En bloc Capsulectomy with Saline implants; Raleigh ,North Carolina*

This is a 39-year-old woman who had saline submuscular breast implants performed about 10 years ago. She was initially pleased with her result but over time had gained some weight and developed some ptosis. She did not feel that she needed breast implants anymore. In addition, the patient was concerned about a number of health problems that could never be diagnosed and she was suspicious that she may be suffering a form of breast implant illness. She felt that some of her health issues may be related to her breast implants. She did not have any evidence of capsular contracture or any other obvious implant-related problems. She desired explantation with mastopexy. Because of her desire to maintain a reasonable size breast she opted for some degree of fat grafting during the procedure During the procedure, an en bloc technique was able to be performed. She underwent mastopexy with some limited fat grafting harvested from her abdomen. 160 cc of fat was delivered to each breast. She was very happy with her ultimate outcome. Her capsules did not reveal any abnormal pathology. En bloc capsulectomy is frequently requested by many patients desiring explantation. In some cases there is reasonable rationale for this procedure but in many cases- the capsules are virtually nonpathologic and filmy and nearly impossible to remove especially around a submuscular saline implant. Unnecessary trauma to the surrounding tissue can occur without sufficient justification for it.