Many women want their breast implants removed, for a variety of reasons. Some may believe the implants are causing them to experience symptoms of Breast Implant Illness (BII), while others have experienced medical complications such as ruptures or movement, while others simply no longer wish to have the implant. The procedure we use to remove implants is called an en-bloc capsulectomy.

What is an en-bloc capsulectomy?

When you have implants – medical or cosmetic – scar tissues naturally forms a capsule around the implant. An en-bloc capsulectomy is the procedure where the breast implant is removed, as well as the capsule around it (so the implant is still covered in the capsule when it is removed).

Why remove the capsule?

Patients can be assured that any silicone or bio film is thoroughly removed with an en block capsulectomy. If new implants are being inserted, they require contact with normal tissue, rather than old, hardened scar tissue so the capsule must be removed. In addition, removing the capsule allows the body to heal faster. Also, if the capsule is not removed, it can show up as a mass on a mammogram.

Is an en bloc capsulectomy a complicated procedure?

It is quite an extensive procedure as the capsule of breast implant needs to be dissected from chest wall and ribs, as well as the muscles that span the ribs. The patient often requires drainage tubes for several days (usually 5-7 days at least – when the implants are replaced). If the procedure is performed without replacement implants, there is no left over space and therefore the drainage tubes may come out a bit earlier.

How long does it take to heal?

Recovery is not fast after an en-bloc capsulotomy. Drainage tubes will likely be in place for a week or so, and you can usually return to work in less than two weeks, however full internal recovery usually takes two to three months.

Does Medicare cover en bloc capsultectomy?

As with everything to do with Medicare, it’s a little complicated, but the short answer is yes, in most cases it is covered, at least partially. If the implants have ruptured Medicare will cover the removal and replacement of breast implants.

Medicare will also likely cover an en bloc capsulectomy if your breast implant scar tissue is indicated because you have a malformation of the breast tissue, or your breast tissue capsule is diseased.

What will my breasts look like after an en-bloc capsulectomy?

If you do not have replacement implants or a lift (also known as a Mastopexy), your breasts will likely appear somewhat deflated, whereas with new implants or a lift they will not. The scars of the surgery will fade, however they will never be completely gone. The patient below had en-bloc capsulectomy performed to remove her more than 25-year-old implants, with no replacement! Her own breast tissue was rearranged to provide ‘auto-augmentation’.


The patient below had en-bloc capsulectomy performed to remove her more than 25-year-old implants, with no replacement! Her own breast tissue was rearranged to provide ‘auto-augmentation’.

Implant And Capsule
Implant and capsule post removal during en-bloc capsulectomy. IMAGE COPYRIGHT: DR DILIP GAHANKARI. PUBLISHED WITH WRITTEN PERMISSION FROM PATIENT. REPRODUCTION IS FORBIDDEN.
Post en-bloc capsulectomy
Post-op (en-bloc capsulectomy) 6 months. No implants – just Mastopexy (breast lift) with auto-augmentation. IMAGE COPYRIGHT: DR DILIP GAHANKARI. PUBLISHED WITH WRITTEN PERMISSION FROM PATIENT. REPRODUCTION IS FORBIDDEN.

Who should perform an en-bloc capsulectomy?

An en-bloc capsulectomy is a more complicated surgery than placing the implants. Your surgeon should be experienced in en-bloc capsulectomy and have a thorough understanding of implants. Ideally, your surgeon will be a Plastic Surgeon (not simply a cosmetic surgeon). To ensure your surgeon is a fully qualified Plastic Surgeon or to find a a fully qualified Plastic Surgeon, go to https://plasticsurgery.org.au/about-us/find-a-surgeon/

For more detailed information on en-bloc capsulectomy, please contact Dr Dilip Gahankari’s office via the contact form below or on 1300 007 300 to arrange a complimentary surgical consult with one of our senior nurses.

Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner. Dr Dilip Gahankari provides this blog as general information. It is not a substitute for professional medical advice and treatment, and should not be accepted in place or in preference to a consultation with a qualified surgeon. It is recommended you obtain specific advice for your individual needs.

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