Should you choose the En Bloc Technique for Breast Implant Removal

Should you have ‘En Bloc’ Removal of your Breast Implant?

An increasing number of women are requesting to have their breast implants removed due to worries over textured implants & BIA-ALCL or experiencing symptoms of BII – Breast Implant Illness. The En-Bloc technique is a surgical option for removing all of the capsule in its complete entirety. You could also choose total or partial capsure removal known as a partial capsulectomy.

What causes Implant Capsule Formation?

When you get a breast augmentation, your body reacts to the foreign object (silicone breast implant) being inserted. Your immune system takes a protective measure against potential harm and begins forming a scar around the implant. This is called an implant capsule and its primary role is to divide the implant from your flesh. When well developed, you shouldn’t be able to feel the capsule, however, as every patient is different, this is not always the case. It is possible for your capsule to thicken, tighten, contract or calcify. This is called capsular contracture and is identifiable by the feeling of hardened implants, pain or a distorted appearance.

what does capsular contracture look like
Deformity of the right breast due to capsular contracture. (Baker grade IV) Courtesy of Walter Peters, Ph.D., M.D., F.R.C.S.C., University of Toronto. Available on the United States Food and Drugs Administration’s website (

What is an En Bloc Removal?

An En Bloc Breast Implant Removal requires removing the entire capsule with the implant still inside to remove the implant and potentially leaked silicon gel. If this isn’t possible, the implant will first be removed and followed by the capsule. The En Bloc Breast Implant Removal is a technique used by Dr Doyle in which the breast implant and its surrounding scar tissue (capsule) is removed in one piece.

This means that the breast implant is not actually viewed until it is outside the body. If there has been a leakage of silicone out of the silicone shell of the implant, then the enbloc technique stops this silicone from being left inside the body. The possibility for doing an En Bloc Breast Implant Removal differs from person to person and technically can’t be performed on all patients,” said Dr Doyle.

This technique removes the complete capsule and allows the complete capsule and any fluid to be sent for pathological tests. There is no scientific test that can confirm a diagnosis of breast implant illness. Dr Doyle has removed breast implants from women who have multiple non-specific symptoms and see a significant improvement in the symptoms after the implants have been removed. To better understand the implications of breast implant illness, Dr Mark Doyle is currently undertaking primary research with his removal patients.

What are the results of En Bloc Technique Breast Implant Removal?

The best results of this procedure will come from the complete removal of your implants so your breast tissue can reform and tighten together as it once was. This procedure isn’t recommended if you want to retain the size and appearance of your breasts, and the only post-operative options for regaining size are fat injections to fill the breast or a lift to tighten the breast skin and lift the breast tissue.


En Bloc Removal and worries about BIA-ALCL

Some patients with textured implants worry about developing a type of lymphoma (BIA-ALCL) associated with the implant capsule. Dr Doyle is aware of the stress this can cause and is becoming increasingly compassionate for patients concerned about their textured implants. Many of these patients seek the en bloc technique for removal to remove the implant and entire capsule intact.

The risk of developing BIA-ALCL is extremely low, significantly lower than developing breast cancer, and the risk also varies between different brands of implants. All patients having their capsule removed have their tissues removed and tested for this lymphoma.

Much of the risk for ALCL comes from the type of implants placed in the breast. The texture on the outer side of the implant contributes to the hosting of biofilm, a layer of bacteria that forms on the surface of the implant. It is thought that the biofilm on textured implants predisposes to the development of BIA-ALCL.

Why Dr Mark Doyle Chooses Motiva Implants

There have not been any cases of BIA-ALCL in patients who have only had smooth breast implants. With this in mind, Dr Doyle uses Motiva implants, which have a nano-textured surface, which is seen by the body as a smooth surface.

The quality of Motiva implants makes a significant difference in the outcome of a breast augmentation. I really can’t risk using textured implants,’ said Dr Doyle.

About Dr Mark Doyle FRACS (Plast) – Queensland Plastic Surgeon

Servicing patients in Gold Coast, Brisbane, Sunshine Coast, Cairns and New South Wales NSW – Northern Rivers, Byron Bay, Ballina, Lismore and more.

Dr Mark Doyle is a Specialist Plastic Surgeon with over thirty years of experience performing BreastBodyFace and Nose surgery. As a highly esteemed plastic surgeon, Dr Mark is driven by an intense passion for helping patients achieve a happier, more beautiful self through advanced cosmetic surgery procedures.

He maintains a strong commitment to achieving the best possible results for all his breast, body, face and nose patients, both men and women.