PIP Removal?

I have PIP implants and am having them removed without replacement. They are 245cc overs. I wanted them removed en bloc but a surgeon I saw said he wouldnt recommend doing it this way for me as I have very little breast tissue (im very thin), he doesnt think they are ruptured, and an ultrasound I had last yr didnt. He said he would try and remove as much of the capsule as possible though. Everywhere I look online women who have explanted are saying it must be en bloc so i'm worried and confused.

Doctor Answers 5

PIP removal?

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 contracture is 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 and without 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 your plastic surgeon who will assist you in determining the right modality for you. Hope that this helps! Best wishes!

Scottsdale Plastic Surgeon
5.0 out of 5 stars 26 reviews

PIP Removal - Factors to Consider

My Guidelines for Capsulectomy for PIP implants
Capsulectomy recommendations with PIP implant removal
In general I would follow these recommendations - If there is no evidence of rupture of your silicone gel implants and your breasts are soft  then I do not recommend capsulectomy to my patients. However if there is a rupture or what is called "silicone bleed" where there is visible sticky silicone on the outer capsule, especially with PIP implants then I recommend capsulectomy to rid your body of traces of free silicone

Larry S. Nichter, MD, MS, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 157 reviews

PIP implant removal

The goal is to remove the capsule with the implants in many cases you can do that.  Sometimes there is not alot of soft tissue or it is very adherent ot he chest wall( submuscular pocket) and it is difficult.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

Explantation PIP Breast Implant

The recommendation now is to remove the PIP implants.

Explantation will cause some changes to the breast. As much as possible of the capsule is to be removed. Most of the time a full capsulectomy (Enblock Removal ) is very possible. The use of the Harmonic Scalpel can remove the implant and the capsule enblock with out much fat of the breast is removed. The incision for the enblock explantation would be bigger and needs to be through the infra mammary incision

Samir Shureih, MD
Baltimore Plastic Surgeon
4.2 out of 5 stars 7 reviews

PIP Breast Implants Removal

The French breast implant company PIP produced both saline filled and silicone gel filled breast implants. The French government has com out and officially recommended explantng ALL these breast implants. The traditional way of silicone gel implant removal s surgically separating the impant and it's surrounding scar tissue (capsule) frm the surrounding breast tissue. How much capsule to take and how much to leave is a decision which should be made by the surgeon during the prccedure. It should not be made by non-surgical online pundits who have not done such a procedure and understand the dangers of removing too much breast tissue or entering not the chest cavity. Your best bet is to engage the best Plastic surgeon you can and let him/her do the best they can. 

Peter A. Aldea, MD
Memphis Plastic Surgeon
4.9 out of 5 stars 109 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.