Is the en bloc method of removal best for 18-year old implants?

Thank you for the good question.  Generally speaking,  if the breasts and the underlying  breast implants feel soft (to deep palpation) and the breast implants seem to move freely (not fixed for firm), then it is very likely that the capsules are thin/normal. 





 Some general thoughts regarding this issue may be helpful to you: generally speaking (in my opinion), unless the breast implant capsules have thickened (and/or are otherwise symptomatic),  are associated with the ruptured silicone gel breast implants, or if the patient has concerns about "medical conditions" related to the breast implants, capsulectomy is not universally necessary.  For these patients, en block removal of breast implants is a good procedure.











On the contrary, capsulectomy can expose you to additional risks, such as bleeding and minimal size loss.  In other words, any maneuver performed during surgery exposes patients to additional risk (morbidity).











 Recently I have  become more aware of the fact that there are plastic surgeons who, instead of using good judgment and individualized patient care, are causing fear and unnecessary anxiety among patients. These patients them feel that complete capsulectomy  is always necessary and undergo unnecessary surgery  associated with additional morbidity and unnecessary expenses.







 I hope this, and the attached link, helps. Best wishes for an outcome that you will be very pleased with.

Good day! For your guidance, this type of procedure will enable the surgeon to remove as much silicone as reasonable without creating significant deformity. However, this operation may require a larger incision and longer surgery and recovery time. General anesthesia is usually necessary and subsequently all of the costs associated with this operation will be higher. Do not hesitate to ask your doctor if this is the right route for you and discuss realistic goals and expectations. Best of luck! #RealSelf100

Hello! Thank you for your question! It is a matter of surgeon preference as well as what is seen during your procedure that will determine whether or not a complete capsulectomy is performed. If significant capsule formation is seen intraoperatively, a full capsule removal may be warranted with a drain in order to completely remove all of the tissue and allow better adherence of your breast back to its normal anatomic position down on your chest wall. If minimal contractureis seen, it may be possible to leave the capsule, or place cuts within the capsule to allow better adherence. It truly is dependent on what is seen with your capsule and the issues that may be causing you to have such a procedure (e.g., contracture from rutptured implant vs pain vs simple pocket adjustment, etc). Without knowing your issues andwithout an examination, it is difficult to tell you what may be the best thing for you. I tend to favor performing capsulectomies (in an en bloc fashion) in order to create a fresh pocket, reshape the pocket, allow better shape and adherence of the overlying breast. I would discuss your issues with yourplastic surgeon who will assist you in determining the right modality for you. Hope that this helps! Best wishes!