En Bloc With Lift


Procedure Time: 2-5 Hrs

Recovery Time: 7 Days


People with breast implants, like any bodily implant, may eventually require or desire implant removal. When this occurs, the exact method of explant is going to vary based on the situation, the patient’s anatomy, the patient’s goals, and various other factors. One of these techniques is an en bloc resection for the removal of the implants. Furthermore, some patients may need a breast lift for the best results. This culminates in a procedure known as an en bloc with breast lift, or en bloc lift. Dr. Craig Jonov at Seattle Plastic Surgery provides the best en bloc lift Seattle and Tacoma offers.


Patients may seek the removal of their breast implants for various reasons. In many cases, there is no inherent problem with their implants the patient simply does not want their implants anymore. In other cases, a patient may experience capsular contracture, rupture, or a rare complication known as breast implant illness.

The technique used for breast implant removal does have some bearing on the reasons for removal. For example, if a patient wants new implants inserted, there is usually no reason to perform an en bloc resection. However, if a patient with decades old implants experienced a rupture, an en bloc may be necessary.

The en bloc capsulectomy technique involves removing the breast implant and the entirety of the surrounding scar tissue in one complete piece. This is not always possible or needed. Many patients experiencing breast implant illness request an en bloc resection due to the belief that removing the scar tissue in pieces or partially leaves the possibility of continued symptoms. This is best discussed with Dr. Jonov during a consultation since the best technique and en bloc candidacy depends widely on the situation, symptoms, and patient preferences.

Combining With A Breast Lift

Following the removal of breast implants, some patients may need a breast lift to restore an aesthetic breast appearance. This is especially common for patients who have had their breast implants for several years, have had children since implant placement, and those who have seen major weight gain or loss since undergoing breast augmentation.

Dr. Jonov, as an experienced breast surgeon, can easily perform a breast lift at the same time as an explant, whether using the en bloc technique or not. However, this does add surgical time. Therefore, not all patients may be good candidates for combined surgeries. Dr. Jonov can evaluate your candidacy during a consultation at Seattle Plastic Surgery.

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    When I decided to finally pull the trigger and get the lift and reduction I’d been longing for, I had no clue where to start. I knew my insurance wouldn’t cover it as it was purely cosmetic so I just perused websites and relied on reviews (like this!) Even with the great accolades and reviews for Dr Jonov it still felt like a gamble... but this one really paid off. Dr Jonov is an exceptional doctor and takes great pride in his work. I could not be happier with the outcome. I am so happy I did this procedure and used Seattle Plastic Surgery. They have been fully engaged in my healing process which has been really helpful as well.


    Dr. Craig Jonov is the best. Seriously; if you're looking for someone who's both so competent and so personable, he's the one to go to. He knows his stuff and beyond. I got a consultation with almost every surgeon in the Greater Seattle Area and Dr. Craig is the only one that felt comfortable to operate.


    I want to recommend Dr Jonov he’s the best!!! I’m so happy with the results of my surgery!!!


    I LOVE this office!! I tell all my friends about how amazing this team is!! Dr. Jonov is so personable, funny, and made my entire experience from start to finish a breeze!! He did such a great job, scarring is minimal. Back for my 1 month check up today and decided to get dysport as well!! Great prices. Clean and welcoming atmosphere.


    The surgical techniques to remove breast implants varies. Ultimately, the differences come in with how the scar tissue is removed. All breast implants (and implants in the body in general) will have scar tissue around them, regardless of if they are healthy or not. It is perfectly normal for scar tissue to form. Problems arise if it grows too thick and/or hardens. This is known as capsular contracture. 

    The technique Dr. Jonov will recommend will depend on your needs, reasons for removal, and patient anatomy. Additionally, patient preference does matter. Even if en bloc resection seems unnecessary, Dr. Jonov may move forward with the technique if the patient is a good candidate and it seems viable.

    Partial Capsulectomy

    A partial capsulectomy involves removing the breast implant and some of the scar tissue. Typically, some scar tissue is left behind and the tissue that is removed is done so in pieces. Partial capsulectomy is most commonly used during breast revisions where Dr. Jonov places new implants.

    The partial capsulectomy technique may best for you if:

    • Exchanging breast implants
    • It is too risky to remove all of the scar tissue
    • Scar tissue attached to or too close to the chest wall to make other methods practical
    • Certain cosmetic concerns
    • Prefer the smallest incision and the patient does not mind leaving scar tissue behind

    Total Capsulectomy

    A total capsulectomy involves removing or destroying all of the scar tissue as well as taking out the breast implant. However, in this method, the scar tissue is removed in pieces. When this method is used, it is usually determined that all of the scar tissue can be removed safely. If this proves not to be the case, Dr. Jonov may destroy the remaining tissue via cautery.

