove them. Sometimes if can be quite difficult to remove the whole capsule as well.  A lift sounds reasonable if the implants are removed.

Steven Wallach, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 16 reviews

You might also like...

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.