I've had my silicone implants over the muscle for 30 years. In my case would it be alright to not remove enbloc? (Photos)

For 27 years I had no problems at all! The last 3 years I've had my right breast harden in areas! I've been told that a doctor could remove implants and try to remove most of the capsule! No one in SC removes en bloc! In my case would it be alright to not remove enbloc? I later want fat transfer!

Doctor Answers 6

Capsule and implant removal

You are not alone. It is not uncommon for me to perform removal of the capsule with the implant. This is especially true for hard calcified capsules.

Please see the examples of such situations in the attached web reference.

There is nothing wrong with your request. Find someone comfortable and experienced with doing it


Gainesville Plastic Surgeon
4.9 out of 5 stars 24 reviews

In my case would it be alright to not remove enbloc?

En bloc removal of breast implants is a useful technique for patients with ruptured silicone gel breast implants or who have specific concerns about the implants "causing" medical concerns.  My best suggestion: select a well experienced board-certified plastic surgeon in your area who can demonstrate significant experience achieving the types of outcomes you would be pleased with. Working together you will come up with a good plan to  proceed with. Best wishes.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,499 reviews

Hard capsule

If you indeed have spotty hard calsified portions of your capsule, it is in your best interest to remove en bloc. Find a surgeon with the skills necessary to do this(most are more than capable, but philosophically might not want to for whatever reason). Fat transfer is always an option later down the road. 

I've had my silicone implants over the muscle for 30 years. In my case would it be alright to not remove enbloc?

The decision for en bloc removal is best made during the surgery. If in fact, the calcification is extensive- removal may be in your best interests. What 's more important - is your goal for your breasts. You have major ptosis. This is best addressed by a mastopexy . Hope this helps

Thomas Trevisani, Sr., MD
Orlando Plastic Surgeon
4.9 out of 5 stars 64 reviews

Can there be en bloc resection of the capsule surrounding an implant or should it be done partially?

you have asked some very good questions, and the proper answers might only be able to be given after a full examination.  I customarily try to remove the full extent of the capsule this long after having the original breast augmentation performed.  .  The capsule may be very calcified and distorted, oftentimes forcing a removal, but may create irregularities in the thickness of the breast tissue.  Fat grafting could be considered, breast lifting may be discussed, replacement of implants with new implants may be mentioned as well.  This discussion will be properly established by you with your chosen Plastic Surgeon.

Good luck to you.

Frank Rieger M.D.  Tampa Plastic Surgeon

En bloc removal

If you have enough soft tissue coverage then it stands to reason that an en bloc removal might be necessary and reasonable. Best of luck.

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