Robert M. Wald, Jr., MD - The Aesthetic Institute
Contact Us : (714) 312-3549

Orange County | Fullerton, CA

En Bloc Capsulectomy

En Bloc Capsulectomy Model

Women with breast implants sometimes change their minds about wanting larger breasts, or they may develop complications or other concerns that require breast implant removal. Unfortunately, an implant rupture, implant rippling, capsular contracture, breast implant illness, BIA-ALCL (breast implant-associated anaplastic large cell lymphoma), or being unhappy with your breast appearance after Breast Augmentation may require the removal of your breast implants.

En bloc capsulectomy is a surgical procedure designed to remove the breast implants and surrounding scar tissue (capsule) as one entire unit. The term “en bloc” is French for “all together” or “at the same time,” and capsulectomy is when the scar tissue is removed from the chest. If you have found lumps or experienced sharp pain after breast augmentation, Dr. Wald is a specialist in cosmetic surgery and has successfully performed en bloc breast implant removal in Orange County for many patients.

Who Are the Ideal Candidates for En Bloc Capsulectomy?

Healthy women who wish to remove their breast implants or who exhibit signs of infection may benefit from the en bloc approach.

What Can an En Bloc Capsulectomy Address?

Implant Position and Placement

After breast augmentation, natural scar tissue forms around the implants, known as a capsule. Sometimes, this scar tissue can harden, causing the implants to shift position and appear misshapen. En bloc removes the implants and capsule in one piece to address this.

Removal of All Scar Tissue

Whether you are removing your breast implants to change the style, function, or appearance of your breasts, the en bloc approach removes all of the scar tissue surrounding the implants so that you can start fresh and prevent future issues.


Complications, such as implant rupture or capsular contracture, are issues that need to be surgically addressed. En bloc surgery is designed to remedy complications so you can enjoy your cleavage again, whether with or without new implants.

Your En Bloc Procedure

During your consultation, Dr. Wald will review your medical history, examine the condition of your breasts, and determine a surgical plan that can achieve your desired results. General anesthesia is administered during your surgery to ensure your comfort and safety. En bloc capsulectomy is performed on an outpatient basis.

En Bloc Only

Incisions are made along the inframammary folds or around the areolas depending on the size of your implants, the location of your primary breast augmentation incisions, and other factors. Dr. Wald will discuss these details with you during your consultation.

After an en bloc procedure, there are no implants or scar tissue left behind. Keeping the capsule together with the implant helps avoid the risk of rupturing the implants and leaving any remnants behind. Dr. Wald utilizes his experience and expertise to create a natural, proportional breast shape after he removes the implants.


Capsulectomy refers to the process of removing the breast implants and part or all of the scar tissue capsule. Capsulotomy usually involves breaking up the tissue into smaller pieces to be removed through a small incision to reduce scarring.

En Bloc With Fat Grafting

After an en bloc procedure, some women desire a natural boost in cleavage through fat grafting. Liposuction is used to remove fat from the arms, buttocks, thighs, or abdomen, and the fat cells are then put through a purification process. After impurities are removed, the fat is strategically injected into the breasts for a natural boost.

En Bloc With Lift (Mastopexy)

An en bloc with a Breast Lift (mastopexy) completely removes the breast implants and surrounding scar tissue and then repositions the remaining breast tissue. Breast lift surgery removes excess breast skin, so it is best suited for women who have breast sagging that needs to be addressed. Breast lift incision techniques can vary and depend on your situation and preferences. The remaining breast tissue is sculpted and repositioned, excess skin is neatly trimmed away, and the nipples are adjusted to a favorable position. After this procedure, the breasts appear tighter and higher on the chest without excess skin or sagging breast tissue.

En Bloc With Lift and Fat Grafting

For patients with sagging breasts who want or need their implants removed but also desire to maintain some breast volume enhancement, en bloc with a breast lift and fat grafting may be a good option. After removing the breast implants and scar tissue capsule, the breasts are lifted and reshaped, and purified fat cells are transferred to the breasts. This process results in youthful, voluminous cleavage.

How Long Is the Recovery Process?

Immediately After

After your surgery, the incisions will have gauze or surgical dressings applied. Small drainage tubes may be placed to prevent fluid accumulation while you recuperate. These are removed in a week or so. The breasts will be wrapped with compression garments to support them and reduce swelling. Post-operative care instructions will be provided to guide you through the recovery process. You may encounter soreness, bruising, swelling, and pain.

2 Weeks After

Most of the soreness, bruising, discomfort, and swelling should have subsided, and you may be able to return to work and light activities.

6 Weeks After

You should be able to return to all normal activities at this point unless instructed otherwise by Dr. Wald. Your scars should begin to fade and will continue to do so for several months.

before and after results of en bloc capsulectomy

Before & After Patient

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Questions and Concerns

Dr. Wald and his team at The Aesthetic Institute in Orange County can answer any questions or concerns you may have. Schedule a Consultation with our office today to begin your cosmetic journey and achieve the results you desire.

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Robert Wald, MD
100 E. Valencia Mesa Drive, Suite 300
Fullerton, CA 92835

Phone: 714-312-3549
Fax: 714-738-1862

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