The surgical techniques to remove breast implants varies. Ultimately, the differences come in with how the scar tissue is removed. All breast implants (and implants in the body in general) will have scar tissue around them, regardless of if they are healthy or not. It is perfectly normal for scar tissue to form. Problems arise if it grows too thick and/or hardens. This is known as capsular contracture.
The technique Dr. Jonov will recommend will depend on your needs, reasons for removal, and patient anatomy. Additionally, patient preference does matter. Even if en bloc resection seems unnecessary, Dr. Jonov may move forward with the technique if the patient is a good candidate and it seems viable.
Partial Capsulectomy
A partial capsulectomy involves removing the breast implant and some of the scar tissue. Typically, some scar tissue is left behind and the tissue that is removed is done so in pieces. Partial capsulectomy is most commonly used during breast revisions where Dr. Jonov places new implants.
The partial capsulectomy technique may best for you if:
- Exchanging breast implants
- It is too risky to remove all of the scar tissue
- Scar tissue attached to or too close to the chest wall to make other methods practical
- Certain cosmetic concerns
- Prefer the smallest incision and the patient does not mind leaving scar tissue behind
Total Capsulectomy
A total capsulectomy involves removing or destroying all of the scar tissue as well as taking out the breast implant. However, in this method, the scar tissue is removed in pieces. When this method is used, it is usually determined that all of the scar tissue can be removed safely. If this proves not to be the case, Dr. Jonov may destroy the remaining tissue via cautery.
The total capsulectomy technique may be best for:
- Lower grades of capsular contracture
- Mild breast implant illness
- Cosmetic deformities
- General discomfort
- Thin scar tissue
En Bloc
The en bloc resection technique is the most aggressive form of breast implant removal. It requires an experienced surgeon and also is usually reserved for severe concerns or complications. It is not typically performed when new breast implants are going to be placed (though there are exceptions to this).
This method involves a much larger incision than other explant techniques. It also is more extensive and risky. Therefore, it is important that patients carefully weigh the risks and understand what an en bloc procedure entails.
An en bloc explant may be preferred if:
- One or both implants are ruptured
- Severe capsular contracture
- Breast cancer or major infection occur
- Certain cases of breast implant illness
