Breast implant illness and en bloc capsulectomy

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 What is breast implant illness?

Breast implants are like all foreign bodies in that they have a limited life span, and will need to be revised or replaced or removed at some stage. Breast implants are made out of a silicon outer shell, with softer silicon inside. The longer breast implants have been in place, the higher the risk of complications such as breast implant leak, breast implant rupture, capsular contracture, and even a type of cancer (Breast Implant Associated Anaplastic Large Cell Lymphoma, or BIA ALCL).

In some women a group of symptoms has been subjectively associated with breast implants, including health problems such as general fatigue, weight fluctuations, joint pain, malaise, and fever. While there currently is no scientific evidence that breast implants cause these symptoms, many women with these symptoms strongly feel that they are caused by their breast implants, and furthermore, report that they feel better when they have their breast implants removed.

 

How is breast implant illness treated?

Breast implant illness is treated with removal of the breast implants, and ideally with removal of the entire capsule that surrounds the implants. This procedure is known as an en bloc capsulectomy, essentially meaning removal of the implant and the surrounding capsule all as one. Removal of the implant and capsule ‘all as one’ is thought to reduce the risk of contamination which can lead to ongoing breast implant illness. Done correctly, en bloc capsulectomy is a delicate and precise operation, with the each aspect of the capsule removed entirely, but without damaging your surrounding normal tissue. Dr Colbert has performed many en bloc capsulectomies, including completing a fellowship at the Melbourne Institute of Plastic Surgery, which specialises in cosmetic breast surgery.


How is an enbloc capsulectomy performed?

An en bloc capsulectomy is performed under a general anaesthetic, meaning that you are ‘asleep’ for the procedure. It is performed under through an incision in the natural crease below the breast. Through this incision the breast implant and capsule (scar tissue that surrounds the breast implant) is removed completely. There may be surgical drains (small temporary plastic tubes) that need to be inserted to help remove any extra fluid, and help discourage any further capsule from developing. The procedure takes between two and four hours, and can be performed as day surgery or overnight surgery. In a small minority of cases a complete en bloc capsulectomy may not be able to be safely performed. Dr. Colbert will carefully evaluate your case and discuss your treatment options with you, to help decide which treatment option is best.  


How will I know if removing my breast implants will cure my symptoms?

Unfortunately there currently aren’t any tests to help diagnose breast implant illness. The only way to truly check is by removing your breast implants and assessing how you feel once they are removed. While majority of BII patients report they feel better once the implants are removed, there is always a chance that your symptoms may continue.


What are the benefits of an en bloc capsulectomy?

An en bloc capsulectomy is a procedure that should be carefully and precisely carried out, ensuring your body is removed of silicon from the implants, while also avoiding any damage to your normal tissue. In theory the en bloc capsulectomy ensures the maximum amount of silicon is removed without contaminating the body further. It also allows your breast tissue to return to its natural and normal state.  


How much does breast implant removal cost? Will Medicare help pay for it?

The cost of breast implant removal in Perth can be confusing - so to make things clearer we have listed the fees that make up the final cost.

  1. Surgical fee: For breast implant removal Dr Colbert’s surgical fee is usually between $1000 and $2000 per side, depending on whether a partial or complete capsulectomy is performed. This cost includes the operation, and all aftercare. This cost is further reduced through a Medicare rebate, with the specific rebate amount depending on if a partial capsulectomy (item number 45548) or complete capsulectomy (45551) is performed. A further subsidy is usually provided by your private health insurance, however you’ll need to contact your fund to confirm this.

  2. Anaesthetic fee: The anaesthetic fee is subsidised by Medicare and your private health fund, with usually an out of pocket gap left to pay.

  3. Hospital fee (this includes operation room fee, bed costs, surgical or medication fees, and any other hospital extras): If you have private health insurance then this may be covered by your insurance fund, but you should check with your fund if there is any out of pocket expenses. If you have no private insurance then you will have to pay this fee on discharge from the hospital.


How do I ensure I am treated safely?

When deciding on your surgeon, you should always check their qualifications. Did you know that any medical doctor can call themselves a cosmetic surgeon? To ensure your safety you should always do your homework first, and answer the following questions about your surgeon:

  1. Is your surgeon is a Specialist Plastic Surgeon? This means that they have completed the only government regulated training program for plastic surgeons in Australia. Unfortunately many surgeons who are not Specialist Plastic Surgeons will call themselves “cosmetic surgeons” or “plastic surgeons”, even though they have completed no formal Australian Plastic Surgery training.

  2. Is your surgeon a member of the Australian Society of Plastic Surgery (ASPS)? This is the peak representative body for Plastic Surgeons in Australia, and is only open to Specialist Plastic Surgeons.

  3. Is your surgeon a member of the Australian Society of Aesthetic Plastic Surgery (ASAPS)? This is the peak representative body for aesthetic and cosmetic surgery in Australia, and is only open to Specialist Plastic Surgeons.

Dr Colbert is a Specialist Plastic Surgeon, and is also a member of the Australian Society of Plastic Surgery (ASPS) and the Australian Society of Aesthetic Plastic Surgery (ASAPS).


Where can I find out more?

To find out more about breast implant illness, about removal of your beast implants, or about enbloc capsulectomy, please make an appointment to see Dr. David Colbert. We can be contacted on (08) 64789920, or by emailing hello@davidcolbert.com.au.

David Colbert