Finding a plastic surgeon to perform your explant surgery is tricky because it can be a more complicated procedure than placing implants. If you have already had a negative experience with your breast implants, it is very important to find a surgeon that can remove your implants carefully. Your surgeon needs to be able to minimize any leakage or other problems during the surgery.
You should start by looking for a surgeon who is board-certified by the American Board of Plastic Surgery. The ABPS website lists all board-certified surgeons. It is also important that your explant surgeon understands that breast implants can cause serious health problems, because that surgeon will be more careful when removing your implants.
Your plastic surgeon should be experienced in “en bloc” removal. En bloc removal is when the scar tissue (or capsule) and implant are removed at the same time, with the implant still inside the intact scar tissue capsule. This is especially important if your implants are filled with silicone gel, are ruptured, or are very old. En bloc removal allows the silicone and other chemicals to stay inside the intact scar tissue capsule as it is removed. En bloc removal prevents silicone and other chemicals from leaking into the woman’s body during surgery. It requires a larger incision but it is worth it because it prevents leakage.
En bloc removal may not be possible in all cases, and your surgeon may not know if en bloc is possible until you are in surgery. For example, if your scar tissue capsule is very thick or tightly adhered to the chest wall, en bloc removal may not be possible. However, a surgeon experienced in en bloc removal will know how to remove your implants and scar capsule as carefully as possible.
En bloc removal is also called a total capsulectomy. A capsulectomy is the removal of the scar tissue, or capsule, that naturally forms around a breast implant. A capsulectomy can be partial or total. A partial capsulectomy is when only part of the capsule is removed. A total capsulectomy is when the entire scar tissue capsule is removed. A total capsulectomy is better but is not always possible. For example, if your scar tissue is too tightly stuck to the chest wall, a surgeon may find it too risky to attempt to remove all of the scar tissue.
When you have selected a board-certified plastic surgeon experienced in en bloc procedures, you should ask the surgeon how many en bloc procedures he or she has performed. You also can ask to speak with one or more of your surgeon’s patients who had the same surgery to ask about their experience. If you want a breast lift at the same time, that is something you should also ask your plastic surgeon about. You may also ask for before and after pictures of the plastic surgeon’s own patients.
If you want health insurance coverage for your surgery, you can find out if there are plastic surgeons who participate in your health insurance plan, are board-certified, and experienced in the en bloc removal or capsulectomy procedure. You can start by contacting your insurance company’s member service line to speak with an insurance representative. Many insurance company websites provide online databases of participating physicians.
Once you find participating surgeons, you can call their offices to ask about their experience with en bloc removal/capsulectomy. If the surgeon meets the above criteria, you should request an in-person consultation before scheduling your surgery.
You can also contact us at firstname.lastname@example.org to see if the plastic surgeons you are considering are recommended by other patients we have talked to.