En bloc capsulectomy for removal of breast implants increasing.


En Bloc capsulectomy involves the explant of breast implants, either silicone or saline, as well as total removal of the capsule, a total capsulectomy together or en bloc removal of implants without separating them.

En bloc capsulectomy is increasing exponentially among patients that have breast implants. This procedure involves the explant of breast implants, either silicone or saline, as well as total removal of the capsule, a total capsulectomy together or en bloc removal of implants without separating them.

Edward J. Domanskis,MD,Inc
Edward J. Domanskis, MD, Inc

“I have definitely seen an increase in breast implant removal. If a women decides to have her breast implants removed, then she should consider having an en bloc capsulectomy to also remove the capsule surrounding these implants to be assured that almost all of the silicone is removed,” said Dr. Edward Domanskis, certified by the American Board of Plastic Surgery , who has vast experience with breast implants.

The main impetus for breast implant removal and doing an en bloc capsulectomy is to alleviate or remove the symptoms of breast implant illness. Breast implant illness has been associated with a variety of symptoms such as weakness, fatigue and immune problems. Various studies show different degrees of improvement in patient symptoms after removal of their breast implants.

Another reason for patients seeking breast implant removal and en bloc capsulectomy is the association of an unusual lymphoma, anaplastic large cell lymphoma or BIA-ALCL with breast implants, primarily those with Biocell textured coating. In July, the Federal Food & Drug Administration (FDA) ordered a recall of textured with Biocell breast implants. Allergan, the main manufacturer of the Biocell textured implants, has complied. Approximately 779 cases to date of BIA-ALCL have been diagnosed and treated out of millions of women who have had breast implants.

“When I do an en bloc capsulectomy for removal of breast implants, silicone or saline or textured implant, I send the total capsule to pathology for inspection as well as do specific testing for BIA-ALCL if any fluid is present. I also provide photographs to my patients to verify that I have performed an en bloc capsulectomy,” continued Dr. Domanskis.

Other procedures, like a breast mastopexy or reshaping of the breasts is usually done after an en bloc capsulectomy as well as even fat transfers to minimize the decrease in size that occurs.

According to American Society of Plastic Surgeons(ASPS) latest statistics, however, breast augmentation or enlargement with breast implants is still the number one surgical cosmetic procedure performed and about ten times more frequent than breast implant removal. “Maybe the time will come when I remove more breast implants than are implanted,” Dr.Domanskis concluded.

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