What would be the best procedure to perform an En bloc total capsulectomy on a person with Fibromyalgia?

Question

I have Fibromyalgia and ive been told getting my implants out could leave me in even more severe pain. Also ive recalled implant textured implants under the muscle and now have the waterfall effect going on to. Ive so much complications I dont know what to do? What is best procedure? As i dont want to keep them in as was suggested by a surgeon that i seen yesterday. I used to be a 34b now 38DD.

Richard Baxter, MD · Answer

The first thing to know is that the latest evidence shows that there is no benefit to en bloc removal vs implant removal with capsulectomy. En bloc is a radical operation and can leave significant deformity. It sounds like you will benefit from a breast lift as well, which would not be possible at the same time as en bloc. While there is no way to know whether removing the implants will help with your issues, if you want them out then it needs to be done in a way that minimizes risk.

Daniel Barrett, MD · Answer

Dear Calm3644,
it is hard to tell for sure without an examination. If you are considering surgery, I would suggest you consult a board-certified plastic surgeon. Only after a thorough examination, you will get more information and recommendations.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Alan Gonzalez, MD, FACS · Answer

Hello @Calm3644, thank you for your question. Many women who have breast implants worry about the pain that may be associated with removing them or if the breast will look deflated. While it is true that the surgery can be uncomfortable, the fact is that breast implant removal if performed with breast reconstruction does not leave you in pain or with the breast deflated. In fact, it would be beneficial for the patients health once having removed the implant because the inflammation decreases and the symptoms get better, this procedure is done definitively. That means not to get implants again. The reconstruction of the breast ensures that the breast doesn't look deflated, since removing the prosthesis will result in repositioning of the mammary tissues and improve the overall appearance of the breast. If you are considering a breast explantation, consultation with a plastic surgeon who is experienced in this procedure is essential to ensure optimal results. Best wishes! Alan Gonzalez MD, FACS.

Connie Hiers, MD, FACS · Answer

En bloc surgery is for cancer patients only and not used for implant removed. Your implants and capsules can be removed and checked for heavy metals. You may need a lift as well. An examination will tell if the lift can be done at the same time, or a later time.

Peter Andolina, DO · Answer

Unfortunately I think your only option is to have go forward with the implant removal and at the very minimum an anterior capsulectomy. There are instances where the posterior capsule can be left. That will be a decision and a discussion for you and your surgeon. I wish I had a good answer about the pain. You can see if your surgeon uses Exparel or if the anesthesiologist can perform a block for you. Those modalities can help with post-op pain issues

Darryl J. Blinski, MD · Answer

Great question/s. But no posted photos? The terminology can be very confusing. "en bloc" mean removal of almost all the capsule/scar tissue surrounding the implant. The general meaning as applied in surgery is also partial removal of normal tissue to gain a margin. The margin was applied as in cancer surgery, ie breast cancer mastectomy or "en bloc" mastectomy , removing all the normal breast tissue and some muscles (quite deforming). I use the terminology of "subtotal en bloc' removal. I try to excise only the capsule not any normal tissue. But we live in a real world whether doing enbloc or total enbloc some capsule tissue is ALWAYS left behind. The concept is to decrease the amounts of capsular tissue as to improve the BII syndrome symptoms. Hope this helps you. Regards

What would be the best procedure to perform an En bloc total capsulectomy on a person with Fibromyalgia?

Answers (6)

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