An en bloc capsulectomy is the removal of a breast implant and the tissue that has grown around it to recover overall health. It is not a cosmetic procedure. It is performed when the capsule has contracted around the implant or the implant has ruptured, so as to remove any problematic tissue.


What does “en bloc” mean?

En bloc (in a block or all as one piece) refers to the removal of the implant and the scar tissue that has formed around it (the capsule) as a singular block of tissue. This is often the preferred surgical technique, since it minimizes the possibility of rupturing the implant or disturbing the capsule, either of which could cause problems. Alternatives are to remove only the implant or only the capsule, which would be done by removing each piece.

The exact procedure used by Dr. Teitelbaum will vary, depending on a number of factors that he will evaluate during your consultation in his Santa Monica office.


What are the factors to be considered?

These factors may include:

  • Whether the implant needs to be removed, as with a ruptured implant, or only the capsule.
  • The location and type of incision that will be used (most frequently inframammary, or in the crease below the breast) for the best access to the area.
  • Whether any (and which) portion of the capsule may have adhered to any other adjacent tissues, besides the implant, since there may be additional risks involved in trying to separate it from, say, the underlying ribcage.

Should you replace the implant?

This is a personal decision. Something to keep in mind, however, is the fact that even with saline implants, the shell is made of silicone. Many women choose to replace silicone with saline, or have their breasts returned to their natural size with a custom surgery. If you have textured implants, silicone or saline, you may be interested in replacing them with new smooth implants.


Are there alternatives to replacing the implant to maintain a shapely profile?

Other options for recontouring the breast or adding volume are:

  • A breast lift, for which there are several different techniques available.
  • Fat grafting, which involves using liposuction to harvest fat from, typically, the thighs, tummy, or buttocks, cleansing it in a centrifuge to separate the fatty tissue from other types of tissue, and injecting it into the breast.

Note that there are two requirements for fat grafting:

  • There must be enough fat elsewhere on the body to be harvested for the procedure.
  • There must be a location in the breast area (not where the capsule or implant was) that has enough tissue for the fat to be injected into and support the graft.

What are the procedure and recovery for an en bloc capsulectomy?

An en bloc capsulectomy is an outpatient procedure that, on average, takes two to three hours. The recovery period is typically seven to ten days off from work, if you work in an office, longer if your job involves vigorous physical actions. This will vary, depending on your current health and the kind of stress or strain your job may require. Dr. Teitelbaum will give you exact instructions for recovery, depending on your unique case.


Why is Dr. Teitelbaum an ideal choice for an en bloc capsulectomy?

Double board-certified in both plastic surgery and general surgery, Dr. Teitelbaum has been performing successful cosmetic surgeries in his Santa Monica office since 1995. His advanced training in his areas of specialty were undertaken in highly impressive programs at UCLA, Harvard, and USC, and he is widely recognized by the medical community for the standards of his work.

Having been admitted to virtually every national and international plastic surgery society, he currently teaches final-year plastic surgery students at UCLA.

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