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.