"I have 18-year-old breast implants placed behind the muscle wall. I want the implants removed. I do not want a replacement of implants. Is the en bloc method of removal best for my case?"
DR. POUSTI: En Bloc Breast Implant Removal?
Thank you for the good question. Generally speaking, if the breasts and the underlying breast implants feel soft (to deep palpation) and the breast implants seem to move freely (not fixed for firm), then it is very likely that the capsules are thin/normal.
Some general thoughts regarding this issue may be helpful to you: generally speaking (in my opinion), unless the breast implant capsules have thickened (and/or are otherwise symptomatic), are associated with the ruptured silicone gel breast implants, or if the patient has concerns about “medical conditions” related to the breast implants, capsulectomy is not universally necessary. For these patients, en block removal of breast implants is a good procedure.
On the contrary, capsulectomy can expose you to additional risks, such as bleeding and minimal size loss. In other words, any maneuver performed during surgery exposes patients to additional risk (morbidity).
Recently I have become more aware of the fact that there are plastic surgeons who, instead of using good judgment and individualized patient care, are causing fear and unnecessary anxiety among patients. These patients them feel that complete capsulectomy is always necessary and undergo unnecessary surgery associated with additional morbidity and unnecessary expenses.
I hope this, and the attached link, helps. Best wishes for an outcome that you will be very pleased with.