Newport Beach En Bloc Breast Implant Removal San Diego, CA Breast Implant Illness
×

En Bloc Breast Implant Removal

Breast Implant Removal – Newport Beach and San Diego

When a patient wants her breast implants removed, it’s essential to find the right breast explant surgeon who offers the safest techniques possible. One such technique is the En Bloc breast implant removal method, a special technique that’s known for its high margin of safety and effectiveness.

In most breast augmentations, some tissue forms around the implant creating what is known as a “capsule.” While this is a typical body response whenever a foreign object is inserted into the body (it happens with hip replacements and pacemakers too!), sometimes the scar tissue capsule can cause complications with the breast implant. A technique like the en bloc breast implant removal may be required to remove the implant and the capsule entirely, allowing the surgeon to create a new, healthier pocket for a new implant.

Not every surgeon is skilled in performing en bloc breast implant removal, but board certified plastic surgeon Dr. Sayed specializes in breast surgery, and has performed breast surgeries in plastic surgery-oriented areas. Dr. Sayed performs en bloc breast implant removal surgery because more than anything, he strives to give his Newport Beach and San Diego patients the safest techniques possible.

Read on to learn more about breast explant surgery in San Diego and Orange County. We also invite you to schedule a consultation with Dr. Tim Sayed, one of the best en bloc capsulectomy surgeons in California. 

En Bloc Breast Implant Removal 101

In the case of an implant rupture, the breasts changing in size, the implants changing position, or a patient simply wanting to exchange implants, an en bloc breast implant removal surgery might be warranted. Essentially meaning “as a whole,” the en bloc breast implant removal technique removes the implant and the capsule as an entire unit, making sure no residue is left behind and that the breasts can essentially heal and recover without contamination.

Bacteria and materials from the capsule or a leaking implant may cause certain symptoms like pain or distortion of the result. One of the risk factors for capsular contracture is something known as “biofilm,” a complex mixture of skin cells, proteins, and bacteria that can lead to an excessive inflammatory response. When the en bloc breast implant removal procedure is done, the plastic surgeon removes the whole implant and capsule together to avoid leaving behind any biofilm material, so a new implant is less likely to develop a capsular contracture if the patient chooses to have another breast augmentation in the future.

An en bloc breast implant removal usually will require the creation of an inframammary incision, but these incisions are easy to hide. Of course, if the patient already has an inframammary scar, Dr. Sayed will try to use the original incision to minimize placing new scars whenever possible. Once the implant has been removed, the breasts’ tissue, muscle, or both will be able to revert back to its original position in the chest. Oftentimes, Dr. Sayed will place a drain in the breast to prevent fluid accumulation.

To combat sagging, Dr. Sayed can stage procedures and pair the removal with a breast lift and/or a new breast implant. Learn more about breasts after explant.

Schedule a private consultation with en bloc capsulectomy surgeon Dr. Sayed at his Newport Beach or San Diego area office.

What is Capsular Contracture?

Capsular contracture is when the capsule around the implant starts to get thicker and thicker, eventually squeezing the implant and causing the breasts to harden, become misshapen, or making the implants change position.  No one’s quite sure why capsular contracture occurs, but the capsules may contain substances like silicone gel, silicone gel fragments, bacteria, calcified tissue, and inflammatory cells—all substances that cause further complications. It’s why en bloc breast implant removal is so necessary—by removing the capsule and implant as a unit, the contaminants will be self-contained and less likely to be left behind.

Contact us today!

If you’re in the San Diego or Newport Beach areas and have any questions about Implant Removal or wish to schedule a consultation on implant removal with board certified plastic surgeon Dr. Sayed, please contact our office.

Should I Have My Breast Implants Removed?

While breast augmentation is generally safe and can produce amazing results for many women, there may come a time when having your implants removed may be physically and medically necessary. Some of these reasons include:

  • Capsular Contracture. For some individuals, a capsule of scar tissue forms around the breast implant as the body attempts to isolate the object. This scar tissue is normal and part of the healing process. However, on rare occasions, the scar tissue can harden and contract around the implant, causing the breasts to become misshapen or hard, which can lead to discomfort.
  • Implant Rupture. If an implant were to rupture or leak, surgery becomes necessary to remove the implant, and potentially replaced, immediately.
  • Change of Mind. Many women change their minds about the size or type of their implants due to lifestyle changes, pregnancies, weight fluctuations, or desires to return to their natural breast size and appearance.
  • Discomfort Associated with Implants. Large breasts, while often aesthetically pleasing, can lead to pain in the back, neck, or shoulders due to increased weight in the front. A knowledgeable and experienced plastic surgeon will help their patients choose the right size for their body type to avoid this discomfort. For some women who didn’t have a plastic surgeon recommend an appropriate size breast implant, implant removal or exchange is often the solution.
  • Breast Implant Illness (BII). Some women report a variety of symptoms that they attribute to their breast implants, often referred to as “breast implant illness” or BII. These symptoms can range from fatigue, cognitive issues, joint pain, to autoimmune-like symptoms. While the relationship between these symptoms and breast implants is still under research, some women choose to have their implants removed due to concerns or experiences related to BII.

