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An en bloc capsulectomy (and similarly total capsulectomy) is the removal of not only the breast implant but also the tissue that has grown over time around the implant. It has been seen when this is accomplished to commonly help tremendously in a patient's recovery. 

This procedure is not done for cosmetic purposes, the entire purpose is to remove the capsule that has grown around the implant. It also is the procedure often performed if an implant ruptured so as to remove any tissue that could cause a problem for the patient. 

What is “en bloc” referring to?

As mentioned above En bloc is the removal of the breast implant as well as the scar tissue that has grown around it, referred to as the capsule. This implant and capsule are then a singular block of tissue. The En Bloc procedure is an advantageous technique because it lessens the possibility of rupturing the implant during removal. If rupture of a silicone implant occurs during explant, the procedure can become a bit more difficult for the surgeon. Another similar procedure (total capsulectomy) removes the entire capsule, and sometimes requires that the implant be removed separately during the procedure. However, it has been seen to be more advantageous, when a patient is experiencing an issue with their implants, to perform the En Bloc Capsulectomy if possible. An important point to keep in mind is the En Bloc Capsulectomy will likely require a larger surgical incision (and surgical exposure) than a standard Total Capsulectomy will. This should be discussed with your surgeon prior to surgery.

The final determination of what procedure is needed for the patient will vary from patient to patient. In a consultation with Dr. Brenner, he will help evaluate what is the best approach to resolve your issues. 

If receiving a breast implant removal, should you replace the implant?

There are many women that replace the old implants with new ones. This really is more of a personal decision than anything else. Some women want to replace silicone with saline, and some woman just want new silicone implants to maintain their existing size. Again, this is all a personal preference. 

At this point, there is no recommendation by the FDA to replace any textured implants, including BioCell implants. However, if you are thinking of removing your textured implants, they can be replaced with similar smooth implants if so desired. 

Is there any way to maintain the existing size without using an implant?

Multiple options are available for shaping or adding volume to the breasts:

  • A breast lift is one option. 
  • Fat grafting is another option. This technique involves harvesting fat from liposuction. This is taken from the thighs, tummy, or buttocks, and then cleansed in a centrifuge to separate the fatty tissue from other types of tissue. After this is done it is then injected into the breasts.

There are two requirements for fat grafting:

  • The patient has to have enough fat to harvest for the procedure.
  • There also must be a particular place in the breast area, not where the capsule or implant was, that has enough healthy tissue for the fat injection to be supported.


Dr. Brenner received his Bachelor of Science degree at the University of Wisconsin. He then received his Medical Degree at Loyola University in Chicago.

He completed his five-year general surgery residency at RUSH University and Cook County hospitals in Chicago, after which he completed a three-year residency in plastic and reconstructive surgery at the University of California.

He is a board-certified plastic and reconstructive surgeon.

As a leading Beverly Hills breast revision surgeon, Dr. Kevin Brenner has performed countless surgeries helping women achieve the natural, beautiful look they were originally intending. His years of experience and superior results have earned him the respect of his peers and a stellar reputation among his patients for providing among the best en bloc capsulectomy in Beverly Hills.

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