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En Bloc Capsulectomy – case study

Wednesday, May 19, 2021

The human body reacts to every implanted device, whether it is a cardiac pacemaker or a breast implant, by forming a “capsule” around the foreign body.  This capsule is made of collagen (scar tissue).  Every capsule is different.  The capsule may be thick or thin.  In the case of breast implants if the implant has been placed behind the pectoral muscle then the capsule is often adherent to the underlying chest wall making removal difficult and sometimes impossible.  Capsules, especially around textured breast implants, are often inflamed due to constant friction by the implant.  It is this inflammation which leads to the symptoms of Breast Implant Associated Illness.  Conversely, capsules around smooth walled breast implants are often thin with little if any inflammation.

Here is a series of photographs showing how we do an En Bloc capsulectomy.

The patient had smooth-walled implants inserted in front of the pectoral muscles.  The implants were large and her overlying skin had stretched.  Therefore, she was undergoing a breast lift at the same time and this gave us excellent access to do the En Bloc capsulectomy.

1. As we cut down onto the implant we encounter the thin capsule.

 

2. We are able to dissect all the way around this capsule and this shows the capsule being delivered with the smooth-walled intact silicone implant protruding.

 

3&4 Pictures of the implant being removed from the capsule once the entire structure has been removed from the body.

 

Note how thin and translucent the capsule is.  This is a sign of the minimal inflammation around the smooth-walled implant.

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