En Bloc vs Partial Capsulectomy for Breast Implant Removal

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or explant surgery is a procedure to remove silicone or saline implants from the breasts. This is often pursued due to complications from a , changes in aesthetic preference, or health concerns related to the implants.

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The choice of explant surgery technique depends on several factors, such as the patient’s health, the type of implants, the of complications, and the patient’s preferences.

The best technique for your explant surgery will be determined after a detailed discussion with your surgeon. The surgeon will evaluate your health history, health status, type and condition of your implants, and your personal goals and preferences. The surgeon will also the potential risks and benefits associated with each technique to help you make an informed decision.

At Centre for Surgery, our highly skilled and experienced surgeons have expertise in all these explant techniques. We are committed to providing personalised care and achieving the best possible outcomes for our patients. We will guide you through the entire process, ensuring you feel comfortable and confident with your decision.

What is Capsulectomy?

Capsulectomy is a surgical term referring to the removal of a breast implant along with the scar tissue capsule that forms around it. It is typically conducted in two forms: partial capsulectomy and total capsulectomy, each having distinct characteristics and purposes.

A partial capsulectomy, also known as capsulotomy, involves surgically loosening and removing part of the scar tissue encapsulating the implant. This procedure is often chosen by patients who experience discomfort or changes in the aesthetic appearance of their breasts due to capsular contracture. In this condition, the scar tissue tightens and squeezes the implant. In a partial capsulectomy, the surgeon removes sections of the troublesome scar tissue, relieving pressure around the implant. This results in softer, more natural-looking breasts. Some patients may also opt for implant replacement during this procedure, although it’s not a compulsory part of the surgery.

On the other hand, a total capsulectomy involves the entire scar tissue capsule, typically in pieces or sections. Should a patient wish for an , it is common for the surgeon to recommend a different type of implant and potentially suggest a change in implant placement. These recommendations are geared towards minimising the patient’s future risk of capsular contracture or other complications.

In both partial and total capsulectomy, the central goal is to alleviate discomfort and restore a desirable breast aesthetic, all the while ensuring the patient’s safety and well-being.

Deciding whether a capsulectomy is appropriate for you involves several considerations. The procedure might not be suitable for individuals who:

Further, if you experience any of the following, it’s vital to communicate this to your surgeon during the consultation:

To assess your suitability for the surgery, your might require various tests, to ensure that the procedure is safe for you. These tests could comprise a Full Blood Count (FBC), pregnancy test, chest X-ray, Electrocardiogram (ECG), breast ultrasound, Magnetic Resonance Imaging (MRI), and in certain situations, a mammogram. These diagnostic tools help provide a comprehensive health profile, aiding in the formulation of a safe and effective surgical plan.

What Is an En Bloc Capsulectomy?

"En bloc capsulectomy" is a surgical derived from the French term "en bloc", meaning "all together" or "as one piece". In the context of breast implant removal, en bloc capsulectomy refers to the method whereby the breast implant and the surrounding scar tissue capsule are removed as a single entity without opening or rupturing the capsule during the process. The intention is to prevent any potential contaminants within the capsule from leaking into the body.

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It’s to understand that en bloc capsulectomy is a complex, demanding surgery for both the surgeon and the patient. From the surgeon’s perspective, the operation extensive expertise, meticulous attention to detail, and considerable time investment.

The scar tissue capsule itself is incredibly delicate, often less than a millimetre thick, which can tear easily. Consequently, the procedure necessitates a larger incision compared to typical implant insertion or straightforward implant removal.

The recovery process can be challenging for the patient, with common post-operative symptoms discomfort, pain, and soreness. Sometimes, bleeding may occur post-surgery. To alleviate potential swelling and fluid due to trauma, surgeons place drains in the breast area.

Determining you are a suitable candidate for en bloc capsulectomy is an essential discussion with your surgeon. This technique isn’t appropriate for every patient. In certain situations, the scar tissue capsule becomes so delicate that it’s virtually impossible to remove in one piece. Moreover, it’s not advisable when the capsule is adjacent to the rib cage, as deeper incisions in this area may lead to a punctured lung cavity and elevated post-operative pain. Due to these complexities, surgeons often avoid making absolute promises about performing en bloc capsulectomy.

The appearance of your breasts an en bloc capsulectomy will depend on several factors, including the size of the implant, the degree of breast tissue displacement, skin elasticity, and whether you opt for implant replacement or removal.

Consulting with an plastic surgeon will guide you towards your breasts’ natural . However, you should anticipate new scars and be aware of potential risks. Extensive and with your surgeon are key to fostering realistic expectations ahead of the procedure.

At Centre for Surgery, we encourage patients to view a range of before and after photographs from individuals who have undergone the procedure, both with and without implant replacement and lifts. This visual will provide a more concrete expectation of potential postoperative outcomes.

