en bloc

Q: Explant of Ruptured Sub-muscular Cohesive Gel Implant: is En Bloc Necessary?

Submitted by Q-A from clee on Sat, 05/14/2011 - 09:27

Hi- I recently discovered, and confirmed through MRI, an intracapsular rupture of my sub-muscular 410 cohesive gel implants. They are about four years old. My surgeon is recommending en bloc removal, however this also seems to be this doctor's standard operating procedure.

Is en bloc necessary with cohesives, and are the potential health risks significant either way? I would be extremely grateful for professional input.

A: Would favor removal

I favor removal with complete capsulectomy if possible. En Bloc sounds very severe but is not really more than a complete capsulectomy since this is still an intracapsular rupture. En bloc is much more substantial procedure for extracapsular rupture into the breast parenchyma.

While it remains an intracapsular rupture, risks of any problems are minimal. The problem is that we do not know when it may progress to an extracapsular disruption. For this reason, I favor removal while it is a relatively simple and easy procedure.