Explant Surgery & En Bloc Capsulectomy — Austin, TX

Breast implant removal — also called explant surgery — is a surgical procedure to remove breast implants and the scar tissue capsule that forms around them. Dr. Whitfield performs a total capsulectomy on every patient with the goal of removing the capsule intact. When the implant, capsule, and a margin of surrounding tissue are removed together as one unbroken unit, this is referred to as en bloc capsulectomy.

En bloc capsulectomy means removing the breast implant, its surrounding scar tissue capsule, and a margin of surrounding tissue together as one unbroken piece — without cutting into or rupturing the capsule. Dr. Whitfield performs a total capsulectomy on every patient with the goal of taking it out intact. The en bloc distinction specifically refers to the inclusion of a margin of healthy tissue around the capsule, similar to oncological resection principles.

Total capsulectomy: the entire scar tissue capsule is removed. Dr. Whitfield performs a total capsulectomy on every patient with the goal of removing it intact. En bloc capsulectomy: the implant, capsule, and a margin of surrounding tissue are removed together as one unbroken unit — the key distinction is the margin. Partial capsulectomy: only part of the capsule is removed. Dr. Whitfield does not perform partial capsulectomy.

On average, Dr. Whitfield reserves approximately 2.5 hours for an explant, approximately 3 hours for an explant with a lift, and approximately 4 hours for an explant with a lift and fat transfer. Any additional procedures would require more time.

Yes. Dr. Whitfield performs explant surgery under general anesthesia at an accredited ambulatory surgery center in Austin. General anesthesia allows for dissection along the chest wall without causing discomfort to the patient. In addition, the anesthesia team provides an ultrasound-guided nerve block prior to surgery to help control discomfort. An ERAS (Enhanced Recovery After Surgery) protocol is utilized to reduce post-operative nausea, vomiting, pain, and inflammation. Dr. Whitfield also uses Exparel, a long-acting local anesthetic, as part of his surgical process.

The basic approach is similar, but silicone implants — especially ruptured ones — require more careful technique because silicone gel can spread to surrounding tissue if the capsule is opened. Saline implants present lower contamination risk but can still form significant capsules that warrant complete removal.

Every capsule specimen has a small biopsy sent for PCR testing to identify bacterial DNA and biofilm, and the remaining capsule is sent to pathology. The capsule is also photographed and documented. Results are shared with you after surgery and help explain the source of symptoms and guide post-operative support.

SHARP stands for Strategic Holistic Accelerated Recovery Program — Dr. Whitfield’s proprietary three-phase protocol. Phase 1: biological preparation before surgery (nutrition, inflammation reduction, immune support). Phase 2: precision en bloc or total capsulectomy with PCR capsule testing. Phase 3: engineered post-operative recovery to optimize healing and symptom resolution. No other explant surgeon in Texas offers this integrated protocol.

PCR (polymerase chain reaction) testing analyzes the removed capsule for bacterial DNA, biofilm contamination, and specific pathogens that standard culture tests miss. Dr. Whitfield’s published research (PMID 39338504) found contamination in 29% of capsules tested — including in patients whose implants appeared visually normal. Knowing what was in the capsule helps guide post-operative treatment and explains persistent symptoms. This testing is not standard at most practices.

Oxylipin testing measures a class of inflammatory signaling molecules in the blood that indicate chronic immune activation and oxidative stress — both elevated in many BII patients. Published research (PMID 38032740, PMID 38299590) has identified oxylipin patterns associated with implant-related systemic inflammation. Dr. Whitfield does not offer oxylipin testing at this time. It is only performed in a research environment. The published studies (led by Dr. Mithun Sinha) demonstrate the connection between biofilm-derived oxylipins and systemic inflammation, but commercial testing is not yet available.

SHARP Phase 1 begins after your virtual consultation with Dr. Whitfield: anti-inflammatory dietary changes, specific supplement protocols approved by Dr. Whitfield, cessation of blood thinners and NSAIDs, hydration optimization, and advanced lab testing. This preparation phase reduces peri-operative inflammation and supports faster, more complete recovery. Most explant practices skip this step entirely.

Dr. Whitfield does not require imaging before surgery. While MRI is the best available study for detecting silicone rupture, it still misses posterior leaks along the chest wall. Because Dr. Whitfield performs a total capsulectomy on every patient regardless of imaging findings, the surgical plan does not change based on imaging results. If you have recent imaging, it can be reviewed, but it is not a prerequisite for scheduling surgery.

Dr. Whitfield defines Breast Implant Illness (BII) as a chronic inflammatory process in which a breast implant is playing a role. That is why he developed the SHARP Method — to identify other drivers of inflammation like toxin burden. While BII does not yet have a single ICD code, it is taken seriously by the FDA and by physicians who treat it. For many patients, explant surgery with complete capsulectomy leads to significant symptom improvement.

Reported BII symptoms include: chronic fatigue, brain fog and memory problems, joint and muscle pain, hair thinning or loss, skin rashes, anxiety and depression, chest tightness, shortness of breath, dry eyes, recurring infections, swollen lymph nodes, hormonal disruption, sleep disturbance, and food sensitivities. Symptoms often begin subtly and worsen over time.

