Breast explant. Is capsulectomy with en bloc style necessary?

An article says that the real reason plastic surgeons avoid Total Capsulectomy and En-bloc style removal because it takes a more skilled surgeon with experience and it more time . Surgeon prefer to do a short 20 mins,pulling the implant but leaving the contaminated capsules in your body. Leaving the capsules in your body means all the contamination within the capsules will be left behind which results in a severe illness for you. Is this correct? Please advice Doctors…Thank you in advance.

Doctor Answers 5

Breast explant. Is capsulectomy with en bloc style necessary?

Thank you for the question. 



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.



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.

Nt. Is capsulectomy with en bloc style necessary

There are many reasons that capsules are removed at the time of explant. Plastic surgeons generally make decisions based upon science and not expediency. No ethical surgeon will leave anything contaminated in your body to take a short cut and save time. Those of us who trained for over a decade to become board certified plastic surgeons do not know the meaning of taking short cuts. 

Richard Chaffoo, MD, FACS
San Diego Plastic Surgeon
4.7 out of 5 stars 17 reviews

How can I look and see if the BA surgeon is for me?

No good surgeon interested in your well being is going to leave anything contaminated in your body. Some patients need capsules removed, others do not. It depends on a great many factors. 

Ronald V. DeMars, MD
Portland Plastic Surgeon
5.0 out of 5 stars 24 reviews

Breast explant. Is capsulectomy with en bloc style necessary?

Thank you for your question.  In most cases a total capsulectomy is performed en-block when removing implants and surrounding scar tissue.  This ensures only a woman's natural breast tissue is left behind and none of the thickened tissue of the capsule.  Hope this helps. 

Nelson Castillo, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 43 reviews

Capsulectomy

Great question.  I prefer to do a full capsulectomy when removing implants. Sometimes I do It en block  and sometimes I remove the implant first and then go after the capsule. I feel better removing all the old scar.  Not good to leave it in place as it can cause a seroma if it is left in.  Look for a board certified plastic surgeon. 

Good Luck!

Andrew Cohen MD

Andrew T. Cohen, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 38 reviews

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.