Procedures

Surgical procedures.

The procedures performed at the practice, described in technical detail. Each surgical plan is determined by the patient's implant history, anatomy and pathology findings, and is confirmed with Dr. Urzola before surgery.

En-bloc capsulectomy imagery
The core procedure

Explant & En-Bloc Capsulectomy

The primary procedure at the practice is the complete removal of breast implants together with the capsular tissue formed around them. En-bloc removal takes out the implant and its capsule as a single, intact unit, so no capsular tissue is left behind.

En-bloc removal is performed wherever the tissue safely allows. Where anatomy or safety does not permit a complete en-bloc, a total capsulectomy is carried out, removing all capsular tissue. The approach applies to both silicone and saline implants, and to the revision of prior augmentations.

  • En-bloc where clinically indicated: implant and capsule removed as one intact unit.
  • Total capsulectomy in all cases: all capsular tissue removed where en-bloc is not indicated.
  • Pathological analysis of every capsule: documented for the patient record.
  • Silicone or saline, primary or revision: the approach applies across implant types.
Understand the science
Surgical standard
“The standard is a complete, methodical explant: total capsulectomy, en-bloc where the tissue allows, and pathology on every capsule.”
U-Flap lift illustration
Dr. Urzola's own technique

U-Flap Breast Lift

The U-Flap is a technique developed by Dr. Urzola. Rather than replacing volume with an implant, it uses the patient's own upper-abdominal and breast tissue as an internal flap to restore fullness and shape at the same time as the lift.

The flap is created through the incisions already required for a breast lift, so no additional scarring is introduced to achieve the added volume. The result is a fuller, lifted breast constructed entirely from the patient's own tissue, with no implant.

  • Autologous tissue: volume restored without an implant.
  • Same incisions as a standard lift: no additional scarring.
  • Restored volume and projection: shape supported from within.
  • Single-stage with explant: combined in one procedure where indicated.
Chest-wall restoration imagery
Restoring the chest wall

Muscle Repair

Where implants were placed beneath the pectoral muscle (a sub-muscular placement), their removal can leave the muscle detached or distorted, sometimes with visible movement on flexing. Left unaddressed, this affects both the appearance and the function of the chest wall.

The pectoral muscle is reattached and repaired during the explant, restoring chest-wall contour and function. This step is performed as part of the same procedure and addresses distortion that removal alone would leave behind.

  • Corrects sub-muscular distortion: addresses what removal alone can leave behind.
  • Reattaches the pectoral muscle: restored to its anatomical position.
  • Restored chest-wall contour: a settled, anatomical result.
  • Reduces animation deformity: limiting the pull seen on flexing.
Fat transfer imagery
Autologous volume restoration

Fat Transfer

Fat transfer is not performed at the same time as the explant. It is a separate procedure, carried out after full explant recovery, because the tissues need to settle before they can support and nourish grafted fat.

At that stage, fat is harvested by liposuction from another area of the body and transferred to restore volume. As a guide, approximately one cup size is added per session, with roughly half of the transferred fat surviving long-term. The final result settles over approximately six months as the graft integrates. Outcomes vary between patients.

  • Performed after full explant recovery: never at the same time as removal.
  • Autologous fat: no implants and no foreign material.
  • Approximately one cup size per session: built up in stages.
  • Roughly 50% graft survival: the surviving fat is permanent.
  • Final result at approximately six months: as the graft integrates.
Hospital & recovery imagery
Anesthesia & safety

Anesthesia & Safety

Surgery is performed under general anesthesia at CIMA, an internationally accredited hospital (JCI-standard), with a dedicated anesthesiology team providing continuous monitoring throughout the procedure.

Preparation follows a defined protocol. Patients fast for eight hours before surgery and must disclose all medications and herbal supplements, some of which are stopped in advance because they can affect bleeding or the response to anesthesia. After surgery, patients recover in a monitored PACU for approximately forty-five to sixty minutes, with 24-hour nursing at selected recovery locations. Anesthesiology care is provided by Dr. Daniel Masis, Dr. Tania Morera Martinelli and Dra. María Luisa Cedeño.

  • General anesthesia: administered and monitored by the anesthesiology team.
  • Internationally accredited hospital (JCI-standard): surgery performed at CIMA.
  • Dedicated anesthesiologists: Dr. Masis, Dr. Morera Martinelli and Dra. Cedeño.
  • 24-hour nursing at selected locations: monitored recovery.
Meet the team
Consultations

Request a consultation.

Submit your history for review by Dr. Urzola, who advises on the appropriate procedure. Consultations are confidential and carry no obligation.

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