American Society of Plastic Surgeons
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bornie
6 months ago
Answered

en bloc capsulectomy and lift simultaneously or separate

I had 2 consultations with 2 different surgeons for en bloc capsulectomy & lift. One said due to my larger implants and minimal fat/tissue that I would need to wait at least a year to have the lift and I would look totally deformed. The other said that it would depend how the explant goes, but would likely be 6 weeks & then I can have a lift. That seems like a large discrepancy. What is the norm

Procedure: Breast Implant Removal
Location: Bremen, AL

Replies 5

M. Zakir Sabry
ASPS Surgeon
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The most important issue here is to maintain perfusion to nipple areolar complex. Unless,, the breast tissue is extremely thin after capsulectomy, a peri-areolar lift may be done at the same time with or without autologous fat grafting. I have performed this safely. Thank you.

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Samir Shureih
ASPS Surgeon

To give a medical advice requires an In person complete history and physical examination.

No mention of why you need an enblock capsulectomy. Where the implant is located, above the muscle or below the muscle. If the capsule is thin an en block capsulectomy might be very difficult if impossible if the capsule is stuck to the ribs or the intercostal muscles without the possibility of major complications.

The only real indications for en block capsulectomy is oncologic for cancer.

A thorough discussion is needed with you to discuss al your options and what each option entails. Make your decisions based on science and not on research on social media with no science. consultations like yours require two hours of consultation. The you make your decision based on informed consent and understanding all aspects of the surgery.

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Aaron Stone
ASPS Surgeon

The indications for en bloc capsulectomy are few and far between such as ALCL. Medial pedicle lift procedures have dramatically improved the results of and the indications for breast lift procedures.

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J. Gerald Minniti
ASPS Surgeon

First, unless you have breast implant associated lymphoma, there is no reason to have an en bloc capsulectomy. A current ongoing prospective trial has shown that those who self report with breast implant illness have the same outcome regardless of how much capsule is removed. Second, staging an explant/lift into two surgeries is always the right thing to due with thin tissues (less than 2 cm tissue thickness), especially if capsule is being removed.

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Ignacio Buenrostro Rubio
ASPS Int. Surgeon

Hi Bornie, I always do en bloc capsulectomy and lift at the same time. If you have minimal fat/tissue there are other surgical options such as fat transfer after 6 months of the breast lift

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