I've had silicone implants since 2004. Implants are hard and causing breathing problems. Is en bloc the way to go?

hello morin909You should seek the advice of a board certified PS, Two choices exist for explantation:
1. Implant removal while leaving the capsule. This is a simple procedure and requires local
anesthesia, IV sedation, or (uncommonly) general anesthesia. It is
relatively inexpensive. Microscopic amounts of gel may remain in the
capsule.
2. Capsulectomy: This will enable the surgeon to remove as much
silicone as reasonable without creating significant deformity. This
operation may require a larger incision. The surgery and recovery time
will be longer. General anesthesia is usually necessary and subsequently
all of the costs associated with this operation will be higher. #options #pre-op

 I am sorry to hear about the problems you are experiencing. Best to have the "breathing problems" evaluated by your primary care or internist;  best not to assume that these concerns are caused by the breast implants. Keep in mind, that there are a variety of different ways to remove breast implants and the en bloc removal is not always necessary or indicated. This procedure does take longer to perform (and is associated with a longer incision);  costs of surgery are generally greater when patients undergo the en bloc removal.
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 patients to additional risks, such as bleeding, size loss, contour irregularities and other serious complications. In other words, any maneuver performed during surgery exposes patients to additional risk (morbidity). For example, attempting to remove very thin capsule densely adherent to the patient's rib cage may expose the patient to significant bleeding and/or entrance into the thoracic cavity.
 
In regards to outcome of the planned procedure, more important than costs of the procedures will be careful selection of your plastic surgeon. I would suggest starting with the American Society of Plastic Surgery and/or the Aesthetic Society of Plastic Surgery to obtain a list of well experienced board-certified plastic surgeons.
Then, I would suggest you visit a few surgeons whose practices concentrate on aesthetic surgery. ***Ask to SEE lots of examples of their work AND preferably speak/see patients who have had similar procedures done.
 I hope this helps. Best wishes.

I would suggest meeting with a board certified plastic surgeon and discussing removal of your implants. I would suggest seeing your family doctor and discuss your breathing issues. Your implants are not interfering with your breathing.