En bloc removal of implants to avoid silicone leakage
18/07/2010 18:45 Filed in: Breast
It’s not often I have to remove breast implants as, thankfully, modern breast implants are so much more robust than implants from the past. When I do remove implants (and replace them at the same time) there are a number of options we have. We can make a small incision, cut into the pocket the implant was put inside (called the capsule) and remove the implant. Alternatively, we can make a larger incision and cut around the implant so that we remove the implant and the capsule surrounding the implant “en bloc”. The en block technique is technically harder to perform by a surgeon, and takes longer to do in the operating theatre. However, when removing old implants it’s important to realise they may be ruptured inside the capsule. This is called an intracapsular rupture, and if this has happened, then the implants can start leaking silicone into the body as soon as the capsule is entered. By removing implants and the capsule together en-bloc, we avoid risking leakage of silicone into the breast. With older implants, we know that the silicone was fairly soft and liquid like; with modern form-stable cohesive gel implants the silicone cannot leak out of the implant shell. So, when we’re replacing old implants, we should really consider removing them en-bloc to avoid silicone leakage into the breast. With replacement of modern implants, we don’t need to be so concerned with avoiding breaching the capsule.