En Bloc Capsulectomy and Total Capsulectomy Surgery in NYC & Long Island

En Bloc / Total Capsulectomy (Capsular Contracture Surgery)

Overview

En bloc total capsulectomy—also called en bloc capsulectomy or total capsulectomy—is a surgical procedure that removes both the breast implant and the surrounding scar capsule in one continuous piece when possible. This approach is often used in cases of advanced capsular contracture, implant rupture, or when a patient requests complete removal of implant-related tissue.

At Town Plastic Surgery, our experienced reconstructive surgeons perform advanced capsulectomy and revision procedures in accredited hospitals and surgery centers across Manhattan and Long Island.

What Is Capsular Contracture?

After a breast implant is placed, the body naturally forms a scar capsule around it. In some women, this capsule tightens or thickens excessively, a condition known as capsular contracture.

Symptoms may include:

• Firmness or hardness of the breast

• Pain, tightness, or discomfort

• Distortion, asymmetry, or displacement

• Visible rippling or changes in contour

If untreated, the contracture may worsen, causing pain and visible deformity.

Why Consider En Bloc / Total Capsulectomy?

Removing the capsule completely is often the most effective treatment for moderate-to-severe capsular contracture or ruptured implants. Benefits include:

• Complete removal of scar tissue and inflammation

• Lower risk of recurrence

• Prevention of silicone leakage in ruptured implants

• Restoration of softness and natural contour

• Ability to exchange, lift, or reconstruct the breast

• Peace of mind and improved comfort

A total capsulectomy removes the entire capsule, while an en bloc capsulectomy removes it intact with the implant inside. The choice depends on capsule thickness, implant position, and safety.

Ideal Candidates

Candidates typically include women who have:

• Hardness, tightness, or pain around one or both implants

• Visible distortion or displacement

• Concern for rupture, leakage, or implant-related illness

• Textured implants or previous reconstructive procedures

• Good general health and realistic goals

Your surgeon will determine if en bloc removal is feasible or if a total capsulectomy is more appropriate.

Procedure and Technique

1. Pre-operative planning – physical exam, imaging, and surgical mapping

2. Anesthesia – performed under general anesthesia in an accredited facility

3. Incision – often through the existing scar or along the breast fold

4. Dissection and removal – capsule and implant are removed as one unit when possible; otherwise, the entire capsule is carefully excised in sections

5. Pathology review – capsule tissue may be sent for microscopic evaluation

6. Reconstruction – new implant placement, lift, or fat grafting as needed

7. Drain placement and closure – surgical drains typically remain 5–7 days

8. Post-operative care – pain control, garment support, and follow-up visits

Risks and Considerations

All surgery carries risk. With capsulectomy, potential issues include:

• Bleeding, infection, or fluid collection

• Temporary numbness or chest wall soreness

• Difficulty achieving intact removal if capsule adheres to ribs or muscle

• Possible need for secondary reconstruction

• Asymmetry, contour irregularity, or skin laxity after implant removal

Your surgeon will review all options and tailor the procedure to your anatomy and safety.

Recovery and Downtime

• Most patients return to light activity within 1 week

• Avoid heavy lifting and strenuous exercise for 4–6 weeks

• Swelling and tightness gradually improve over several months

• Final contour and softness appear by 3–6 months

• Results continue to refine for up to one year

You will receive personalized post-operative instructions and close follow-up care.

Insurance and Medical Necessity

When capsular contracture causes pain, hardness, or breast distortion, surgery is often deemed medically necessary and may qualify for insurance coverage. Town Plastic Surgery assists patients with documentation, pre-authorization, and appeals whenever appropriate.

Cosmetic components—such as implant upgrades or elective lifts—may not be covered, but can be combined into the same procedure for comprehensive correction.

Why Choose Town Plastic Surgery?

• Board-certified reconstructive and aesthetic surgeons

• Expertise in complex revision and explant procedures

• Hospital affiliations throughout NYC, Long Island, and Suffolk County

• Personalized surgical planning and natural-looking results

• Compassionate, patient-centered care

Our offices in Manhattan and Port Jefferson Station provide convenient access for patients throughout New York City and Long Island.

Schedule Your Consultation

If you are experiencing breast hardness, pain, or implant complications, our specialists can help.
Book your consultation today at Town Plastic Surgery to learn whether en bloc or total capsulectomy is right for you.

We’ll review your imaging, discuss your goals, and create a personalized treatment plan to restore your comfort, confidence, and natural breast contour.