En Bloc Breast Implant Removal | Breast Revision San Francisco

What Type of Capsulectomy is an En Bloc?

First developed in France, En Bloc, means “as one,” and it is a procedure that leaves the breast capsule intact when breast implants are to be removed. All of the capsule is removed along with the breast implant by cutting around it.  By removing the entire unit, the silicone is contained within the capsule avoiding contamination of bacteria. If silicone implants are ruptured but contained within the capsule, removing the implant along with the capsule allows removal without any residue left. Breast capsule and implant removed together is a very meticulous and delicate procedure, and not all women are candidates for it.

For women who may be experiencing Breast Implant Illness (BII), the preferred method of removal would be the “En Bloc.”  BII is where women are having symptoms such as; fatigue, memory loss, and joint pain. However, according to the FDA, the causes of these symptoms are not well understood.

How is an En Bloc Capsulectomy Performed?

The procedure is performed through an incision along the infra-mammary fold.  If the original incision were along the fold, it would be the same incision line, so there will not be further scarring. Drains are usually placed to remove any accumulation of fluids and help the breast to return to its natural shape.

A patient of Dr. Delgado with Bilateral Capsular Contraction.

A patient of Dr. Delgado with Bilateral Capsular Contraction.


After En Bloc implant removal on a patient of Dr. Delgado with Breast Implant Illness.

After En Bloc implant removal


This is a 56-year-old female who was seen in my San Francisco office for breast revision surgery. She has had silicone breast implants since 1974 on top of the muscle. She developed capsular contractures over the ensuing years. She complained of symptoms of breast implant illness. She underwent an En Bloc implant removal with replacement of 450 cc silicone implants at the Marin Cosmetic Surgery Center in Marin County, California.

Other Types of Capsule Removal

Capsulectomy – is where part or all of the capsule is removed. The implant will be reinserted into the pocket or may be replaced with new breast implants.

 Capsulotomy is where part of the scar tissue or “capsule” that surrounds the implant is removed, allowing the implant to move more freely. There is open and closed capsulotomy. Open is released surgically, closed is by compression, and done manually. However, due to a high risk of rupture, closed capsulotomy is not a recommended procedure and strongly advised against by manufacturers.

                                                                                                 What a Breast Capsule Looks Like

En Bloc Breast Implant Removal with a pic of the implant and the capsule cut open in San Francisco

En Bloc Breast Implant Removal showing implant and open capsule

Many women consider having a breast lift done at the same time to remove excess skin and position the breast to a more youthful shape. Other options would include new breast implants, or some patients elect to have fat grafting to replace lost volume.

Patient Testimony by Dr. Miguel Delgado’s Patient

Dr. Miguel Delgado is nothing short of phenomenal. Dr. Delgado performed an enblock/capsulectomy surgery for me, which literally saved my life! He literally removed every detail of the issues that were affecting and causing life threatening symptoms within my body. When I tell you that this phenomenal doctor saved my life, I truly believe, that he has the gifted hands of God himself! There are no words great enough to express the depth of how I feel about what this doctor did for me, however, all I know is that I will be forever grateful for what he and his amazing staff did for me on September 19, 2019. There is no doubt in my mind that this doctor is truly the best!!!!! That Chelsea, Mo, Carol, Dr. Riddle, and the rest of doctor Delgado’s staff are so awesome!!! Upon meeting them, you are immediately impressed that your well-being and healthiness is their priority. They are an awesome team and a beautiful reflection of how Dr. Delgado operates and it shows. I so love this staff to life!!!!

This is a 39-year-old female who developed capsular contraction. She underwent bilateral en bloc capsulectomy with the replacement of the silicone implants with Strattice, a human tissue replacement, over the left inferior aspect of her breast due to severe capsular contraction and thin skin. The implants were changed from 450 ccs. silicone implants down to 325 cc

If you have unwanted breast implants that are impacting your life in a negative way a consultation with Dr. Delgado can help to sort out your situation and design a solution.  Dr. Delgado has over 30 years of plastic surgery experience and has performed thousands of breast surgeries in his career. He has a specialty in breast implant revision surgery. Call today 415-898-4161