This procedure involves the removal of breast implants along with the capsule that forms around them, all in one piece. The capsule is a fibrous tissue that naturally develops after breast augmentation surgery and, in most cases, does not cause problems. However, in some patients, complications may arise such as breast implant illness, capsular contracture, or even anaplastic large cell lymphoma.
Breast implant illness may present with systemic symptoms, including joint pain, weight gain, dermatitis, anxiety, difficulty concentrating, hair loss, and autoimmune disorders. If the capsule contracts, it can lead to local breast symptoms and deformities, and pain will not be fully relieved until the capsule is removed. There are several degrees of capsular contracture, which may influence the decision to undergo this surgery.
The Surgery
There are several anesthesia options, with general anesthesia being the most commonly used by plastic surgeons. The incisions depend on the breast implant and may be periareolar, circumvertical, or anchor-shaped.
During the procedure, the capsule surrounding the implant is dissected using electrocautery to avoid rupture. Although the goal is to keep the capsule intact, this is not always possible, and small perforations may occur. The crucial aspect is ensuring complete removal of the capsule.
Once the capsule is removed, blood vessels are coagulated and the breast tissue—potentially deformed by the implant—is reorganized. In some cases, immediate fat grafting or a secondary surgery may be required to achieve the desired shape.
After reconstruction, the tissues are repositioned, and the incisions are closed, usually resulting in an inverted T-shaped scar. To manage any residual bleeding, a drain is placed, which will be removed depending on the amount of blood output in the following days. The wounds are covered with micropore tape, and a postoperative bra is placed to reduce swelling. Finally, the capsule is sent for histopathological examination.
After Surgery.
You must follow the prescription and instructions provided by your plastic surgeon. Wearing the postoperative bra during the first month is recommended, as it will help decrease swelling and improve results.
You may experience pain at the site where the drain is fixed when performing certain movements. The drain will be removed depending on the amount of blood drained, which varies for each patient.
Before discharge, you will be instructed on how to empty the device where the blood and/or serum accumulates. A daily record of drained fluids must be kept.
En bloc capsulectomy cannot guarantee that breast implant illness symptoms will disappear. However, most patients have reported significant relief or resolution of symptoms.