En Bloc Breast Implant Removal Las Vegas

Dr. Pancholi performs en bloc breast implant removal whenever possible


What is en bloc capsulectomy and why is it an important breast implant removal technique?

Las Vegas cosmetic surgeon Dr. Pancholi is well known for his expertise in breast augmentation and breast implant revision; this includes expertise in breast implant removal (explantation). There are many details he considers to ensure a safe, successful procedure and an aesthetically pleasing outcome, whether you are getting new implants or not.

One detail Dr. Pancholi will discuss with you is en bloc capsulectomy: removing your breast implants and the surrounding scar tissue all in one piece. Dr. Pancholi strongly prefers this option for breast implant removal, as he feels it’s often best for his patients’ safety and long-term outcomes.

En bloc capsulectomy

The above photo shows breast implants that Dr. Pancholi removed en bloc to treat capsular contracture. The capsule is fully intact, ensuring no implant material remained in the patient’s body.

Graphic image warning:

These pictures contain photographs of actual breast implants removed due to capsular contracture.

After breast augmentation, your body forms a natural layer of collagen scar tissue around the breast implant. This is called a capsule. The capsule seals the implant from the rest of your body and provides some structure as well.

During breast implant removal, the surgeon may remove this capsule when they take out the old implants. This is called a capsulectomy. A surgeon can open the capsule, remove the old implant, and then peel the capsule away. Alternatively, the capsule can be peeled away from the surrounding tissues while the implant is still sealed inside; this is called en bloc breast implant removal. When performed en bloc, the body is shielded from the actual implant and its contents. This is particularly important when an implant has ruptured.

Is en bloc capsulectomy right for my breast implant removal?

If you are experiencing symptoms of a medical complication, such as capsular contracture, BIA-ALCL, or breast implant illness, en bloc capsulectomy may be the safest way to remove your breast implants and implant capsules during a breast implant removal. Dr. Pancholi prefers to perform en bloc capsulectomy whenever it is safe and appropriate for his patients.

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Dr. Pancholi prefers en bloc implant removal for several reasons:

  • It’s often the method of choice to remove silicone implants that may be ruptured. The capsule acts as a barrier between a ruptured implant and your body. If the capsule can be removed with the broken implant still sealed inside, it can serve to keep the surrounding tissues clean and free from any free floating silicone from the implants.
  • En bloc removal helps to ensure removal of the entire implant shell and contents during explantation. Surgically removing the capsule is one of the most powerful steps in removing the “footprint” of breast implants. The capsule contains cellular and microbial matter, and possibly even silicone particles from a textured implant shell, that may remain after the implant is removed. Removing the capsule en bloc ensures all of this matter is removed thoroughly.
  • Reduced risk of complications after breast implant removal. Leaving the capsule behind after implant removal can create a situation where the body seals the opening made to remove an implant and the capsule fills with fluid. This is known as a seroma and can cause issues later on. Removing the capsule drastically reduces these risks.
En bloc capsulectomy implants

Breast implants removed with their capsules via en bloc capsulectomy. You can see the intact implants inside.

Graphic image warning:

These pictures contain photographs of actual breast implants removed due to capsular contracture.

How is en bloc breast implant removal performed?

When performing breast implant removal using en bloc capsulectomy, Dr. Pancholi meticulously separates the capsule from the surrounding tissues (breast tissue and muscle) while avoiding puncturing the sometimes paper-thin capsule. This way, the implants are left sealed inside the capsule and together the implants and capsule are removed without exposing the implants to the rest of the body.

Typically, this procedure can be done using your previous breast augmentation incision sites. However, in some cases, Dr. Pancholi may need to make an additional incision to ensure complete removal of the capsule.

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En bloc breast implant removal is not always possible

Dr. Pancholi performs en bloc removal when he can do so safely; however, not every patient is a good candidate for this method of breast implant removal. En bloc removal may not be possible if:

  • The capsule is too thin and delicate to remove in one piece. In this case, Dr. Pancholi will remove as much of the capsule as possible with the implant and then carefully remove the remaining scar tissue before closing the incisions and/or replacing the implant.
  • The breast tissue or skin over the capsule is very thin. For patients with very thin skin, removing the capsule could risk over-thinning of the skin and result in tissue necrosis (tissue death); in such cases, leaving the capsule intact may actually be safer.
  • The capsule is adhering to vital tissues. For example, if scar tissue is tightly attached to the rib cage, removing the tissue could risk injuring the lungs.

