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.
When each procedure is recommended
En bloc capsulectomy
Dr. Khan recommends the en bloc method for patients with ruptured silicone implants, confirmed cases of BIA-ALCL (breast implant–associated anaplastic large cell lymphoma), or strong symptoms of breast implant illness. It’s also preferred for patients who want complete reassurance that all potential contaminants are removed in one intact piece. Because the capsule acts as a barrier, removing it intact ensures that no silicone particles, biofilm, or inflammatory tissue are left behind.
Total capsulectomy
A total capsulectomy may be more appropriate when the capsule is extremely thin or attached to vital tissue, making an en bloc capsulectomy too risky. In such cases, removing the capsule in segments allows the surgeon to clear away all scar tissue while minimizing potential injury to the chest wall. Although less complex, this method still achieves the primary goal of eliminating most or all capsule tissue and the implant itself.
Benefits and recovery
En bloc capsulectomy
Because the en bloc procedure ensures complete removal of the implant and capsule as a single unit, it may reduce the risk of residual inflammation or silicone exposure. For patients suffering from BII, this method often represents the most definitive path to renewed health. The recovery process typically involves swelling, bruising, and mild discomfort, but most patients find their energy and well-being improve as their bodies begin to heal naturally.
Total capsulectomy
A total capsulectomy can also relieve pain, tightness, and distortion caused by capsular contracture, helping to restore a natural breast shape and comfort. Because the surgery is sometimes less extensive, recovery may be slightly shorter. However, patients who prioritize complete removal of all implant-related material may still prefer the en bloc approach for its additional level of assurance and containment.
Which method is suitable for me?
If you are experiencing symptoms of BII, have a ruptured implant, or simply want the most comprehensive removal possible, Dr. Khan will likely recommend an en bloc capsulectomy. His signature Khan Procedure is performed using this advanced technique, along with meticulous dissection and natural tissue preservation, to restore your body to its most natural state.
However, for patients whose anatomy makes an en bloc approach impractical, a total capsulectomy can still deliver excellent results when performed by an expert surgeon.
At Executive Plastic Surgery in Bloomfield Township, Dr. Khan thoroughly evaluates each case, reviews your imaging, and discusses every option with complete honesty and transparency. No two patients are alike, and Dr. Khan’s goal is always to deliver the safest and most restorative outcomes. Schedule your consultation today to explore your breast implant removal options with Dr. Khan.