    The total capsulectomy technique may be best for:

    • Lower grades of capsular contracture
    • Mild breast implant illness
    • Cosmetic deformities
    • General discomfort
    • Thin scar tissue

    En Bloc

    The en bloc resection technique is the most aggressive form of breast implant removal. It requires an experienced surgeon and also is usually reserved for severe concerns or complications. It is not typically performed when new breast implants are going to be placed (though there are exceptions to this).
    This method involves a much larger incision than other explant techniques. It also is more extensive and risky. Therefore, it is important that patients carefully weigh the risks and understand what an en bloc procedure entails.

    An en bloc explant may be preferred if:

    • One or both implants are ruptured
    • Severe capsular contracture
    • Breast cancer or major infection occur
    • Certain cases of breast implant illness
    A Before and After photo of a Breast Lift Plastic Surgery by Dr. Craig Jonov in Seattle and Tacoma

    Before & After

    This patient wanted to remove her old saline breast implants and place new silicone ones. Due to age, the patient also required a lift. While new breast implants were placed, the patient still underwent an en bloc with lift in addition to the re-augmentation.

    See More Before & Afters


    For patients who require or are good candidates for an en bloc lift surgery, there are many benefits to undergoing it. Depending on the situation, patients may find individual advantages to the procedure. Some benefits and advantages patients commonly experience include:

    • Cessation or improvement of symptoms of rupture, capsular contracture, or BII
    • Restoration of perky, natural looking breasts
    • Correction of saggy breasts
    • Removal of extra skin
    • Maintaining a fuller appearance without the need for implants
    • Same incisions used for both procedures
    • Less overall recovery time than undergoing individual procedures
    • Can address breasts that have gained additional volume or grown too large following augmentation
    • Make nipples smaller, if desired
    • Improve quality of life and make exercise easier
    • Correct rupture or rippling
    • Breasts may look more youthful


    Can You Use The Breast Lift Incisions For Removing The Implants?

    Yes, the traditional breast lift incision is roughly shaped like an anchor with the incision encircling the nipple, extending down the breast, and through the inframammary fold. Generally, an en bloc procedure involves an incision across the inframammary fold, which already occurs during a breast lift.

    Is En Bloc Truly The Best Explant Surgery?

    It depends on the situation. As discussed earlier, in cases of rupture or cancer where the implants require removal, en bloc is often the only option. With capsular contracture or breast implant illness, a total capsulectomy will usually suffice, though it is important to discuss all possible techniques with Dr. Jonov during your consultation.

    One of the major considerations patients need to make when considering en bloc breast implant removal is the risk. Removing an implant with the en bloc method may necessitate getting close to the chest wall and important bodily structures. This increases the overall risk of the procedure. While in some patients an en bloc does not carry this added risk, it is generally not preferred because the surgeon has less visibility than during other capsulectomy techniques.

    Dr. Jonov is an expert at the en bloc technique and has performed the procedure numerous times. He can discuss the procedure with you, your risks, and the best technique for your specific situation.

    How Do You Know If You’ll Need A Breast Lift After Explant?

    If your nipples point downward, you have accumulated a noticeable amount of extra skin, or your implants have significantly stretched the skin, this may mean you will need a breast lift to see the best results. Though, sometimes it is not always obvious you may need a lift following explant. Dr. Jonov will assess this during your consultation. 

    What Is Recovery Like?

    Recovery after an en bloc lift in Seattle typically involves around a week or two off work. Like after breast augmentation surgery, Dr. Jonov will likely restrict strenuous forms of exercise and lifting for about four to six weeks. Light duty work and some low impact exercise can often begin after about two weeks.

    It is recommended that patients do not smoke or drink for at least 3 days before and after surgery. Though, it is best not to smoke during recovery at all since smoking slows down and hinders the healing process. Dr. Jonov will provide a personalized recovery plan before surgery as well as be available during your recovery to answer questions.

    What Is The Cost & Do You Offer Financing?

    It is difficult to quantify the exact cost of an en bloc with breast lift procedure before physical examination since the extent of the surgery is impossible to determine without a consultation. Once you meet with Dr. Jonov, you will receive a customized price quote for your surgery.

    Seattle Plastic Surgery does work with three outside financing companies to help make your en bloc lift in Seattle fit your budget. You can find more information and direct links to apply on our financing page. You will also receive more information following a consultation.


    Seattle Plastic Surgery is a premier plastic surgery practice that has served Seattle and Washington State for nearly twenty years. Located centrally in First Hill, Seattle Plastic Surgery provides a cozy, private environment to meet with Dr. Jonov to discuss your en bloc with lift procedure. As part of Seattle’s medical hub, Seattle Plastic Surgery proudly provides the best en blow with breast lift Seattle and Tacoma can offer.

    Dr. Craig Jonov is a plastic surgeon who performs multiple breast surgeries every week. He has decades of experience in both surgical and non-surgical procedures. His expertise is often sought by other physicians and cosmetic providers. Dr. Jonov customizes each procedure to the individual patient.

    To schedule a consultation with Dr. Craig Jonov, call us at 206-324-1120. You can also reach out online via Price Simulator®, chat, and our contact form.