 

If you are experiencing any of these complications or symptoms, it is highly recommended that you schedule a consultation to learn more about whether breast implant removal surgery is right for you.

What Will I Look Like After Breast Implant Removal?

Depending on the size of your breast implants and the health and vitality of your skin, your breasts may sag, droop, or appear misshapen following implant removal. During a breast lift, Dr. Sayed will remove any excess skin and reshape the breast tissue to appear more akin to your natural breast appearance before your breast augmentation.

Why Should I Remove My Breast Implants?

The decision to undergo breast implant removal surgery is deeply personal. A breast implant removal procedure can help restore your breasts to their natural shape, size, and appearance. This can be beneficial for patients who are no longer satisfied with the appearance of their implants, whether it be the size, shape, or feel of their initial procedure. Removal is also recommended for patients experiencing complications with the implants, such as rippling, asymmetry, or capsular contracture.

PHOTO GALLERY

View real patient before & after results in our photo gallery.

Breast Implant Removal Recovery

Recovering from your breast implant removal procedure is similar to the recovery from your initial breast augmentation. It may take up to six to eight weeks to heal after surgery, depending on the extent of your procedure and overall health. Most patients can resume light work about a week after their removal procedure. However, physical activities like exercising or sports will need to wait until after six weeks or when Dr. Sayed clears you to continue.

Some common symptoms after a breast implant removal procedure include soreness, tenderness, swelling, and bruising. These symptoms will resolve on their own over the course of your recovery, but they’re generally the most challenging in the first three days. Dr. Sayed and his team will help to keep you comfortable during your recovery with a compression garment that should remain in place for  three to six weeks, as well as prescribed pain medication and management.

Am I A Candidate for Breast Implant Removal?

In general, candidates for a breast implant removal procedure are those who are unsatisfied with the results of their initial breast augmentation or are experiencing rare conditions associated with their implants. Dr. Sayed suggests that breast implant removal candidates in Newport Beach be:

  • Non-smokers
  • In good overall health
  • At a stable weight
  • Understand the details of the procedure
  • Have a positive outlook and realistic expectations regarding their results
  • Be prepared to closely follow all pre- and post-operative care instructions

FAQs About En Bloc Breast Implant Removal

  • A patient experiencing pain from previous breast implants
  • A patient who is symptomatic from a silicone breast implant rupture
  • A patient who wants to remove implants because of hardening, malposition, or asymmetry
  • A patient concerned that her implants may be causing other symptoms in her body
  • A patient with certain textured implants who may be concerned about rare risks of ALCL cancer

As the swelling dissipates, it’s normal to see some shrinkage in volume. Obviously, your implants are gone, but changes of the breast due to aging and stretching from the implants will lead to further change in shape and sagging. When removing an implant and the capsule, you might experience a longer recovery time than a regular breast augmentation: about a week longer than the typical 2 weeks of abstaining from any strenuous activity. After that, you can return to light fitness activity, and it’s advised that you take about a week from social activities and refrain from driving from at least 10 days or as long as you’re taking any prescription medication. You will be asked to wear a surgical bra for a few weeks.

Breast implant removal cost will be dependent on a few factors, so if you would like an accurate quote we encourage you to contact us for a consultation. You can also contact us for a pre-consultation if you want to learn more, or you can visit our Zwivel page for a virtual consultation.

With a total capsulectomy, the capsule is removed from the breast. The breast implant may be removed first before completing the capsule removal if necessary for exposure or safe conduct of the procedure. The implant may be reinserted into the breast pocket or completely replaced. An en bloc breast implant removal includes removal of both the total capsule and the implant contained inside the capsule. This is most commonly done for ruptured older generation silicone implants, where it is important to try to leave no residue of the original implant and capsule behind. Sometimes en bloc removal includes a small cuff of breast tissue that may have become hardened or inflamed over time. 

The en bloc procedure is also offered for patients who may be concerned that they have “Breast Implant Illness,” a nonspecific set of symptoms that can include joint pain, fatigue, vision changes, anxiety, gastrointestinal or other symptoms. While there is no proven causal relationship between implants and the development of these symptoms in a small percentage of patients, symptoms are often debilitating enough to prompt patients to seek removal of the implants and capsules in an effort to try to improve how they feel. In March 2019, the US FDA met to discuss concerns regarding breast implant illness, textured implants and other considerations.  Continued monitoring of approved implant devices was advised. Breast implants are foreign bodies and it is possible a small percentage of patients do not react well to them, but currently we have no scientific way to validate or predict the development of symptoms in relation to the placement of the implants. For now, we feel it appropriate to offer patients an effort at en bloc capsulectomy with explantation of the implants to help patients with these concerns move forward in their lives.

