My saline implants are being removed. Do I need to insist on an en bloc or not? They are loose and move easily.

Hi, and thank you for your question. Given that you have saline breast implants, and that you are completely asymptomatic, it is not necessary for you to have an en bloc removal of your breast implants.  A complete capsulectomy at the time of removal of your breast implants should be sufficient address the problem, and allay any future concerns.

Normal capsules do not have to be removed in healthy patients.  At surgery, the capsule can be inspected.  If the capsule is calcified or otherwise abnormal it can be removed.  However, capsulectomy can greatly increase morbidity because a large raw surface with punctate bleeding may be created.  Dissection can be simple, or a nightmare.  Drains should be used.  Bleeding complications increase significantly.A normal capsule will shrink.  Removing strategic segments of it without creating large raw surfaces will accelerate the process.  En Bloc resection is overkill in healthy patients.If a patient thinks that her implants are affecting her health (which is very unlikely) a complete capsulectomy will be prudent to eliminate the physcological anxiety.