Do I need a complete en bloc if my capsules are soft and no rupture. I have saline implants? (Photo)

Hello I have saline implants I believe are making me very sick either by the outer shell braking down with 11 year old implants or possibly mold. Either way since diagnosed with positive autoimmune and feeling sick. I'm removing them and want to know if they are not ruptured and I don't have cc do I still need a en bloc or just removel of Capsule and implant. Ps said my capsule would be like peeling a hard boiled egg.? My implants are over the muscle.any advice would help

Doctor Answers 8

Do I need a complete en bloc if my capsules are soft and no rupture.

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Thank you for the question.

As you know, there are patients who present to plastic surgeons for breast implant removal surgery hoping that removal of breast implants will alleviate a variety of medical conditions that they may be experiencing.  Given that there is no science associating the presence of breast implants with these illnesses, I cannot promise the patient's relief or improvement;  on the other hand, out of respect for the patient (and with enough medical experience to know that patients are often right about their own bodies), I do remove the breast implants (en bloc). This involves removing the breast implants and the surrounding thickened capsule "in one piece".  Given the concerns, implants and tissues are sent to microbiology and pathology. 

 I think that as time goes on, as our experience increases further, we will learn more about any possible association between breast implants and "illnesses".  I think that it is important, as physicians, to keep an open mind.

 In the meantime, I hope the plastic surgeons will individualize patients care based on good ethics and not "scare" as many patients as possible to remove breast implants and capsules, exposing patients unnecessarily, in many cases, to unnecessary risk (morbidity) and expenses.

Best wishes.

Auto immune disease and implants

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 Your question involves one of the most controversial areas in plastic surgery . There have been many studies but as yet there is no conclusive evidence that implants cause autoimmune disease. Having said that I have over a period of 25 years had several patients who were definitely sick and definitely improved  with implant removal. Therefore it is a procedure that I offer but there can be no guarantees as to whether it will actually help you. The only way to find out is to actually remove the implants. In my experience if there is no significant capsule  and the saline im plants are smooth there is no need to remove the capsule because there is no silicone material in it. Your best option is to consult with a plastic surgeon who has considerable experience with breast augmentation and removal 

Andrew Kaczynski, MD (retired)
Sacramento Plastic Surgeon

Removal of capsule

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Hello, without a proper assessment it is not possible to comment whether you might benefit from removal of the entire breast capsule.  In my practice I don't typically remove the breast capsule if it appears normal during surgery, but other surgeons might have a different approach.


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though there has been conclusive evidece that implants do not cause the diseases you have mentioned, there are still a few patients in whom removing the implants makes them feel better for reasons that are not medically explainable. however, these patients are not ones with a positive autoimmune test, whatever one that is. that test is unrelated to the implants

Jonathan Saunders, MD
Newark Plastic Surgeon

Do I need a complete en bloc if my capsules are soft and no rupture. I have saline implants?

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If you feel that your implants are making you feel sick then, I would recommend removing the capsules and implants at the same time. However, I do tell patients that after surgery, you may or may not feel any better. Capsulectomies with implants placed above the muscles are general less difficult to remove compared to implants placed under the muscles.

Gregory Park, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 177 reviews

Breast Implant Removal

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Breast implants do not cause auto immune disease. Saline implant do not have mold in them. The outer shell of the implants are not 'breaking down'. These are urban myths. I am sorry you feel sick, but your implants aren't to blame. 

Gerald Minniti, MD, FACS
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 100 reviews

Removal of Saline breast implant and Capsule

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Depending on how much tissue you have on top of your muscle (it appears that you have adequate), the difference between explant and complete capsulectomy vs. En bloc is rather small. If what you are concerned about is Leaving small particles behind that are making you sick, I think that if implants and your capsule are intact, removing them should remove the problem-- if that is the culprit. I know there has been press lately with celebrities being "allergic" to their breast implants, but that is virtually impossible. Both silicone and sterile saline are very inert things and have been used for medical use for generations. 

Lily Lee, MD
Pasadena Plastic Surgeon
5.0 out of 5 stars 29 reviews


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Thank you for the question and removing implants and capsules as you have described is a fairly straight forward operation in the hands of an expert in the field and may even be covered by insurance

Dr Corbin

Frederic H. Corbin, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 65 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.