When breast implant illness support groups started telling each other to ask their plastic surgeon for an “en bloc capsulectomy,” they were borrowing a term from cancer surgery — and asking for something most surgeons knew was impossible. The plastic surgery community didn’t correct them. They listened, and then they renamed it.Dr. Luke Swistun walks hostess Monique Ramsey through the Breast Surgery Collaborative Community Consensus and the four types of capsulectomy that came out of it: total intact capsulectomy (the surgery the en bloc community was actually asking for), total precise capsulectomy, partial capsulectomy, and the original cancer-surgery en bloc — a procedure he’s performed exactly once in his career, on a woman with breast implant–associated lymphoma. He covers when leaving a sliver of capsule is the safer choice, why every capsule he removes goes to pathology, what imaging he wants done before surgery, and why he films almost every explant for the woman who just had it.
Find out why Dr. Swistun openly credits the breast implant illness community for forcing the conversation, what recovery actually looks like across all four procedures, and the one thing he admits is overdue on his own website.
Links
Meet San Diego plastic surgeon Dr. Luke Swistun: https://www.ljcsc.com/about/meet-the-team/plastic-surgeons/dr-luke-swistun/
Learn more about breast implant removal: https://www.ljcsc.com/procedures/cosmetic-surgery/breast/breast-implant-removal/
Please request your free consultation online at https://www.ljcsc.com/ or call La Jolla Cosmetic Surgery Centre, San Diego, at (858) 452-1981 for more information.
Questions answered by this episode
1. What is a capsulectomy?
2. What does “en bloc” mean in breast implant removal?
3. What is a total intact capsulectomy?
4. What’s the difference between en bloc and total intact capsulectomy?
5. Do plastic surgeons always remove the entire capsule with the implant?
6. When is it safer to leave part of the breast implant capsule behind?
7. Who actually needs an en bloc capsulectomy?
8. Should I get imaging before breast implant removal surgery?
9. Why do plastic surgeons send breast implant capsules to pathology?
10. How long is recovery after breast implant removal and capsulectomy?
About this podcast
Learn from the talented plastic surgeons inside La Jolla Cosmetic Surgery Centre (https://www.ljcsc.com/), the 12x winner of the San Diego’s Best Union-Tribune Readers Poll, global winner of the 2020 MyFaceMyBody Best Cosmetic/Plastic Surgery Practice, and the 2025 winner of Best Cosmetic Surgery Group in San Diego Magazine’s Best of San Diego Awards.
Join hostess Monique Ramsey as she takes you inside LJCSC, where dreams become real. Featuring the unique expertise of San Diego’s most loved plastic surgeons, this podcast covers the latest trends in aesthetic surgery, including breast augmentation, breast implant removal, tummy tuck, mommy makeover, labiaplasty, facelifts and rhinoplasty.
La Jolla Cosmetic Surgery Centre is located just off the I-5 San Diego Freeway at 9850 Genesee Ave, Suite 130 in the Ximed building on the Scripps Memorial Hospital campus.
To learn more, go to https://www.ljcsc.com/ or follow the team on Instagram @LJCSC (https://www.instagram.com/ljcsc/).
Watch the LJCSC Dream Team on YouTube @LaJollaCosmeticSurgeryCentre (https://www.youtube.com/@LaJollaCosmeticSurgeryCentre/).
The La Jolla Cosmetic Surgery Podcast is a production of The Axis: https://www.theaxis.io/
Theme music: Busy People, SOOP
Chapters
00:00 Why women are asking to take their implants out
02:30 Where the “en bloc” term came from
04:56 Total intact and total precise capsulectomy explained
09:11 When some capsule has to be left behind
11:25 Imaging and breast cancer screening before explant
14:48 The one case that calls for a true en bloc — ALCL
17:46 Pathology, post-op videos, and the recovery timeline