The en bloc procedure is attempted in most cases where capsulectomy is desired. Keeping the implant in the capsule while dissecting the capsule from normal tissue provides a roadmap and a three-dimensional structure to follow. However, in some cases, it becomes difficult to safely complete the procedure if the implant obscures the surgeon’s ability to see around the surgical site fully. Additionally, in some patients, the capsule may be stuck down to the chest wall and removing the back wall of the capsule may place the patient at risk for entry into the chest cavity. This is called a pneumothorax (if air enters) or hemothorax (if blood does). The treatment for this complication is usually straightforward with placement of a chest tube, but the surgeon would always prefer to avoid the complication if possible. Most surgeons will continue the effort at en bloc removal for as long as the surgical dissection appears safe and feasible with the implant remaining in the capsule. In cases where the implant may need to be removed during the procedure, the surgeon will work to avoid contamination of any ruptured silicone or other material in the breast tissues. Additionally, if any capsule can not be safely removed, it is usually cauterized.

The best analogy is removing a sticker from a windshield: sometimes it easily comes off in one piece; in other cases, the sticker may tear partly, and in order to remove the sticker completely, one has to start peeling it from another direction. This is the process by which the surgeon works to peel the capsule off the rib cage and surrounding breast tissue. There is currently no scientific literature of which we are aware to suggest a risk of fungus (mold) or bacterial contamination if incidental entry into the capsule occurs during removal. 

Yes, this is commonly recommended. A patient having implants removed may have extra loose skin that can be reduced, in order to improve the aesthetic appearance of the breast at the time of device removal. Many patients may also have sagging breasts due to pregnancy/breastfeeding, weight changes, aging and other factors. In some cases, breast lifting can help mask any contour irregularities (indentations, bulges, creases, etc.) that can occur with capsule removal, while also enhancing the “perkiness” of the remaining breast tissue.

This can be hard to fully predict, but most patients can expect the breast to return to about the size it was before implants were placed (assuming there has not been significant change in the underlying breast tissue from pregnancy, weight gain or other factors). Patients who had implants placed through an incision around the nipple (periareolar incision) may develop creasing in the scar when the breast is deflated by removal of the implant. This is one reason why fat grafting to the breast may make sense for you. Fat grafting can return some of the volume lost with implant removal as well as help minimize contour defects. The fat is usually placed in the layer of the breast tissue and breast fat, as opposed to the space under the muscle or in muscle. Fat for grafting is usually taken from the abdomen and/or love handle (flank) areas, creating some cosmetic improvement in the donor site in the process.

Yes, we routinely use drains to evacuate fluid from the space where the implant and capsule used to sit. This also helps the remaining tissues heal back together more rapidly. 

In selected cases, Dr. Sayed will repair the pectoralis major muscle down to the rib cage if it will help the healing process or aesthetic result. This maneuver is not necessary in most cases, however.

Yes, we routinely send the capsule for pathology testing. The pathologist will send a report, typically around a week after surgery, describing the tissues. It is rare to find anything other than expected capsular scar tissue, with perhaps some attached muscle or breast tissue. If cancer or anything else suspicious is noted, the pathologist will report on that and make further recommendations if appropriate.

If en bloc breast implant removal isn’t the best option for your case, Dr. Sayed can also use other methods. There are a number of issues that can be treated through breast augmentation revision, including capsular contracture, symmastia, assymetry, changing implant size, scarring, and contour irregularities. Dr. Sayed also offers breast reduction and nipple surgery. Meeting with Dr. Sayed in a consultation is the best way to determine which procedure is right for you. 

While neither implant types have been directly correlated to increased risk of cancer, recent years have also seen the rise of secondary health issues related to breast implants. For patients experiencing breast implant illness, symptoms like headaches, chronic fatigue, fever, and joint pain can be especially debilitating and provide enough reason for women to seek explant. Furthermore, the FDA has identified over 450 cases of Breast Implant-Associated Anaplastic Large Cell Lymphoma – a rare form of cancer that can develop in the scar tissue around the implant. In the face of these very real medical concerns, many patients have chosen to implant removal as a means of protecting their overall health.

The most successful treatment in San Diego and Newport Beach currently, is breast implant removal (explant surgery). Given the increasing number of cases and recent FDA announcement regarding breast implant related cancers such as lymphomas (ALCL) and a new squamous cell carcinoma (SCC), Dr. Sayed approaches each breast implant removal case very carefully. During explant surgery Dr. Sayed removes the entire capsule (Total Capsulectomy) in one piece without rips or tears (En Bloc). Depending on the initial incision and breast implant size implants can be removed through a previous areola incision under the fold or through a breast lift incision.

If you have breast implants and have noticed an increase in unexplained symptoms such as fatigue, joint pain, breast pain or burning, enlarged axillary lymph nodes, brain fog or other symptoms that doctors have not been able to get to the root cause of; it may be time to schedule a visit with an explant surgeon.

Breast Implant Illness can be difficult to manage for many San Diego and Newport Beach women and their families as they struggle with extreme fatigue and other symptoms, some of which may even be debilitating. Many women have visited countless doctors and specialists and still do not have definite answers or an improvement of symptoms. Following a low inflammatory diet and limiting exposure to other environmental toxins is a great place to start in reducing other sources of inflammation within your body.