I've Been Reading About En Bloc and Would Like to Have a Dr. Explain It to Me? Sould I Ask for It?

I've had my implants for 22 years, I have cfs and am wondering if the implants have something to do with it. It is part of the reason I'm having them removed, I want to make sure that anything that can cause health issues down the road will be removed. Do I need to ask my dr. for an en bloc? thank you.

Doctor Answers 5

En bloc removal of implants

Thank you for the question. What this means, is removing the implants and capsule around the implants together without opening the capsule and have the contents spill into the surrounding tissues. This is important if you have silicone implants only and a rupture is suspected. See a board certified plastic surgeon for an evaluation. Good luck.

En bloc breast implant removal

Thank you for your question, you would need to be seen by a board-certified plastic surgeon with expertise in this area at which point in time after thorough examination you may need an MRI preoperatively. Depending on whether or not you have silicone implants and whether or not there is any rupture of the silicone shell you may need an en bloc removal of your breast implants which will include a capsulectomy.  Best of luck. 

Kevin Tehrani, MD, FACS
New York Plastic Surgeon
4.8 out of 5 stars 88 reviews

En Bloc

Thank you for the question. En bloc breast implant removal refers to a procedure where the breast implant and the surrounding capsule is removed as a single unit.  The procedures is performed such that the  contents within the breast implant capsule do not come into contact with the surrounding tissues.  Generally, the procedure requires a longer incision (6-7 centimeter) usually in the inframammary fold, in my experience.  Also, in my experience, the procedure is more successful when capsules are thickened as opposed to when patients are very thin (normal) capsules.  Also,  sometimes complete capsulectomy is not safely possible;  for example, breast implants place in the sub muscular position may have a capsule that can be  densely adherent to the patient's rib cage. Removal of this posterior capsule can be potentially dangerous.



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 (again), 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.


You may find the attached link, dedicated to breast implant removal surgery concerns, helpful to you as you learn more. Best wishes.

  

En bloc removal of breast implants

En bloc removal usualy refers to removing the implant with the capsule intact.  It is done  most commonly for capsular contractures and leaks.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 24 reviews

En bloc removal of capsule and implant

There is no evidence that implants are the cause of any connective tissue or autoimmune disease.  If you desire removal of the implants and there is evidence that the implants are ruptured then an en bloc removal involves removal of the capusle and the implant together to prevent leakage of the silicone gel into the exposed breast tissues.  

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 16 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.