If you’ve been living with breast implants and are now experiencing pain, tightness, or changes in the shape of your breasts, you have two options for implant removal: en bloc capsulectomy and total capsulectomy. Both of these procedures aim to remove implants and the surrounding scar tissue, but they differ in technique and intention.
At Executive Plastic Surgery in Bloomfield Township, Dr. Shaher Khan, our double board-certified plastic and reconstructive surgeon and a nationally recognized breast implant illness (BII) specialist, has devoted his career to safely removing implants and restoring patients’ health. He performs both procedures when indicated, using his advanced and proprietary technique, known as The Khan Procedure, which represents the gold standard in safe and complete implant removal.
Overview
En bloc capsulectomy
The term en bloc comes from the French phrase meaning “all together.” In this procedure, Dr. Khan removes the implant and the surrounding capsule as one intact unit, ensuring that nothing inside the capsule, such as silicone gel, toxins, or bacteria, spills into the surrounding tissue. This is the safest approach when there’s concern about implant rupture, silicone leakage, or systemic symptoms linked to breast implant illness (BII). The goal is total containment.
Total capsulectomy
In a total capsulectomy, the entire capsule is removed, but not necessarily in one piece. The surgeon first removes the implant, then excises all sections of the capsule from the surrounding tissue. This is often done when the capsule is thin, fused to the chest wall, or otherwise unsafe to remove in one block. A total capsulectomy can still eliminate most of the problematic tissue, though it does not always guarantee that the implant and capsule remain sealed as one.
How the procedures are performed
En bloc capsulectomy
During an en bloc procedure, Dr. Khan carefully dissects around the entire capsule without opening it, thereby separating it from the surrounding tissue. The implant remains sealed inside throughout the process. Once fully freed, the entire structure, including the implant and capsule, is removed together. Because it’s performed in one piece, the en bloc technique requires longer operating time, high precision, and extensive surgical expertise.
Total capsulectomy
In a total capsulectomy, the implant is removed first, followed by the capsule, which may be taken out in sections. If portions of the capsule adhere tightly to vital structures, such as ribs or chest muscles, some tissue may remain in place. The surgeon thoroughly inspects the cavity and removes any remaining fragments. While this method is less complex and may be more widely performed, it does not offer the same level of containment as en bloc capsulectomy.
