En Bloc Implant Resection
Undergoing revision surgery can cause stress and uncertainty. However, Dr. David Passaretti uses advanced techniques to reduce your risk.
At his practice in Darien, CT, Dr. Passaretti can perform an En Bloc implant resection to remove the implant and capsule at the same time.
What are the benefits of the En Bloc implant removal technique?
Advanced Implant Removal with a Lower Risk
Reduced Risk of Complications
Since the implant and the capsule are removed as one unit at our Fairfield County office, it can help prevent any chemicals or bacteria from entering the body.
Protect Your Health
If you are suffering uncomfortable or dangerous symptoms associated with a ruptured implant or breast implant related illness, or you have textured implants your health is in jeopardy. Undergoing implant removal can alleviate these side effects.
Improved Feel of Implants
Your implants can become hardened due to capsular contracture. Undergoing an En Bloc removal and replacing your implant can allow you to enjoy more natural-feeling results.
Achieve Better Implant Results
You can remove and replace unwanted implants if you are unhappy with their shape, size, or position. Replacing your implants can restore your body confidence and achieve more aesthetic results.
Factors That May Impact Whether You Qualify:
State of Your Health
You should be in good overall health before undergoing an En Bloc implant removal as certain conditions can impact your body's ability to heal properly.
The Capsule is Too Thin
In cases where the capsule is very thin, it cannot be kept fully intact and the contents can leak. As such, an En Bloc implant resection cannot be performed safely.
Overly Large Implant & Capsule
If the implant and capsule are too large to remove as a unit, this technique may not be recommended because it cannot fit through the small incision.
Dr. Passaretti has extensive experience in breast augmentation and is fully equipped to perform any revisions necessary.
What Is an En Bloc Resection?
En Bloc implant resection is a highly specialized surgical procedure that removes a breast implant and all of the surrounding scar tissue (or capsule) as one unit. This prevents any additional contact between your tissues and the implant. If you are concerned about the impact of your breast implants on your health or if you have a breast implant-related illness, an En Bloc procedure may be right for you.
For your safety and comfort, Dr. Passaretti can perform the procedure in our private operating facility. Because we operate with the highest safety standards, we can ensure that you are not exposed to any additional contamination or bacteria that is commonly found in hospitals.
What Are the Types of Capsulectomy?
En Bloc capsulectomy is often confused with total capsulectomy, but they are very different procedures. While both procedures remove the breast implant and the surrounding scar tissue known as capsule, they require different approaches.
There are several types of capsulectomy procedures, including:
En Bloc comes from the French term meaning "all together." The term is used to describe the surgical removal of something as one piece and without disruption. When performing an En Bloc capsulectomy, the plastic surgeon cuts around the implant and the capsule enclosing the implant. Then, he carefully removes it without causing any contamination to the body. This technique allows the silicone to stay safely inside the capsule during its removal, preventing chemicals and bacteria from leaking inside the body and potentially causing health issues. Often, this technique requires the removal of portions of muscle and rib due to the adherent, sticky nature of the scar.
Capsulectomy, or a partial capsulectomy, is a procedure that removes only part of the scar tissue. This procedure is commonly used by plastic surgeons to correct capsular contracture.
Total capsulectomy removes all the scar tissue. During this procedure, a cosmetic surgeon will remove the implants first, then remove all of the capsule tissue. This technique increases the risk of introducing contamination from the implant into the patient's body.
Capsulotomy is a procedure that cuts or releases some of the scar tissue around the implant. In most cases, plastic surgeons perform this technique to reshape the breast, reposition an implant, or soften a hardened breast. With this technique, the entire capsule is left behind.
Why Choose Dr. Passaretti for This Procedure
Dr. Passaretti has been performing the advanced En Bloc technique for fifteen years. He is one of the few surgeons in Connecticut and across the country to be certified by leading En Bloc patient groups, including the group Healing Breast Implant Illness.
About En Bloc Capsulectomy
Will I need a drain?
Usually not! Although most surgeons use surgical drains, through very gentle tissue handling technique and the meticulous obliteration of dead space, Dr Passsaretti has found that he can avoid surgical drains in 99% of his patients. This also helps to reduce the risk of outside contamination of the surgical field.
Will there be a scar?
To ensure minimal scarring, the En Bloc procedure is usually performed through your existing surgical scar. But since the implant and capsule are removed as one unit, the scar is often longer than that from a typical breast augmentation - usually about four or five inches. In the end, the size of your scar will depend on the size of your breast and the size of the implant.
Will I need a breast lift?
While a breast lift is not required, many women choose to undergo a lift at the same time as their implant removal. If the breast skin is stretched or the nipple is situated too low, a breast lift (or mastopexy) can help reshape, elevate, and rejuvenate the breast. Many plastic surgeons will not perform a breast lift at the same time as the En Bloc procedure, but Dr. Passaretti has the surgical experience and skill to safely combine the two procedures for virtually all of the patients who desire it.
How will I know if all of the scar tissue was removed?
All too often, we hear of patients needing additional surgery because some scar tissue was left behind. Due to the complex nature of an En Bloc resection, many surgeons fail to completely remove all of the scar. This is where experience counts. Dr. Passaretti has performed hundreds of En Bloc procedures. Although we cannot make any guarantees, Dr. Passaretti has never failed to completely perform a patient-requested En Bloc procedure over the past 15 years.
After removal, we also photograph the implant and scar to give patients peace of mind that it was all removed.
Will the tissue and implant be tested?
Yes! Do not trust your pathology to just anyone. Dr Passaretti has worked closely with Dr. Babkowski, a breast pathologist with a specialty in BII and lymphoma, to develop a protocol for bacterial and pathologic testing of all the specimens.
What is the recovery like?
During an En Bloc removal, it is often necessary for the surgeon to remove portions of muscle and rib. While this is a completely safe and an essential part of the procedure, it does make the first week of recovery slightly more difficult than that of the original breast augmentation.
Is breast implant-related illness the same as implant-related lymphoma?
No. Breast Implant Associated Anaplastic Large Cell Lymphoma (BIA-ALCL) is a rare but treatable type of lymphoma that can develop around textured breast implants. BIA-ALCL can occur in both silicone and saline implants as well as reconstructive and cosmetic patients. It is not associated with smooth-shelled implants and it is not a form of breast cancer, but it is an indication for en bloc resection.
Meanwhile, breast implant-related illness is an autoimmune reaction to the presence of the implants or bacteria on the implants. There is no way to accurately diagnose it and it does not seem to lead to cancer.
Both conditions can be treated with En Bloc resection.
Start Your Journey to Wellness We Are Here to Help
I cannot say enough about Dr. Passaretti and his staff. I had a en bloc capsulectomy with Dr. Passaretti in October 2019. He was extremely knowledgeable, professional and warm. His staff members were on top of it -- every question was answered and the environment was comforting yet sophisticated. In a world in which many plastic surgeons are dismissive of breast implant illness, Dr. Passaretti acknowledges that breast implants are rejected by some patients bodies and helps those of us with BII start our healing process. Five Stars on Google
En Bloc Implant Resection Experience Counts
By carefully dissecting the scar capsule from the surrounding tissue, Dr. Passaretti ensures that the implant is removed en bloc to avoid any contact with the implant material or infection.