Removing the capsule can require a more complex surgery, so sometimes it is actually best to leave it alone, especially if Dr. Pancholi feels removing it may introduce new risks to your health or appearance after surgery. Read more from Dr. Pancholi about breast implant replacement and capsule removal on our blog.

En bloc breast implant removal

These breast implants were removed via en bloc capsulectomy to preserve the implants’ structure and reduce the risk of contamination.

Graphic image warning:

These pictures contain photographs of actual breast implants removed due to capsular contracture.

Frequently Asked Questions about Breast Implant Removal

Do I need my implants removed?

Women often desire to have their implants removed for a number of reasons and desired results. If you suspect you are experiencing symptoms as a result of complications from your implants, then an a breast explant procedure may help reduce or resolve them. Many women also find their implants no longer suit their aesthetics goals, and opt to have them replaced during a breast implant removal with a different shape or smaller size of implants, or removed all together. No matter your case, we assure you that your reasons are valid and are here to help you achieve aesthetic results your desire.

  • Complete removal of implant and capsule with the En Bloc technique
  • Potential relief from Breast Implant Illness (BII) symptoms
  • Elimination of Capsular Contracture
  • Potential improvement in autoimmune symptoms
  • Anesthesia: Medications used to prevent pain during surgery; can be general (inducing unconsciousness) or local (numbing a specific area).
  • Breast Implant Illness (BII): A term used to describe a variety of symptoms thought to be potentially associated with breast implants, such as fatigue, chest pain, hair loss, and headaches.
  • Capsular Contracture: A complication of breast augmentation where scar tissue forms around the implant, causing firmness, distortion, and sometimes pain.
  • Capsulectomy: The surgical removal of the capsule of scar tissue formed around a breast implant.
  • En Bloc Removal: A surgical technique used in breast implant removal where the implant and the surrounding scar tissue capsule are removed together in one piece.
  • Explant Surgery: The surgical procedure for removing breast implants. This can include different techniques, such as en bloc removal, where the implant and surrounding tissue capsule are removed together, or simple removal of the implants without the capsule.
  • Implant Rupture: A tear or hole in the implant’s outer shell, which can occur in both saline and silicone implants.
  • Inframammary Fold: The natural crease under the breast, often used as an incision site in breast surgeries to minimize visible scarring.
  • Saline Implants: Breast implants filled with sterile salt water (saline). If these implants rupture, the saline is safely absorbed by the body.
  • Scar Tissue: Fibrous tissue that forms as a natural part of the healing process following surgery or injury. In the context of breast implants, it can sometimes form a tight or thick capsule around an implant.
  • Silicone Implants: Breast implants filled with silicone gel. If these implants rupture, the gel may either stay in the implant shell or escape into the breast implant pocket.
  • Subglandular Placement: Placement of breast implants above the chest muscle but beneath the breast tissue.
  • Submuscular Placement: Placement of breast implants beneath the chest muscle.

Does implant removal cure breast implant illness?

Breast implant illness (BII) is a term commonly used to describe a wide range of symptoms that some women with breast implants experience, such fatigue, joint pain, and brain fog. While some women see improvement in their symptoms after removing their implants, there is currently no hard evidence suggesting implant removal cures BII. However, some women with implants may have underlying medical conditions that are contributing to their symptoms, and having their implants removed may reduce some of their discomfort.

Can insurance cover breast implant removal?

For the vast majority of explant cases, because their initial breast augmentation was a cosmetic procedure, insurance does not cover the removal of their implants. However, If the removal is deemed medically necessary due to complications or risks to your health, insurance may cover the procedure. It is important to check with your insurance provider to understand the extent of your coverage and any potential expenses you may be responsible for paying out-of-pocket.

Where will my implant removal be performed?

