Robert Whitfield MD explains why a patient requested en bloc breast implant removal, which means taking out the implant along with the scar capsule around it without disturbing either one. He compares it to an Easter egg: you want to keep the whole thing intact. The patient didn't say why she wanted it done this way, but he did it anyway.
She asked me to do something I had never been asked before by a patient. She said, can you take out my implants? Enbloc. And so for the audience, en bloc is a term used in pathology. It's tumor extirpation, or removal is done en blanc, say, for a sarcoma or any cancer, you want to be around it, not in it. Okay, so she wanted you to take the tissue around the capsule, the scar capsule and the implant together. So when I talk about it, I say it's like taking things out in an undisturbed manner, like not breaking the Easter egg. Okay, so the Easter egg, just for listeners, you have the silicon or whatever, the bag of fluid is made out of the implant, and then you have a scar capsule around it that your body made. And you could take out just the implant and leave the scar. Correct. Okay, good deal. And so en blanc meant removing the scar tissue and the balloon. En blanc versus total versus partial capsulectomus. Okay. So, I mean, I had done cancer surgeries with my colleagues and on our own and reconstructed. And so this was not a big thing for me to do. Yeah. And so I did it that way. But how dare you do what your patient wanted? I mean, aren't you the doctor? Well, I. I think. I think it was just kind of one of those things. Whereas I was like, I've always been intellectually curious, and I didn't make a big deal about her asking me that. I said, well, I take them out that way, basically, anyway. So, yeah, it's fine. There's some nuances to it, but, yeah, of course. Why did she want that? She didn't allude to that at the time. She did not tell me anything. And I was like, okay. So I took her to the operating room.
