En Bloc Capsulectomy

En Bloc Capsulectomy

En bloc capsulectomy is very different from regular capsulectomy. En bloc capsulectomy is not only the complete removal of the scar tissue surrounding a breast implant, but doing so in one complete piece.

The surgery involves the removal of a breast implant while it is still encased in the entire scar tissue capsule that surrounds it, as the term “en bloc” means “all together”. Many surgeons remove the capsule in pieces, while others may leave significant portions of the capsule in the breast pocket, and neither approach is equivalent to the en bloc procedure. The difficulty for the patient is that they may never know what type of capsulectomy is being performed, even if the surgeon claims to perform en bloc capsulectomy.

This complex procedure requires a great deal of surgical precision to perform correctly, and it is wise to seek out a surgeon who has experience in en bloc explant techniques if you need and/or desire the procedure. When silicone implant leakage occurs, certain health problems have developed, or an elevated risk of BII (breast implant-related illness) or BIA-ALCL (breast implant-associated anaplastic large cell lymphoma) is causing concern, your physician may suggest en bloc capsulectomy.

En bloc explant surgery
The en bloc explant procedure aims to simultaneously remove the breast implant and the entire capsule of scar tissue that surrounds it—all in one piece. It prevents any fluid, silicone gel, bacteria, chemicals, and other potential pathogens from leaking out of the capsule. Helps ensure that all scar tissue is cleanly removed from the body, since it is all dissected in one piece.

The hope is that by removing the breast implants with the scar capsule intact, any symptoms or risk of illness can be completely eliminated; however, this is not a guarantee and there is not adequate clinical data to support this idea. While en bloc explant can be indicated under a variety of circumstances, including when removing ruptured, old, and/or leaking silicone gel breast implants, most recently the procedure has become more widely recommended in response to concerns about confirmed cases of BIA-ALCL in patients with textured breast implants.

It is important to understand that while en bloc removal may be the most desirable option in certain circumstances, this procedure is not always possible, as thin scar tissue capsules that have adhered to the ribs may be more difficult to remove all in one piece.