Dr. Pancholi performs all surgical procedures, including removing breast implants, in his fully accredited in-office surgical suite that meets the highest standards for patient safety. Dr. Pancholi also has full admitting and surgical privileges for all of the cosmetic procedures he performs at Spring Valley Hospital, located about 3 miles from our office in Las Vegas.

Will my breasts look completely different? When will I see my results?

The appearance of your breasts after your explant procedure will depend on a few factors: the size of the implants removed, the amount of remaining natural breast tissue, and the laxity of your skin. While you will likely immediately notice a difference in the shape and profile of your breast, the final shape of your breast can take up to one year to become fully visible, as it will take time for swelling to go down and for the skin and tissue to retract.

Can I combine my breast implant removal with a breast augmentation or breast lift?

Yes, in fact, many patients decide to follow their explant procedure with a secondary breast augmentation or a breast lift. Secondary breast augmentations are a good fit for patients who still desire implants, they would just prefer to replace their current implants with a different type, shape, or size. Many explant patients who would prefer to no longer have implants at all find that a breast lift is a great way to remove any excess, sagging tissue resulting from the sudden reduction in breast size and aesthetically reshape the breast.

Video transcript

“We can help augment the size of the breast after we take the implants out, and often, we do that with fat transfer. That means we liposuction a certain area of the body and take that fat to transfer it to the breast to create a fuller or at least more voluminous breast.

Other reasons that people are taking their implants out can be that they are experiencing some level of symptomatology from their implants. This is something people call breast implant illness, and I believe it exists. I think there is a certain set of symptoms that continue to show up, and when the implants are removed, people seem to improve significantly from this.

Now, the caveat to this is that there is not a test that we can use to diagnose this. It’s not like you can take a test that will tell you definitively if you have breast implant illness. These are essentially diagnoses that are made when we haven’t been able to find another reason for the symptoms, and when we take the implants out, and people get better, this is what’s referred to as breast implant illness, or at least how we can diagnose or attribute it.”–Dr. Samir Pancholi

Why Choose Dr. Pancholi for your breast implant removal?

Las Vegas cosmetic surgeon Dr. Samir Pancholi

As a fellowship-trained cosmetic surgeon, a diplomate of the American Board of Cosmetic Surgery, and a specialist in breast implant revision, Dr. Samir Pancholi has helped hundreds of women in Las Vegas correct problems with their implants through individualized breast implant revision surgery. He is known for his precision, artistry, and attention to detail.

In fact, his motivation to specialize in breast surgery grew from the realization that a lot of women in Las Vegas were unhappy with their results from less experienced surgeons. Dr. Pancholi finds implant removal surgery especially rewarding, as his patients regain confidence in their appearance and get peace of mind.

Have questions? Call us for more information or to schedule a personal consultation.

Patient safety is Dr. Pancholi’s top priority, and he will take all the time you need during your consultation to make sure you understand your options for breast implant removal and replacement. Please contact as online or call our Las Vegas office at 702-363-0240 to request more information or schedule your appointment with Dr. Pancholi at Cosmetic Surgery of Las Vegas.

References »

Anastasio Collins R, Lima HK. Surgical Performance of En Bloc Total Capsulectomy Breast Implant Removal With Uninterrupted Breastfeeding. Journal of Human Lactation. 2023 Feb;39(1):76-81. doi: 10.1177/08903344221127195. 

Bewtra C, Gharde P. Current Understanding of Breast Implant-Associated Anaplastic Large Cell Lymphoma. Cureus. 2022 Oct 20;14(10):e30516. doi: 10.7759/cureus.30516. 

Habib PM, Serena T, Derosa A. Breast Implant Illness: A Case Series. Cureus. 2022 Mar 31;14(3):e23680. doi: 10.7759/cureus.23680. 

Lee M, Ponraja G, McLeod K, Chong S. Breast Implant Illness: A Biofilm Hypothesis. Plastic and Reconstructive Surgery Global Open. 2020 Apr 30;8(4):e2755. doi: 10.1097/GOX.0000000000002755. 

Swanson E. Evaluating the Necessity of Capsulectomy in Cases of Textured Breast Implant Replacement. Annals of Plastic Surgery. 2020 Dec;85(6):691-698. doi: 10.1097/SAP.0000000000002301. 

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