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What is an en bloc Capsulectomy?

Nearly all implants used in the United States have a warranty of 10 years or more. While some implants can last for long periods of time, some other breast implants will need to be replaced after a few years of use. Do not expect the implants to last forever. 

Data collected by the implant manufacturers indicates that approximately half of the implants have to be replaced within seven years. Rupture of the breast implant, infection, and capsular contracture are some of the most common problems that affect the longevity of implants.

Virginia Institute of Plastic Surgery, led by board certified plastic surgeons Dr. Burton M. Sundin and Dr. Reps B. Sundin, provides breast implant removal to patients in Richmond, Fredericksburg, Northern Virginia, and surrounding communities.


Capsular Contracture

Capsular contracture refers to the scarring that happens around the implant. All breast implants -textured, smooth, round, shaped, below or above muscle – will form a capsule. The implants are a foreign body, so the body of the patient tries to form a wall by developing a capsule around it. This wall acts as a barrier from the implant. 

The capsule can be either flimsy or soft – nearly like an unnoticeable film or it can become painful and firm– like a hard shell that you feel contracts and shrinks over a period of time. When the implant forms a capsular contracture that is hard and painful, it is not a complication in itself. However, some women may want to remove both the implant and the capsule if the capsular contracture is severe and causes pain or discomfort. 


En Bloc Capsulectomy

An en bloc capsulectomy plastic surgery is performed to take out the capsule and implant in a single piece. A complete en bloc capsulectomy is a thorough and painstaking surgical process that takes out every bit of the capsule, along with the section that may be very close to the ribs and the chest wall. In a partial capsulectomy pieces of the capsule are left inside the breast pocket. 

The surgical separation from an en bloc capsulectomy causes irritation to the remaining tissue of the breast, and leads to production of fluid from the body. Therefore, after an en bloc capsulectomy, the surgeon needs to place drains to make sure the fluid from the breast pocket can exit the body. 

In case a fresh breast implant is to be placed, it should be positioned in a new space. If the original breast implant was in the subpectoral position, the new implant may have to be placed prepectorally. 

On the other hand, if the original implant was placed prepectorally, the fresh implant might have to be positioned subpectorally. At times, when the pectoralis muscle has been damaged or divided, it will be essential to repair it. 


Capsulectomy without Replacement of Implant

If you undergo implant removal and en bloc capsulectomy procure and do not want the replacement of your implant, the drains for fluid removal will have be left for a little longer period of time. Breast lift or mastopexy plastic surgery might be needed to build a breast mound for patients who may have any remaining breast tissue. 


How should you Prepare for Surgery?

It is important to stop smoking and drinking a few weeks before your en bloc capsulectomy procedure, because this increases the chances of swelling and bruising. You should also stop all supplements and medications at least two weeks prior to your surgery. Please arrange for someone who can drive you home safely after your surgery – either a close friend, family member, or even pay a ride servicing company to give you a lift.

Plastic surgeons at VIPS receive patients from Richmond, Fredericksburg, Northern Virginia, and nearby areas for breast implant removal.

For more information on the surgical and non-surgical procedures and treatments by Board Certified Cosmetic Plastic Surgeons Dr. Reps Sundin and Dr. Burton Sundin please visit

Serving Richmond, VA, Fredricksburg, Williamsburg, Northern Virginia, Washington DC, Vienna, McLean, Fairfax, Loudoun County, Ashburn, Tysons Corner, Reston, Arlington and surrounding communities.

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