Capsulectomy for Capsular Contracture

A is a surgical procedure designed to rectify issues stemming from capsular contracture and other complications. refers to the body’s response to foreign material, such as a breast implant. This reaction can prompt the production of collagen, which then inflames the surrounding tissues, rendering them fibrous, firm, and potentially painful.

It’s worth noting that these complications can arise immediately post-surgery or might take years to manifest. However, in many cases, these issues do not present at all, particularly when recommended precautionary measures are taken.

Grade 1: The breast retains a natural appearance and feels soft.

Grade 2: The breast appears natural but feels slightly firm.

Grade 3: The breast appears distorted, feels firm, and is hard to touch.

Grade 4: The breast appears distorted, is hard, and causes pain.

Addressing capsular contracture typically involves performing either a partial or complete capsulectomy, often followed by implant replacement, if by the . It’s important to highlight that capsulectomies are not solely conducted to treat capsular contracture.

Other reasons for a breast implant removal procedure the following:

: This condition arises when a tear forms in the silicone implant’s outer shell, leading to gel leakage.

Infection: The region surrounding the capsule may become infected.

Implant Extrusion: Occasionally, the implant can protrude through the skin.

: This is a rare form of cancer that develops within the scar capsule that encapsulates the implant.

: This is a condition associated with a wide range of symptoms related to having implants. While a lot about BII’s causative factors remains unclear, diligent medical research continues to offer better understanding and treatment .

How Is Capsulectomy Different From an En Bloc Capsulectomy?

The terms capsulectomy and en bloc capsulectomy are often used interchangeably, but they refer to slightly different procedures.

Capsulectomy is a broad term, referring to the removal of a breast implant along with its surrounding scar tissue capsule. There are two types: partial and complete. During a capsulectomy, the capsule is removed in sections or pieces.

On the contrary, en bloc capsulectomy entails removing the breast implant and scar tissue in a single, unbroken piece without slicing into the capsule. This approach is considered more invasive than a partial capsulectomy. It has gained considerable attention on the internet, and numerous plastic surgeons profess their expertise in this technique.

Despite its popularity, the en bloc technique won’t necessarily affect the outcome of the surgery. Actually, it’s considered more invasive, leading most surgeons to prefer a partial capsulectomy. However, this isn’t to say one technique is superior to the other. The choice of procedure can only be decided after a comprehensive evaluation of your condition by an experienced plastic surgeon at our .

In particular situations, like implant or risk of BIA-ALCL (Breast Implant-Associated Anaplastic Large Cell Lymphoma), an en bloc capsulectomy may be preferred as it minimises certain risks. This method can alleviate related to BIA-ALCL and ensures the safe removal of implants, to enhancing your comfort and overall well-being.

The importance of choosing a specialist plastic surgeon for capsulectomy surgery

Choosing an appropriate plastic surgeon for your breast surgery is vital in any potential complications associated with breast . They will assess your condition and determine the most suitable surgical procedure to safeguard your health and wellness.

To assist in your selection of a surgeon, you should:

While both en bloc and partial/complete aim to eliminate complications associated with implants and enhance your health and well-being, the procedures differ in their approach and technique. After discussing these options at Centre for Surgery, evaluating the potential risks of each procedure, you can make an informed decision that best suits your needs.

Why choose Centre for Surgery?

Choosing the Centre for Surgery for your cosmetic or medical procedures comes with a variety of benefits:

Our team of skilled have training and experience in their respective fields. They remain up-to-date with the latest techniques and technologies to provide the best possible results.

We believe in a holistic approach to healthcare, which means we not only focus on the surgical procedure but also on the pre and postoperative care to ensure a smooth and comfortable .

We offer state-of-the-art facilities equipped with advanced technology to ensure the safety and comfort of our patients.

Understanding that each patient is unique, we provide personalised treatment plans tailored to the individual needs and goals of each patient.

We provide clear and transparent information about the procedures, including risks and benefits, to help our patients make informed decisions.

Our top priority is patient satisfaction. We strive to exceed patient expectations at every stage of the process, from consultation through recovery.

We are committed to maintaining the highest standards of safety. Our clinical governance framework ensures rigorous of all aspects of care delivery.

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Centre for Surgery is a CQC-regulated private hospital on London’s Baker Street, delivering plastic and cosmetic surgery through GMC-registered specialist surgeons. Our expertise spans facial procedures including and , , for men, and body contouring procedures such as and . Patient safety, surgical and natural-looking results sit at the heart of everything we do.

Centre for Surgery is a CQC-regulated hospital on London’s iconic , offering plastic and cosmetic surgery led by GMC-registered consultant surgeons.

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