Some patients decide they no longer want breast implants and choose to remove them. Typical implant removal includes the removal of the capsule as well. A capsule occurs with virtually every foreign object that is placed inside the body. It is a scar-like shell of collagen fibers that encases the object and is usually harmless under normal circumstances. Sometimes the capsule can grow very thick and tighten around the breast implant, causing the breast to feel very dense and possibly painful. 

There are different techniques for removing implants and capsules. Traditional implant removal includes removing breast implants as well as the capsule which may be removed in pieces. En Bloc or In Toto implant removal is the removal of the implant with the capsule in one piece rather than removed in pieces. Typically, an En Bloc or In Toto removal takes longer in surgery. Some patients who choose En Bloc or In Toto implant removal also request to have cultures and tests done on the capsule or breast pocket to determine if any bacteria are present. These tests are usually sent to a hospital lab and may range from $300 to $4500 or more in additional costs to the patient.