Dr. med. Dr. med.

Christina Irene
Günter

Board Certified Plastic Surgeon

International Center for
Plastic and Aesthetic Surgery

personal - trusting - passionate

International Center for
Plastic and Aesthetic Surgery

Plastische Chirurgie München - Dr. med. Dr. med. Christina Günter
Blende schräg - Dr. med. Dr. med. Christina Günter Plastische Chirurgie München
Removal of breast implants / En bloc resection

BRUSTIMPLANTAT ENTFERNEN / EN BLOC RESEKTION

Removal of breast implants / En bloc resection


Undesirable side effects of silicone breast implant

Even though silicone breast implants have been used for more than 50 years, and millions of women worldwide have breast implants, scientific research and regulatory studies show that there are specific risks and considerations you should be aware of. Breast implants are foreign bodies that, like any other foreign body, may cause health problems.

In any event, you should discuss these risks with me, or your attending plastic surgeon, before any breast augmentation.
The website of the U.S. Food and Drug Administration (FDA) is an excellent, reputable, and recommendable source of information on this subject:
FDA  … (https://www.fda.gov/medical-devices/breast-implants/risks-and-complications-breast-implants).
Download Info: Breast Implants – Certain Labeling Recommendations to Improve Patient Communication – Guidance for Industry and Food and Drug Administration Staff (fda.gov)

Some of the risks may not be harmful to health, but aesthetically disturbing:

  •  z. B. Rippeling = Faltenwurf des Implantates Andere können gesundheitliche Beeinträchtigungen hervorrufen, die zu einer erneuten Operation (zur Entfernung/zum Austausch) der Implantate führen können.
  •  z. B. Rupturen = zerreissen der Implantathülle im Körper (die kohäsiven Silikongele laufen zwar nicht aus, können aber zu chronischen Entzündungsreaktionen führen; die Entfernung der Implantate wird empfohlen, ich empfehle soweit möglich, auch die Kapsel zu entfernen)
  • z. B. Kapselfibrose = verhärtete innere Narbe um das Implantat herum (Die Kapselfibrose ist harmlos. Je nach Stadium (Baker I bis IV) kann sie aber zu Schmerzen und sichtbaren Verformungen der Brust führen; die Entfernung der Implantate wird empfohlen, ich empfehle soweit möglich auch die Entfernung der Kapsel)
  • z. B. Breast Implantat Illness (BII) = Brustimplantatkrankheit (Wie die BII entsteht wissen wir noch nicht. Bei der BII handelt es sich um eine Ausschlussdiagnose. Sie umfasst verschiedene unspezifische Beschwerden, wie z. B. Gedächtnisschwäche, chronische Müdigkeit, rheumatische Erkrankungen: Arthritis, Weichteilrheuma, chronische Schmerzen, Schlafstörungen, Kopfschmerzen, Hautausschlag, Haarausfall, etc; die Entfernung der Implantate wird empfohlen, ich empfehle auch die Entfernung der Kapsel)
  • z. B. BIA-ALCL Anaplastischen Large Cell Lymphom So kann es bei Brustimplantaten wie auch bei anderen Implantaten (z. B. Zahnimplantate, Herzschrittmacher, etc.), zu einem bösartigen Lymphom, dem s.g. „Anaplastischen Large Cell Lymphom“ (BIA-ALCL), einem bösartigen Non-Hodkin Tumor, kommen. Besteht der Verdacht auf eine BIA-ALCL, müssen die Implantate zwingend zusammen mit dem Tumor entfernt werden.
Sehr seltene schwerwiegende Komplikationen können zur zwingenden Entfernung der Implantate führen. So kann es bei Brustimplantaten wie auch bei anderen Implantaten (z. B. Zahnimplantate, Herzschrittmacher, etc.), zu einem bösartigen Lymphom, dem s.g. „Anaplastischen Large Cell Lymphom“ (BIA-ALCL), einem bösartigen Non-Hodgkin Tumor, kommen. Besteht der Verdacht auf eine BIA-ALCL, müssen die Implantate zwingend zusammen mit dem Tumor entfernt werden. You will find further information under the following link: https://www.dgpraec.de/patienten/sonderthemen/alcl And on the FDA website https://www.fda.gov/medical-devices/breast-implants/risks-and-complications-breast-implants In most cases, a complete recovery is possible after the removal of the implants.

You are welcome to confidently contact me if you feel anxious or if you suspect that you are experiencing any of the adverse implant side effects mentioned above.


Removal of breast implants / En bloc resection

Brustimplantate entfernen kann chirurgisch sehr heikel sein und gehört auf jeden Fall in die Hände eines erfahrenen Brustchirurgen, der sich mit den unterschiedlichen Techniken auskennt.

The term “en bloc resection“ has its origins in cancer surgery and describes a surgical technique where diseased tissue is removed in one block together with surrounding healthy tissue.

Transferred to the removal of breast implants, it describes the surgical technique, where the implant is removed together with the surrounding capsule in one piece, without damaging the capsule (i.e.: without a hole).

This technique is mastered only by experienced breast surgeons and is very demanding, surgically speaking. It cannot be denied, however, that even the best and most experienced breast surgeons may not be able to perform “en bloc resections” in all cases.

Here, too, the implant and the capsule are removed.

Here, too, the implant and the capsule are removed.
However, the capsule may be damaged (holes), or the implant and capsule are removed separately in one operation.

At the current state of science, an “en bloc resection“ is medically indicated only in the case of a malignant disease, e.g., BIA-ALCL.
In the case of an implant rupture and a BII, an "en bloc resection" is desirable; according to the latest scientific findings, the prospect of recovery is the same for a complete capsulectomy and an en bloc resection.
Some experts believe that leaving the capsule or parts of the capsule in the body to avoid surgical complications and additional volume loss.

However, I do not share this opinion.

If necessary, it is possible to remove a capsule that has been left in place after the implant has already been removed in a second operation.
A capsulectomy or “en bloc resection“ is generally associated with a larger resulting scar than implantation. “En bloc resection“ or capsulectomy may be combined with a breast lift or augmentation with autologous fat, either at the same time or in consecutive operations.

Which surgical technique is suitable for your personal requirements can only be clarified in an individual consultation.

The most important facts about breast surgery / breast implants removal

  • DURATION OF SURGERY:: 1 to 6 h
  • ANESTHESIA: General anesthesia
  • HOSPITAL STAY2 nights
  • COSTS:will be determined individually after the preliminary consultation, depending on the work involved
  • FOLLOW-UP TREATMENT: 6 weeks
  • REMOVAL OF SUTURES: not applicable or 2 weeks
  • SOCIAL ACTIVITIESafter 1 to 2 weeks
  • PHYSICAL EXERCISE:: after 6 to 12 weeks
Plastische Chirurgin in München, Dr. Med. Christina Günter

Risks

As with any surgical procedure, an “en bloc resection“ / capsulectomy may lead to bruising (hematoma), secondary bleeding, swelling, wound healing disorders, infections, and wound dehiscence. Temporary numbness of the treated area may also occur.

If you decide on an ”en bloc resection“ / capsulectomy, it is essential that you are cared for professionally and individually during the entire process.

I attach great importance to perceiving, advising, and treating you as an individual, with all the facets of your personality. My many years of experience, expertise, empathy, and communication are central pillars of my therapeutic success.
Intensive and personal post-treatment care is as much a focus of my work as the preparation and the treatment itself. After all, a perfect result can only be achieved by working together as a team.
It goes without saying that your health is always given priority. Surgery that negatively affects your health or physical integrity is not recommended and should not be performed in the first place.


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