Dr. Stephan understands that patients’ lifestyles, aesthetic goals, and bodies change over time. At Stephan Surgical Arts, we ensure each breast augmentation patient receives the utmost quality, care, and cutting edge-safety procedures during their implant procedure. 


However, the introduction of a foreign object into the body may cause complications in a small number of patients. Dr. Stephan is an expert at en bloc breast implant removal and wants to be sure patients have a full understanding of this process.


Patients deserve all the information necessary to make a decision before or after undergoing a breast augmentation procedure. Read on to learn more, and if you have any further questions, do not hesitate to

contact us today. 

What is En Bloc Breast Implant Removal or Capsulectomy?

An en bloc breast implant removal (also referred to as en bloc capsulectomy) is the surgical process of removing both the saline or silicone breast implant and the surrounding fibrous capsule “en bloc.” 

This process differs from other implant removal techniques, which often involve making an incision into the capsule, then removing the implant and finally removing the capsule. 


By keeping the capsule intact during en bloc removal, we can ensure containment of the silicone gel. This is especially beneficial for removing ruptured silicone implants or if a complication such BIA-ALCL is suspected.

En Bloc Breast Implant Removal for Lymphoma or BIA-ALCL Abnormalities

What abnormalities can be found in the implant capsules?

Scientists are uncertain as to what specifically causes this type of lymphoma. However, it has only been associated with textured breast implants, both silicone, and saline.

What causes BIA-ALCL?

BIA-ALCL is a rare, though highly treatable, type of non-Hodgkin’s lymphoma that may develop in the fibrous scar tissue and fluid surrounding breast implants. It occurs most frequently in patients who received textured implants and may spread to the rest of the body. 

It is not a type of breast cancer; it affects the immune system. The current risk of BIA-ALCL is estimated to be 1 out of 3817 to 1 out of 30,000 for women with textured implants. These numbers are based upon current data. Most cases occur years after receiving an implant. If diagnosed early on, BIA-ALCL is generally considered curable.


Typically, symptoms develop after more than one year after receiving your implants, and on average, after 8 to 10 years. 

What signs do I look for?

The most common symptoms include painful breast swelling, enlargement, or hardening, lumps in the breast or armpit, asymmetry, and localized skin rash. 

Rarely, symptoms may be subtle. Women who develop symptoms should see their physician to be evaluated with a physical exam and further testing.

How is breast implant-related lymphoma diagnosed?

First, schedule a follow-up with your treating surgeon or medical care provider. They will discuss any concerns you may have or symptoms you may be experiencing regarding your breast health.

During your appointment, you will receive a physical examination. If you are presenting any symptoms of BIA-ALCL, your physician may complete an ultrasound or MRI to evaluate the symptomatic breast. They will look for fluid or lumps surrounding the implant and within the lymph nodes.

If your doctor finds a mass or fluid, patients require a biopsy via hypodermic needle. Your physician will drain a small amount of the fluid and test for BIA-ALCL. Testing for CD30IHC immune staining will determine a diagnosis or rule out BIA-ALCL.


When performed appropriately, en bloc breast implant removals offer the highest level of certainty that all potential contamination is removed.

As with all surgical procedures, it is incredibly important to choose a surgeon who has been well trained to perform the operation that you seek. Ideally, one who has vast experience with breast surgery and breast implant removal. 


Dr. Stephan is one of the few triple board-certified surgeons in the country and has particular expertise in breast surgery. 

Yes, these operations are performed under general anesthesia. This is an extremely safe and comfortable was to have this procedure performed.

Usually around two to three hours. 

Some patients have experienced health issues that they or their physicians believe were caused by adverse reactions to breast implants. The majority of these patients feel significant improvement after removal. 

The major drawback of an en bloc capsulectomy is a need for the incision to be modestly longer. This ensures your surgeon will have full visibility to remove everything en bloc.

Usually, after receiving an en bloc capsulectomy, patients require several days of rest and avoiding anything more than light activity. After this period, you may return to some activity, but it is important to avoid strenuous activity and exercise until cleared by Dr. Stephan. 

The first postoperative week is generally mildly-moderately uncomfortable. If your previous breast implant had been placed under the pectoralis muscle, this could exacerbate the postoperative pain. However, Dr. Stephan takes many precautions to minimize pain – including tissue handling and a multi-modal approach to pain management.

As with all surgical procedures, there is some risk of bleeding or infection, which can be treated with antibiotics. You may also experience a loss of sensation or unevenness of the breasts, scarring. Some patients experience a feeling of hardness, though this usually goes away. Other complications, although exceedingly rare, are possible and will be discussed during your consultation.

You can lower the risk of complications by avoiding aspirin or compounds that contain aspirin, as well as herbals. Immediately after surgery, it is vital to limit activity for a minimum of two weeks. 


Finally, you should maintain light motion while healing, especially in your legs to prevent blood clots. You should also tell your surgeon if you have had any history of problems with bleeding or are taking regular medications and/or drugs.


Contact Dr. Stephan today if you have any questions or concerns.