What Are the 3 Types of Capsulectomy?

2 Minute Read: 

woman wearing a compression garment after a breast surgery.A capsulectomy is the surgical procedure used to remove the scar tissue that naturally forms and surrounds a breast implant (called a capsule). There are four main reasons that women with breast implants choose to have a capsulectomy. 

  • To treat a condition known as capsular contracture where the scar tissue contracts and hardens around the breast implant, causing pain, breast deformity, and other issues. 
  • When it is performed as part of a breast revision procedure (in some cases) to remove breast implants that are no longer wanted. 
  • As an important part of the treatment of breast implant-associated anaplastic large cell lymphoma (BIA-ALCL), a very rare type lymphoma that has been associated with textured surfaced breast implants, most notably Allergan™ BIOCELL® textured implants. 
  • To attempt to address a constellation of symptoms categorized as breast implant illness (BII) that some women attribute to their breast implants.

Regardless of your reason, there are three types of capsulectomy surgical procedures that can be performed.

What Is a Partial Capsulectomy?

A partial capsulectomy is usually the easiest and least “invasive” one to perform. It involves the removal of a variable portion of the capsule, leaving the rest in place which may be partially or totally resorbed over time. Because it is the least involved, it can be associated with lower risks. The postoperative discomfort typically is minimal.

What Is a Total Capsulectomy?

A total capsulectomy involves the removal of the entire capsule that surrounds the implant though not in one, intact piece. It can be piecemeal or involving several larger sections. There are several reasons why this approach is employed, with the most common being capsular contracture. 

Before and after image showing the results of a breast revision surgery performed in Scottsdale, AZ.

What Is an En Bloc Capsulectomy?

An en bloc capsulectomy is when the breast implant and capsule are removed in one piece as a single unbroken mass. This is a more complex and higher-risk procedure but it has some advantages when treating conditions like BIA-ALCL or implant rupture (when the silicone is still inside the capsule). It is not possible to perform this type of capsulectomy on patients whose capsule is thin or soft. Under such circumstances, a partial or total capsulectomy would be the approach. 

In recent years, many unfounded theories about BII have swept across the internet. Based on conspiracy theories and marketing by self-proclaimed experts, it has been touted that the en bloc capsulectomy is the best and only acceptable solution for the treatment of BII. The reality is that there is no scientific evidence linking en bloc capsulectomy to any significant improvement in BII-associated symptoms when compared to partial or total techniques. 

Interested in Learning More?

If you have more questions about capsulectomy surgery, BII, or the issues surrounding en bloc capsulectomy, contact Dr. Turkeltaub at the Arizona Center for Breast Surgery by calling (480) 451-3000 or by filling out our online contact form.