En Bloc Technique for Breast Implant and Capsule Removal


Breast implants are not intended to be permanent medical devices and for a variety of reasons may need to be removed or removed and replaced.  The En Bloc technique for breast implant and capsule removal was first developed in France in response to ruptured silicone implants.  En Bloc refers to the technique whereby the capsule and implant are removed as a single unit.  Leaving the capsule in tact prevents the contents of the implant from leaking outside the capsule,  In addition, this method ensures a more complete removal of the capsule.

All breast implants will develop a breast capsule which is a thin layer of scar tissue which forms around the implant.  Implant capsules are usually soft and pliable and remain asymptomatic.  However, in some cases the capsule can become thicker and more firm making the breast hard and sometimes disfigured.  Implants capsules are graded on the Baker Scale of 1 to 4.  

Baker Grade I:  The breast is soft and normal.
Baker Grade II:  The breast has a slightly firm feel but looks normal.
Baker Grade III:  The breast is firm and visibly distorted.
Baker Grade IV:  The breast is hard, painful, and visibly distorted.

Regardless, of the type of capsule surrounding the implant, the En Bloc technique can be used to ensure that the entire capsule is removed with the implant in tact and any contaminants within the capsule.  

Dr. John L. Burns, MD

Board Certified Plastic Surgeon 

Dallas Plastic Surgery Institute

Dallas, Texas

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Dallas Plastic Surgeon