02 Oct What are the differences between “en bloc” and total capsulectomy when discussing explant procedures?
Dr. Shaun Parson is a board-certified plastic surgeon who performs hundreds of explant procedures yearly. Many times patients come in wanting a total “en bloc” capsulectomy with their explant. We like to refer to this type of procedure more as a “total capsulectomy.” More differences are also explained in the Aesthetic Society article that can be found here. https://www.theaestheticsociety.org/medical-professionals/patient-safety/patient-safety-advisory-breast-implant-removal-and-capsulectomy
Most of the explant procedures that Dr. Parson performs involve a total capsulectomy. A total capsulectomy is a surgical procedure involving the complete removal of the scar tissue capsule that naturally forms around breast implants. This procedure is often performed in cases where there are complications related to breast implants, such as implant rupture, capsular contracture, suspected infection, or concerns about implant-related illnesses. Here’s a more detailed explanation of the procedure:
Procedure:
- Incision: The surgeon makes an incision typically along the same incision line used for the original breast augmentation surgery. The size and location of the incision depend on various factors, including the type of implant and the patient’s anatomy.
- Access to the Capsule: Once the incision is made, the surgeon carefully accesses the breast implant and the surrounding capsule. The capsule is the fibrous tissue that naturally forms around any foreign object, including breast implants.
- Capsulectomy: The surgeon then proceeds to remove the entire capsule. This process involves carefully dissecting the capsule from the surrounding tissues, which can include the breast tissue, muscle, and other structures. The goal is to remove the entire capsule, including any adhesions or attachments to nearby tissues.
- Implant Removal: After the capsule is removed, the surgeon proceeds to remove the breast implant itself. This can involve dislodging the implant from the remaining tissue and gently extracting it.
- Closure: Once the implant and capsule are removed, the surgeon closes the incision using sutures or other closure methods. Drains may be placed to prevent fluid buildup, and dressings are applied to promote healing.
Benefits of Total Capsulectomy:
- Complete Removal: Total capsulectomy ensures that all the scar tissue surrounding the implant is removed, which can be important in cases of complications or concerns about the capsule’s role in health issues.
- Improved Symptom Resolution: For cases where patients attribute health symptoms to their implants, complete capsule removal can be considered as part of addressing these concerns.
Considerations and Potential Risks:
- Surgical Complexity: Total capsulectomy can be a more complex surgical procedure compared to simple implant removal. The surgeon needs to carefully navigate and dissect tissues to remove the capsule completely.
- Bleeding and Infection: As with any surgical procedure, there are risks of bleeding and infection.
- Recovery: Recovery time can vary, but patients may need to follow post-operative care instructions and restrictions.
It’s important to discuss the procedure, risks, benefits, and potential alternatives with a board-certified plastic surgeon who has experience in breast explant surgeries like Dr. Shaun Parson has. Patients fly in all over the country to have him perform their explant with total capsulectomy procedures. The decision to undergo a total capsulectomy should be based on a thorough evaluation of your individual circumstances, symptoms, and medical history.