En Block Implant Removal

An implant may be removed for various reasons. Certain patients may desire implants to be removed simply because they no longer desire the implants in their body. Other causes may include capsular contracture, implant rupture, infection, anaplastic large cell lymphoma (ALCL), and breast implant illness. 

Although almost all implant companies have a 10 year warranty, implants may need to be changed within a shorter period of time.

Capsular Contracture

Capsular contracture is hardening or scarring of the capsule around the implant. Your body naturally walls off any foreign object, including the implant, and this capsule may harden. Hardening of the implant is not dangerous, but it may develop discomfort and change in shape of implant. The treatment if it progresses to this stage is implant and capsule removal.

Rupture

Implant rupture may also occur as a result of trauma or other reasons. This may result in shape change or coincidentally identified on routine breast imaging. Saline implant rupture are usually identified immediately. Saline is safe in the body, as this is the solution used for IVs. Silicone is inert, but it may still cause inflammation in the body. A ruptured implant will need to be removed with or without replacement.

Infection

Since breast implants are foreign objects, your body may not be able to fight off an infection if the bacteria involves the implant. Symptoms may include breast skin redness or drainage. If infection is along the skin layer, antibiotics may be the treatment. If the infection involves deeper spaces of the implant, implant removal may be necessary.

Anaplastic Large Cell Lymphoma (ALCL)

ALCL is a rare form of Non-Hodgkin lymphoma involving the immune cells of the body. The FDA is currently investigating possible association with breast implants. The worldwide incidence is currently 60 cases in 5 million women. The risk appears to be extremely rare, and FDA does not recommend prophylactic implant removal at this time. Breast implants are FDA approved for breast augmentation and reconstruction.

Breast Implant Illness (BII)

Some women have a variety of symptoms including fatigue, chest pain, hair loss, headache, chills, photosensitivity, chronic pain, rash, sleep disturbance, depression, neurological issue, and hormonal issues that they feel may be directly related to breast implants. There are currently no direct testing for Breast Implant Illness, but various studies have shown different degrees of improvement in patient symptoms after removal of implants. Total en bloc removal of implant is an option to remove all of the implant and capsule.

An en bloc implant removal entailed removing the implant and capsule in one piece. This is a meticulous process in which every part of the capsule is removed, including parts that may be adherent to your chest wall. Often, the contents of the breast pocket is then sent off to pathology for further analysis.

WHAT IS YOUR TREATMENT APPROACH TO AN EN BLOC IMPLANT REMOVAL?

Any residual capsule may trigger a response from the body, so it’s important that the entirety of the capsule and implant are removed. If implants are not being replaced, drains are left in the pocket to collect extra fluid the body produces and help collapse the previous pocket. In other patients in which the implants are replaced, the implant may be placed in a new pocket space.

WHAT TYPE OF ANESTHESIA IS USED DURING EN BLOC IMPLANT REMOVAL?

General anesthesia is used, and the procedure usually takes around two hours.

WHAT IS THE POST OPERATIVE CARE AND RECOVERY LIKE AFTER AN EN BLOC IMPLANT REMOVAL?

The recovery time is approximately one week. During this time, you should avoid strenuous exercise or lifting. A compression garment is used after surgery to help collapse the previous breast pocket and to allow it to heal.

WHAT ARE THE RESULTS OF EN BLOC IMPLANT REMOVAL?

The result is removal of the capsule and implant in its entirety. Without implant replacement, you may have some extra breast skin. This may contract over time with the help of compression bra. Other patients may opt for mastopexy (breast lift) to remove the excess skin.

IS A EN BLOC IMPLANT REMOVAL RIGHT FOR ME?

You may be a candidate if:

• You no longer wish to have implants in place.

• You are having problems such as capsular contracture, implant rupture, or illness related to the implants.

YOUR CONSULTATION WITH DR. CHEN

Dr. Chen will create a personalized treatment plan after a comprehensive physical examination and a detailed discussion regarding your personal goals. At this time, you will discuss how much breast skin may remain after implant removal and if implant replacement and/or mastopexy is indicated. A thorough medical history will also be obtained to ensure surgery is a safe option for you. Dr. Chen will discuss all surgical and non-surgical options so that you can make an informed decision about what is the right choice for you.

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