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Implant Removal (Explant), Capsulectomy and En Bloc

There are many reasons why a woman may look at removal of breast implants (explant).  These can include personal reasons and medical reasons.

Personal reasons may include that as a person ages she feels the implants no longer suit her shape or weight, or her lifestyle has changed and they now prefer smaller breasts to having the implants in. It can also be that the patient no longer wants implants, there is no medical reason just a personal preference.

Medical reasons for an explant can include implant complications such as implant rupture, capsular contracture, breast asymmetry, implant displacement, infection or leakage of silicone.

There are 3 common techniques used for implant removal:

  1. Removal only of the breast implant – Removal is often through surgical incision sites.  Breast deformity or sagging of the breast area may be evident afterwards.
  2. Removal of the breast implant and a breast lift – this technique may require some breast tissue removed to result in a smaller but non saggy appearance of the breasts. Sometimes the areola may also need to be reduced in size.
  3. Deflation of saline implants. Further surgery may be required to remove the empty implant and possibly a breast lift as well.

Capsulectomy and Enbloc are the removal of the capsule or scar that forms around the implants.

In a Capsulectomy, a large portion to all of the capsule will be removed to either make way for a new implant and capsule to form or for the breast to heal without an implant.  In some cases where the breast has poor tissue quality, part of the capsule may be kept to help provide stability for a new implant or for the breast itself.   The scar is kept to a minimum by removing the implant separate to the capsule.

With an Enbloc Capsulectomy the implant and capsule will be removed in total and as one piece.  This is usually performed at patient request.  This technique requires a longer procedure time and often more scarring than a partial or full capsulectomy, in order to remove the implant and as one piece.   Sometimes, due to the quality of the capsule or firm adherence to the ribs, it is impossible to perform this procedure even with the best technique.

As mentioned before, a breast lift is often combined with either new implants or no implants reinserted. The breast lift assists to provide shape and position of the breast after a removal or change of size in order to have a more aesthetically appealing appearance.

Dr Craig Layt removes implants and capsules for patients regularly and is very happy to discuss the options for explantation of breast implants.