Many patients report significant symptom improvement after explant with complete capsulectomy. NIH-reported research indicates approximately 90% of patients experience symptom improvement within three months of explantation with capsulectomy. Dr. Whitfield’s SHARP protocol is designed to maximize the likelihood of resolution by addressing both the surgical and biological components of recovery.

Some patients notice relief within days to weeks. Others experience gradual improvement over 3–6 months as systemic inflammation resolves. SHARP Phase 3 supports this process with targeted nutritional and lifestyle interventions. Resolution varies based on how long implants were in place, capsule contamination findings, and individual immune response.

Yes. Textured implants have a higher documented association with BIA-ALCL than smooth implants. Their surface also creates more area for biofilm colonization. Many patients with textured implants — especially macro-textured or polyurethane designs — are choosing elective removal even without current symptoms as a preventive measure.

BIA-ALCL (Breast Implant-Associated Anaplastic Large Cell Lymphoma) is a rare type of non-Hodgkin lymphoma associated specifically with textured breast implants. It develops in the fluid or tissue around the implant, not in breast tissue itself. Dr. Whitfield has also treated a patient with Breast Implant-Associated B Cell Lymphoma — at the time of treatment, one of only eight documented cases in the world. If you have textured implants, discuss your risk with Dr. Whitfield. En bloc capsulectomy is the recommended treatment when BIA-ALCL is confirmed or suspected. <a href='/breast-implant-associated-cancers'>Learn more about breast implant-associated cancers</a>.

Capsular contracture is the hardening, tightening, or firmness of the scar tissue around a breast implant. The scar around the implant is essentially a collagen sack, graded Baker I through IV. Baker III and IV contracture require intervention, with capsulectomy as the definitive treatment. In the summer of 2025, a paper published from Denmark showed that patients with capsular contracture may be experiencing an organ rejection response at the tissue level, based on increased T cell, B cell, and plasma cell activity measured in their research. This makes sense given that the first kidney transplant was performed between genetically identical twins, and everything since has required immunosuppression. At the tissue level, it follows that some patients have a more enhanced immune system response — we see chronic inflammatory changes on pathology every time we explant a patient. There is currently no commercially available test to evaluate this response.

Each patient comes to the office the day after surgery to begin recovery treatments including the Human Regenerator, hyperbaric oxygen therapy, lymphatic massage, Juvé red light therapy, and NanoVi. These treatments continue over the first week after surgery. No lifting over 10 pounds for the first few weeks. Most patients can return to light work within one to two weeks. Vigorous exercise is avoided, but walking is encouraged. Patients who have pectoralis major repair are placed on a specific protocol and released to activity based on their surgical repair and healing, followed closely by our team. Surgical follow-up occurs at one week, one month, three months, six months, nine months, and twelve months. In parallel, patients work with our SHARP functional practitioners on a separate but coordinated path for detoxification and recovery.

It depends on your breast tissue volume, skin elasticity, and personal goals. Many women elect a simultaneous mastopexy (breast lift) to address ptosis (sagging) that becomes apparent after implant removal. Dr. Whitfield will give you an honest assessment of what to expect without surgery and what a lift could achieve.

Yes. Dr. Whitfield is one of the few surgeons in the world who will perform simultaneous explant and fat transfer with or without a lift. This is possible through the use of his SHARP Method and team of trained functional providers. Fat transfer uses your own body fat to restore volume after implant removal — a natural alternative to synthetic implants. Results vary based on available volume and the amount transferred.

Yes. Implant replacement is possible after removal, though it is typically staged at least 3–6 months later to allow the tissue pocket to fully heal and BII symptoms time to resolve. If your reason for removal was BII, Dr. Whitfield will counsel you on the risk of symptom recurrence with new implants before you decide.

Dr. Whitfield does not participate in insurance plans and does not file insurance claims or write letters of medical necessity. All patients will have access to their results and documentation to file their own claims with their insurance provider if they choose to do so.

Yes. Dr. Whitfield regularly cares for patients traveling from across Texas and from other states. Virtual consultations are available for initial evaluation. Our team coordinates surgical scheduling, pre-operative testing, and post-operative follow-up protocols that are manageable for traveling patients. Austin-Bergstrom International Airport (AUS) is 20 minutes from the practice.

Yes. Dr. Whitfield offers virtual consultations for patients who are exploring options or traveling from outside Austin. A virtual consultation allows you to discuss your symptoms, implant history, and goals before committing to an in-person visit.

Three things: (1) Published PCR research — the only explant surgeon in Texas with peer-reviewed research on capsule biofilm contamination (PMID 39338504), identifying bacterial contamination in 29% of capsules. (2) The SHARP Method — a proprietary three-phase protocol (preparation → precision surgery → engineered recovery) not offered anywhere else in the region. (3) Total capsulectomy on every patient — with the goal of removing the capsule intact, combined with PCR testing to identify what was actually inside the capsule and guide post-operative care.

Schedule your consultation using our online booking form at <a href='https://discovery.drrobertwhitfield.com/form'>discovery.drrobertwhitfield.com/form</a>. We offer both in-person and virtual consultations. Patients traveling from outside Texas can begin with a virtual visit to review imaging and history before scheduling surgery.

Dr. Whitfield has performed over 2,000 explant procedures, with a focus on complex cases involving BII, capsular contracture, and textured implants. His practice is dedicated to the full BII patient journey — from pre-surgical preparation through post-operative recovery — not just the operative step.