Breast augmentation surgery, a long-time synonym of plastic surgery itself, is enjoying an ever-growing popularity. According to a 2020 report published by the American Society of Plastic Surgeons (ASPS), more than 190,000 breast augmentation procedures were performed nationally in 2020.
Most patients have a seamless healing process following their procedure. Still, in a minority of cases, some patients experience complications. A study in the Archives of Plastic Surgery Journal states that 10.6% of breast augmentation patients endure a complication known as capsular contracture. This condition occurs when the protective layer of scar tissue created by the body around the breast implants (aka the “capsule”) hardens and starts to tighten, causing discomfort and aesthetic deformities of the breasts. Pain and deformation will persist and potentially worsen if the condition is left untreated.
Thankfully, this condition can be effectively and safely addressed by removing breast implants, even if temporary, and the surrounding tissue. There are two approaches to this procedure:
- The traditional technique, known as a total capsulectomy, whereby the breast implants and scar tissue are removed one after the other in two or more pieces.
- An en bloc capsulectomy, where the breast implants and scar tissue are removed in one piece simultaneously.
En bloc removal has been rising in popularity, but for many women, removing the entire capsule in one piece is unnecessary and carries an unnecessary increased element of risk. To help you distinguish between the two aforementioned procedure approaches and empower you to choose a method that represents the safe removal of breast implants, we have compiled everything you need to know about en bloc capsulectomy and implant removal below!
What is an En Bloc Capsulectomy?
In the event of injury, the body creates a layer of scar tissue around the affected area when encountering a foreign object as a protective measure. This response is not different for women who wish to have their breasts augmented with implants, whereby a scar capsule forms around the implants, and for many patients, it simply holds them in place.
However, in some patients, the scar capsule hardens and contracts, leading to discomfort and deformation. As a result, breast explant surgery becomes necessary to remove the affected breast implants.
An en bloc capsulectomy is an explant surgery performed under general anesthesia. The scar tissue around a breast implant is carefully separated from the surrounding breast tissue so that the capsule is removed in one piece with the breast implant inside.
En bloc capsulectomies differ from a total capsulectomy surgery, where the breast pocket is removed in two or more parts instead of entirely intact.
In some cases where capsular contracture is less problematic, such as when the breast shape is impacted only slightly, removing breast implants or breast implant replacement may not be necessary. Here, a partial capsulectomy may suffice, which involves loosening the capsule tissue so that discomfort is alleviated and the desired aesthetic effect is retained.
Who is a Candidate for an En Bloc Capsulectomy?
An en bloc procedure is suitable not only for patients who want their implants removed but is also considered a specialized procedure for the surgical removal of a breast implant in the case of a type of cancer called breast implant-associated anaplastic large cell lymphoma (BIA-ALCL).
While both a total capsulectomy and an en bloc capsulectomy require the complete removal of a breast implant and its scar tissue capsule, en bloc implant removal addresses the concerns and risks of removing cancerous cells.
By performing an en bloc capsulectomy, the surgeon ensures that the cancerous cells caused by a breast implant do not come in direct contact with other breast tissue since the entire capsule is removed intact.
While an en bloc procedure has the potential to be a life-saving procedure for those with BIA-ALCL, a surgeon would generally not use this procedure for other patients who need to have a breast implant removed for other reasons due to the unnecessary risks associated.
Recovery After an En Bloc Capsulectomy Procedure
A patient who has undergone an en bloc capsulectomy will experience some discomfort and pain in the surgical area and wear a compression bra for a few weeks. Depending on your discomfort level, you may be prescribed pain management medication.
It is generally advised not to engage in physically-intensive activities for at least two weeks after surgery to allow your breasts to heal fully. The recovery time can be longer for patients with postoperative drainage devices in their breasts.
Each patient’s recovery journey depends on:
- Genetic factors
- Overall health
- The surgical approach
Is En Bloc Capsulectomy a Risky Procedure?
Like any invasive procedure, an en bloc capsulectomy carries an element of risk. Some documented complications include:
- Surgical site infections
- Healing complications such as wound dehiscence
- Blood loss
Many researchers consider an en bloc capsulectomy riskier than other capsulectomy procedures due to the precision and care required to keep the capsule intact during implant removal. The level of bleeding is higher than in other capsulectomies, and the necessity of a larger incision often leads to more pronounced scarring.
Does Dr. Vinyard Recommend an En Bloc Capsulectomy?
Unless necessary, Board-Certified Plastic Surgeon Dr. William J. Vinyard, MD, FACS, and his team of experts generally recommend against en bloc capsulectomies due to health concerns. However, every patient’s needs and circumstances are unique, and if the need is present, Dr. Vinyard is capable of performing the procedure.
Due to the complexity of en bloc implant removal, a board-certified plastic surgeon with extensive experience, such as Dr. Vinyard, must perform the procedure. Dr. Vinyard pursued and completed the Advanced Breast and Aesthetic Surgery Fellowship, equipping him with the necessary skills and experience for an en bloc implant removal.
Consult With Dr. Vinyard Before Undergoing an En Bloc Capsulectomy!
Contact us to schedule a personal consultation, or call (772) 362-3357 to find out the next steps in your breast rejuvenation journey! Our office at 291 NW Peacock Blvd, Suite 103, Port St. Lucie, FL 34986, proudly serves the South Florida area! We also invite you to check out our blog page, Facebook, and Instagram to learn more about the treatment options available at our office!