Conveniently located to serve Washington DC, Arlington, Bethesda
What is en bloc capsulectomy?
Some patients desire removal of their implants. This can be due to discomfort, the desire for smaller breasts, capsular contracture, or other symptoms. Some patients who have textured implants desire removal of the implants and capsule due the risk of ALCL (Anaplastic large cell lymphoma). In these cases, removal of the implant and surrounding breast capsule is performed.
How is the procedure performed?
Under general anesthesia, the capsule is separated from the breast tissue. The back wall may be fairly adherent to the ribs and chest wall muscles. Ideally the implant and capsule is removed as a unit. In some cases, fixing the chest wall may require removing part of the capsule in more than 1 piece. A drain is placed, the incisions are then closed and dressed and a surgical bra is placed. In many cases a patient may desire either placement of a new smooth round implant or augmentation with their own fat. Commonly a lift is performed at the same time if no implant is placed, due to the excess remaining skin.
This varies depending on if there are other combined procedures. Generally most patients are back to work in 1-2 weeks and back to the gym by 3 weeks.
- Poor cosmesis – due to the removal of the implant, if no further surgery is performed, loose skin or deflation is likely
- Fluid buildup – a drain will be placed to remove serous fluid/blood, but in some patients when the drain is removed, fluid may build up and may need to be removed in the office
- Pain – due to the capsules adherence to the ribs, this procedure can sometimes be painful
- Asymmetry – if implants are removed and you have preexisting asymmetry, you may have asymmetry after the surgery without reconstruction
- Risks of associated procedures – if you have a breast lift, placement of a new implant or placement of fat, the risks of those procedures would be relevant to this surgery
- Need for revision – some patients may opt to just have their implants removed, and then in the future decide that they desire reconstruction.
This has been an amazing experience from the consultation to post-surgery!!! I honestly can’t even express how happy & grateful I am with the results. Everyone….Dr. Ramineni and his whole team are impeccable, to say the least. A very thoughtful, professional, kind, and knowledgable team. I will 100% always refer anyone I know to this amazing team…Dr. Ramineni had a challenge when I came to see him with my issue but he 1000% went above & beyond to achieve perfection with my results. I can’t thank this team enough!! I genuinely want to thank you so much!
Dr. Ramineni was recommended to me by my plastic surgeon as a masterful surgeon who could figure out why I was having complications. He diagnosed the problem correctly and fixed it. I am grateful for his openness, his honesty, and skill.
- Saiyyaed A.
Life-altering surgeon. He helped make my dreams come true with the most flawless surgery I’d been waiting my whole life to get. Healing and recovery has been almost disturbingly easy and pain-free. I could not recommend enough. Everyone there is so sweet as well!
Dr. Praful Ramineni
Plastic SurgeON IN WASHINGTON D.C.
Dr. Ramineni is the founder of District Plastic Surgery. He is board certified and has over 15 years of experience in plastic and reconstructive surgery. He started his career as one of the busiest surgeons at Medstar Washington Hospital Center with a focus on complex reconstructive surgery including cancer and trauma reconstruction, microsurgery and aesthetic surgery.