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Explant and En Bloc Capsulectomy

Many breast augmentation patients spend years wanting, planning, and preparing for their breast implant surgery. Most of those patients never consider the possibility that they may consider removing those implants one day.

Explant with an en bloc capsulectomy removes the implant and the scar tissue capsule surrounding it as a single unit. This surgical process is performed for several reasons, including the development of implant complications, aesthetic discontent, and fear for the long-term safety of the implants.

Dr. Batra at Coastal Plastic Surgeons performs explant and en bloc capsulectomy in San Diego, California, for breast augmentation patients looking to part ways with their implants.

Reasons to Consider Explant and En Bloc

ImplantComplications

Some women’s dissatisfaction with their implants stems from a physical complication. These include:

  • Implant rupture: This occurs with both saline and silicone implants. The shell of the implant weakens and tears, allowing the contents to escape into the body.
  • Capsular contracture: This happens when scar tissue tightens around the implant and causes pain.
  • Implant displacement: This occurs when the implant moves out of the breast pocket.

AestheticChanges

While some women are provided with reliable mock-ups and images of what to expect from their augmentation results, nothing can prepare them for the look and feel of their implants.

Some women are pleased with their choices; others develop dissatisfaction, whether it be immediately after the procedure or years later when lifestyles change or weight fluctuations alter the appearance of the implants. For women who decide that they no longer want implants, explant and en bloc capsulectomy allow them to return to their natural breasts. New implants can add additional volume.

Fear ofBIA-ALCL

Breast implants are continually being tested and evaluated for safety. Recently, the FDA and Allergan™—a manufacturer of breast implants—released a report linking Allergan™ textured saline and silicone breast implants to breast-implant associated anaplastic large cell lymphoma (BIA-ALCL), a rare but treatable type of immune system cancer.

Women with these implants can choose explant and en bloc capsulectomy to minimize any concern over the implant’s presence. BIA-ALCL is only linked to textured implants, and it occurs in less than one out of every 25,000 patients.

Your Explant and Capsulectomy Options

Explant and En Bloc Capsulectomy

Explant and en bloc capsulectomy is a type of breast implant removal surgery that is performed when patients need the removal of both the implant and the scar tissue that forms around the implant. Here are some facts about En Bloc removal:

  • En Bloc removes the implant and scar tissue in one piece.
  • The incision runs along the inframammary fold.
  • The tissue capsule, with the implant inside, is carefully separated from the breast tissue.
  • As loose silicone from ruptured implants tends to stay in the breast pocket, the En Bloc method allows the ruptured implant to be removed without leaking silicone into the body.
  • En Bloc capsulectomy eases the discomfort and aesthetic concerns caused by capsular contracture.

Explant and Implant Replacement

Explant and capsulectomy can be performed with the En Bloc method during a breast revision before a new breast implant is inserted.

  • This can be important for a patient with textured implants who wish to switch to non-textured implants over concern of BIA-ALCL.
  • The implants and tissue capsule will be removed, the pocket will be cleaned, and new implants will be inserted.
  • The implants can be the same style or can be a different size, material, shape, and texture.

Explant and Breast Lift

Breast lift surgery can be combined with an explant and en bloc capsulectomy for patients experiencing moderate to severe breast sagging (ptosis).

  • This is common with larger or longer-existing implants.
  • Minimizes breast scarring
  • Recommended for women looking to reduce the size of the areolas

Easing Your Concerns

The explant and capsulectomy process will result in bruising and swelling that may cause some discomfort. A specialized surgical bra will be wrapped around your chest following the procedures to facilitate the healing process by reducing swelling, circulating blood flow, and ensuring proper breast placement. Most women feel good enough to return to work after one or two weeks, but strenuous activity should be avoided for at least six weeks.
Explant and en bloc capsulectomy are performed under general anesthesia to minimize any pain during or immediately following the procedure. Some pain or discomfort will develop once the anesthesia wears off. This can be lessened with prescribed pain medication, over-the-counter pain medication, and rest. This discomfort is often most intense during the first 24 to 48 hours.
Explant and en bloc capsulectomy traditionally utilize the incisions from your breast augmentation. Since the En Bloc method removes the implant and scar tissue in one piece, the incision tends to be longer than the initial one. This will result in a larger scar; however, this scar heals well and is easily concealed by bras and bathing suits. Scars can be minimized by applying silicone strips or gel, keeping them out of the sun, and avoiding stress to the incisions. All scars fade with time.
Your explant and en bloc capsulectomy procedure is tailored to your body. Because of this, we cannot provide an accurate price quote before your consultation. The cost of your explant and en bloc capsulectomy will vary depending on the techniques used, combination of procedures, anesthesia, location, facility fees, and surgical fees. Dr. Batra and his team at Coastal Plastic Surgeons will provide you with a price quote during your consultation.

Frequently Asked Questions

BIA-ALCL, like any form of cancer, is a frightening and life-altering diagnosis. While this is a condition is scary, it is easily treatable when found early. Women should be aware of any abnormal changes to the breast shape or feel. Hard bumps, lumps, and fluid buildup that cause pain or swelling around the implant are common symptoms of BIA-ALCL. A biopsy of the scar tissue diagnoses this cancer. If the cancer is detected before it spreads to the lymph nodes, removal of the implant and the scar tissue capsule with explant and en bloc capsulectomy is often sufficient. If the cancer has spread to lymph nodes or other region of the body, chemotherapy may be required.
Breast implant illness is a patient-diagnosed condition that has been gaining momentum over recent years. While this is not a medical diagnosis and has no physical proof, several women with breast implants have developed bizarre and unexplainable side effects. Since these side effects are similar to those of an autoimmune disease, diagnosis is difficult. These may include:
  • Fatigue
  • Joint pain
  • Muscle weakness
  • Brain fog
  • Memory loss
  • Anxiety
  • Depression
  • Hair loss
  • Skin rashes
Even though BIA-ALCL is a form of cancer, it is not breast cancer. Even after numerous studies and years of research, there is no link between breast implants and breast cancer. Breast implants can sometimes make identification of breast cancer more challenging, so you must undergo routine MRIs, ultrasounds, and mammograms to ensure that your breasts remain healthy.
Yes. Breast implants can be placed at any time, even if you previously had and removed implants. Any additional surgical procedure does come with the same risks and potential for increased scarring.
Dr. Batra at Coastal Plastic Surgeons is a skilled and highly regarded breast surgeon with over two decades of experience. Regardless of whether or not Dr. Batra performed your initial augmentation, he can ease your concerns by removing a damaged, unwanted, or fear-inducing implant.
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