Do Textured Saline Implants Need to Be Removed "En Bloc"?

I have had Mentor, saline (550 cc), teardrop, textured, implants (behind the muscle) for 14 years. I have very little natural breast tissue.I want to have my implants removed and not replaced. Do they need to be removed "en bloc"?

Doctor Answers 8

Removal of textured saline implants

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You do not need to remove all the capsule and sometimes no capsule need be removed after removing implants.  I would say that with 550cc implants and "very little natural breast tissue" you would be at risk for some resulting dimpling and deformity of the breast.  I would need to see you to give you specific advice, but I would recommend strongly considering replacing the saline implants with smaller silicone implants.  Talk to a board certified plastic surgeon about your options.

La Jolla Plastic Surgeon
4.0 out of 5 stars 6 reviews

Do Textured Saline Implants Need to Be Removed "En Bloc"?

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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!

Lewis Albert Andres, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 28 reviews

Implant removal

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if you should decide to have an explantation procedure performed, you do not always need to remove the capsule.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Breast implant removal

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First and foremost you need to be absolutely sure you want your implants out and no replacement.

Then in behind the muscle position of implants remove the anterior leaflet of the capsule and curett the posterir capsule sothey can stick together and decrease the risk of deformity, filling with fluid.

Samir Shureih, MD
Baltimore Plastic Surgeon


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It would be typical to remove only part of the capsule. Trying to get it off of the rib cage is frustrating and met with much bleeding. If no implants are being replaced, the presence or absence of a capsule is not very relevant

Implant removal without replacement

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Whether or not to remove the capsule around your breast implants is not as important as the potential for significant deformity with simple explantation. Since you had saline implants and little breast tissue your breasts probably felt very unnatural. Switching over to  silicone implants would like give you a much more natural look and feel. Get at least one or two more opinions from experienced breast surgeons. Good luck!

Marcel Daniels, MD
Long Beach Plastic Surgeon

Implant removal

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En block removal of a saline smooth or textered implant is usually not needed. Patients with a ruptured silicone implant will need en block removal for best results and to remove all the silicone from the area. If you have a hard capsule formation around the saline implant, I sometimes remove the dome of the capsule to give you the best outcome and look. Many times we leave the capsule to retain firmness and lift. The decision is usually made during the consultation sometimes and for sure during the procedure itself. Thanks, Luis Vinas MD

Luis A. Vinas, MD
West Palm Beach Plastic Surgeon
4.8 out of 5 stars 30 reviews

Removal of Texture Saline Breast Implants?

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Thank you for the question.

It is not possible to give you good advice without direct examination.

Generally, when breast implants,  or any other foreign body,  is inserted into the human body,  the body forms a lining around it.  This lining is referred to as the “capsule”.   This capsule is normally very thin and soft;  however, it can become  thick and hardened in a process called encapsulation or capsular  contracture.  if this is the case,  then capsulectomy  may be indicated at the time of breast implant removal.

In the process of breast implant removal, if the breast implant capsules are soft and asymptomatic,  there is no reason to remove them (capsulectomy). Removal of breast  implant capsular  tissue increases  the risks of surgery (for example bleeding  and palpability/rippling of the breast implants).

I hope this helps.


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.