Total Capsulectomy | Explant | En Bloc

Total Capsulectomy| En Bloc Implant Removal

Part of your body’s natural healing response is for scar tissue to form around a medical device, including a breast implant. In most cases, this “capsule” of scar tissue remains thin and flexible and can even help hold the implant in place. However, sometimes the tissue thickens and hardens into a condition known as capsular contracture, putting pressure on the implant. 

Capsular contracture can distort the affected breast, causing pain. Capsulectomy is surgery to remove the problematic implant and scar tissue, restoring comfort and an attractive appearance. I can also use this procedure to correct other problems, including ruptured silicone implants.

I have 27 years of experience performing capsulectomy procedures. I have treated countless patients who have had ruptured silicone implants, experienced capsular contracture, and had issues with their implant size and shape, correcting the problems with partial or total capsulectomies. I also have years of experience with performing en bloc implant removals, which is a routine surgery that takes the capsulectomy one step further for women who suspect that their implants may be causing systemic issues in their bodies. If you are experiencing discomfort or complications with your implants, I can help treat your concerns.

To learn more about how a New Jersey breast implant removal can help you, call (973) 736-5907 or contact us today.

Implant Removal gallery

Please review our capsulectomy and implant removal before-and-after pictures to see our patients’ amazing results after surgery.

Why You Might Consider or Require Capsulectomy and Implant Removal

You might desire explant surgery – with or without replacement – to change your breasts’ size or shape or switch to a different implant material. You might require capsulectomy as part of your implant removal procedure if problems with the original implants have affected or might affect the surrounding tissue or if tissue removal is necessary to ensure a successful implant replacement.

I can solve problems like these with capsulectomy and implant removal.

  • Rupture or leakage of a silicone implant: Capsulectomy removes tissue the silicone has leaked into, preventing further spread.
  • Capsular contracture: Capsulectomy addresses the thickened, hardened scar tissue, relieving your discomfort and restoring an attractive form and feel to the breasts. 

I can also perform capsulectomy and implant removal to address any concerns about implant-related illnesses. Removing the implant and surrounding tissue (en bloc removal) further reduces the low risk of Breast Implant-Associated Illness (BLL), restoring your peace of mind.

In capsulectomy with implant removal, I can replace implants as part of the procedure or remove them entirely. If you opt to have an explant procedure without getting new implants, I can perform an auto-augmentation breast lift that repositions tissue to create an attractive shape and fullness.

Meet Scott SpiRo, M.D., F.A.C.S.


I am a board-certified plastic surgeon specializing in breast cancer reconstructive surgery and cosmetic procedures of the breast, body, and face. To me, every patient is unique and deserves results tailored to their concerns. You can understand my approach to care by reviewing the testimonials and before and after galleries on this site and learning about the many “Top Doctor” awards I have won.


Art is my other passion, and my artist’s vision guides my work as a surgeon. I have done technical illustrations for many journal articles, book chapters, and patient resource pamphlets for national societies. I am also an accomplished painter, sculptor, and photographer. When you visit our office, you’ll see a gallery of reproductions of many of my pieces in oil, graphite, and photography.

Capsulectomy and Implant Removal Candidates

Capsulectomy and implant removal involves removing the breast implants and scar tissue that has formed around an implant. Women whose breasts feel firm, hard, and painful are good candidates for this surgery, as they are potentially suffering from capsular contracture. Ideal candidates for this procedure also have realistic outcomes for their results after surgery and are in overall good general health.

What to Expect During Your Consultation for Capsulectomy and Implant Removal

During your consultation, I will talk to you about your medical history, current medications, and surgical goals. I will also evaluate and examine your breasts based on your concerns with your implants. My staff and I will review the procedure with you and explain possible risks, complications, and surgical outcomes.

Types of Capsule Removal Surgery

If you are a good candidate for capsulectomy, I will choose and explain the safest and most effective approach during your consultation

  • Total capsulectomy: In a total capsulectomy, I’ll remove all the scar tissue after taking the implant out. Depending on your unique surgical plan, I’ll then replace the implant or reshape the breast without an implant. 
  • Partial or subtotal capsulectomy: In a partial capsulectomy, sometimes called a capsulotomy, I remove a portion of the capsule scar tissue. In some cases, this is sufficient to release tension around the implant. If you choose not to have your implant replaced, the surrounding breast tissue typically absorbs the remaining scar tissue after a partial capsulectomy.
  • En bloc capsulectomy: In an en bloc capsulectomy, I remove the implant and its capsule as a single unit. En bloc capsulectomy may be the option when a silicone implant has ruptured or when there is a risk of implant rupture during the procedure.

How to Prepare for Capsulectomy and Implant Removal

Before having capsulectomy and implant removal surgery, you will need to stop taking certain medications that may slow your body’s ability to heal. If you smoke, vape, or use any nicotine, cannabinoid, and/or ADHD medication, you must be willing to stop for several weeks before and after your surgery.

As part of your planning for the day of the surgery, you should also arrange to have a family member or friend drive you to and from the hospital.

Capsulectomy and Implant Removal Surgery in New Jersey

I perform capsulectomy and implant removal surgery while patients are under general anesthesia. Based on my recommendations during your initial consultation, I will remove all the capsule scar tissue by performing a total capsulectomy or an en bloc capsulectomy, or I will remove only a portion of the capsule scar tissue in a partial capsulectomy. It is up to you to determine whether you prefer to have a breast implant replacement as part of your procedure.

If you have chosen not to have an implant replaced after removal, I may repair your pectoralis muscle and reattach it back to the chest wall. This process diminishes the possibility of post-operative seroma, which is a fluid accumulation in the space previously occupied by the implant. I generally propose combining a breast lift procedure with capsulectomy and implant removal if it is feasible. An auto-augmentation breast lift uses the tissue that I would otherwise remove in a breast lift or reduction, to add fullness to the breast.

Capsulectomy and implant removal can also manage suspected anaplastic large cell lymphoma (a rare type of non-Hodgkin’s lymphoma) and other suspected illnesses associated with breast implants; I have developed a comprehensive protocol in our outpatient hospitals for evaluating the tissue specimen after surgery. These processes include pathology and microbiology assessments, including testing for BIA-ALCL, standard tissue pathology, anaerobic and aerobic culture with gram stain, and acid-fast bacteria and fungi to test for ALCL or breast implant illness. Additional markers for BIAALC and squamous cell cancer will be tested. We take patients’ health concerns seriously, which is why we subject the tissues to comprehensive testing.

What to Expect in Recovery after Capsulectomy and Implant Removal

After surgery, I will place drainage tubes in the area to help reduce swelling. I will also give you a compression bra to wear for several days. Your breasts may feel sore, but the full recovery for capsulectomy and implant removal is only two weeks. You can also return to work within 4-7 days after surgery and resume fitness activities in about a month. The overall procedural outcome is extremely satisfying to patients from a cosmetic standpoint and for relief from discomfort.

Trust your outcome to an expert

Dr. Scott Spiro is a board-certified plastic surgeon at Spiro Plastic Surgery in West Orange, NJ, specializing in capsulectomy and implant removal procedures to help women experiencing capsular contracture and other problems with breast implants. Call us at (973) 736-5907 or reach out online to learn more.


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Graphite/Pencil Hybrid-Painting by Dr. Scott Spiro