(855) 687-6227

1080 Beecher Crossing N, Suite A
Gahanna, Ohio 43230
Fax: 855–687–6227


Total En Bloc Capsulectomy is a breast implant removal (also known as explant surgery) procedure that is offered to patients who have undergone breast implant placement for either breast augmentation or after mastectomy for breast cancer.

Dr. Kocak and Dr. Tiwari are skilled board-certified plastic surgeons and have performed hundreds of implant removal surgeries over the years. Aside from patients in Columbus and Cincinnati, Ohio, our doctors are frequently visited by women from all around the world who experience problems with their breast implants.

Ideal Candidates

Ideal candidates for explant surgery are patients who experience symptomatic changes as related to their breast implants and are subject to breast implant-associated illness. Symptoms include:

  • Dissatisfaction with the current appearance of the breasts
  • Complications such as Capsular Contracture (scar tissue around the implant), Breast Implant Associated-Anaplastic Large Cell Lymphoma (BIA-ALCL), and other infections
  • Asymmetry and implant shifting
  • Implant rupture/deflation and wrinkling
  • Breast cancer diagnosis
  • An occurrence of calcium deposits in the breasts
  • Animation deformity
  • Muscle-flex deformity
  • Jumping implants
  • Implant-related illness

Many patients also experience brain fog, lethargy, pain, rashes, and even hair loss. These breast implant illness symptoms tend to range in magnitude and scope widely.

Breast Implant Illness Related Articles

Here are articles where we tackled several breast implant illnesses which opt patients to have explant surgery.
Breast Implant Associated Autoimmune Disease Bacterial Biofilm Formation on the Breast Implant

Cost and Financing

Midwest Breast & Aesthetic Surgery is comfortable working with your insurance plan for an explant surgery. We will work with your insurance company by submitting a pre-authorization request after our first consultation alongside your pictures.

If insurance is unable to cover the explant surgery cost, we offer the procedure at the following prices:

Total En Bloc Capsulectomy & Implant Removal $7,700.00
Total En Bloc Capsulectomy & Implant Removal w/ Fat Transfer $14,400.00
Total En Bloc Capsulectomy & Implant Removal w/ Anchor Mastopexy $12,450.00
Total En Bloc Capsulectomy & Implant Removal w/ Anchor Mastopexy & Fat Transfer $18,600.00

The final costs will cover surgeons fee, anesthesia (including nerve block), and other miscellaneous medical expenses. Prices are subject to change based on complexity and length of surgery. An accurate quote will be given during your initial consultation with our doctors.

The Procedure

Total en bloc capsulectomy is an outpatient procedure that often lasts for 2 hours under general or local anesthesia. It can last longer if additional procedures like fat transfer and breast lift are performed together with the breast implant removal.

The procedure involves removing not only the implant but also the capsule that surrounds the implant as one single unit. It is important when performing explant surgery to remove capsular tissue from the chest wall and pectoralis major muscle to improve the patient’s muscle and chest wall function. The procedure may also include repair of the pectoralis muscle as both implant based breast reconstruction and breast augmentation can involve separation of the muscle at the time of the initial procedure.

The en bloc procedure ensures removal of the implant as a single unit and accounts for potential implant rupture to avoid leaving any silicone material in the body. After the capsule and the implant are removed, your breast tissue and muscles will settle back to their original position, leaving you with breasts that look and feel natural. Some patients will also need a breast lift at the time of total en bloc capsulectomy and implant removal to restore a natural breast shape.


Following the explant surgery, women begin to have a sense of normalcy regarding their new breast size and shape. Other benefits of explant surgery include:

  • Return of natural softness to the breasts
  • Being able to sleep in a prone position
  • Performing exercises without pain and discomfort
  • Wearing smaller and more comfortable bras
  • Significantly improved body image and sexuality

Recovery & Results

Most patients experience an improvement in symptoms soon after total en bloc capsulectomy and implant removal. A generalized feeling of wellness is the most common report to our practice in the post-operative healing phase.

We do ask that patients avoid strenuous upper body activity for at least 3 weeks due to muscle repair and swelling. Our surgeons will wrap patients in a post-operative Ace wrap that will be removed the following morning. We will send the patient home with a post-surgical bra for compression. Drains are removed when the output is less than 30ccs over a 24-hour period. This is typically one week after surgery.

Additional aftercare instructions are provided to ensure that the healing process proceeds with lower risks for complications. It often involves the following:

  • Avoiding strenuous activities that increase pulse and blood pressure
  • Reducing the use of the chest and arms for at least 2 – 6 weeks
  • Getting enough sleep and rest to alleviate feelings of fatigue and soreness
  • Taking some days off work to recover
  • Drinking the prescribed medications for pain and nausea

The chest and breasts may become swollen and sore over the next few weeks, which typically resolves on their own. However, prolonged manifestations of these symptoms require an urgent consultation with your explant surgeon.

Frequently Asked Questions

How long do you wear a compression bra after explant surgery?

We typically recommend that patients use the compression bra for 2 – 3 weeks. The duration varies on the needs of each patient.

Is breast implant removal painful?

Discomfort after surgically removing your implants is completely normal. Medication will be prescribed to ensure you remain comfortable and pain-free.

Do you send tissue for pathology?

Yes. We send capsule tissue for aerobic and anaerobic bacteria, atypical bacteria, and fungus/mold. We also send tissue for ALCL lymphoma. Certain types of implants (textured) have been shown to have an increased incidence of large cell lymphoma (a blood cancer). As such, we are knowledgeable in BIA-ALCL testing.

Do you take pictures?

Yes. We will take intra-operative pictures to confirm and demonstrate your total en-bloc capsulectomy and implant removal.

How do you manage out of town patients?

We will do a phone consult with you that will last approximately 45 minutes. We then submit your claim to your insurance company for pre-authorization. We will ask that you send us pictures to our secure email server. For out of town patients, we can arrange accommodations at the Renaissance Hotel in Westerville.

The evening prior to surgery or the morning of surgery we will plan a face-to-face consult. Post-operatively, we ask that patient’s remain in the Columbus area for 24-hours. The following morning we will plan on a post-operative visit. Drain management will be coordinated with health care professionals close to your home (primary care physician, urgent care, family member).

Where Is The Surgery Performed?

We perform these surgeries at Onyx and Pearl Surgical Suites (OPSS) in Westerville, Ohio. We are fortunate that OPSS has an exceptionally low rate of infection as the facility is brand new.  We are also up the street from Mount Carmel St. Anne’s hospital, a full-service, five star rated in-patient hospital.

Do you offer any post operative pain control?

For post operative pain control we utilize local anesthetic blocks to the chest and the Enhanced Recovery after Surgery and Anesthesia (ERAS) pain protocol that relies on non-narcotic pain control.  Often times antibiotics are given prior to surgery induction but are not necessary post-operatively.

Request Your Consultation

To learn more about breast implant removal, you can schedule an appointment online or you can call 855-687-6227

make an appointment

*The information available on this page was created to educate our patients. It is not an alternative for a formal consultation with a board-certified plastic and reconstructive surgeon. Individual results vary per patient. For more information, we strongly recommend scheduling a consultation with our doctors.