Pain one year post op

[nine]

Dr. Bahram Ghaderi,

I had my breast augmentation Feb. 23 2007. I was a 34A and now have 325cc smooth round mod. profile saline implants completely under the muscle with the placement achieved via periareollar (Mentor implants). I've had several follow up appointments with my surgeon (a board certified surgeon of Newport Beach with an impressive background and experience) and he said my pain is not capsular contracture. My PS said everything looks and feels fine. Everyday and nearly all the time I have an ache in my right breast which was the smaller breast prior to surgery. My surgeon also lowered the crease in my right breast. The pain started about 3-4 months after surgery. The pain is below my clavicle and above where I would think the implant starts. I also have consistent pain in the area connecting my arm to side of breast (above the armpit area). I think that may be muscle area. I continue to have and have had for years muscle spasms in my neck and right shoulder area. I was also diagnosed with a bulging disc in my neck years ago. Is the pain I'm feeling muscle related? Will my muscle eventually adjust to the implant or am I suffering from something else...like chronic pain from damaged tissue or nerves from the cutting of the muscle and fascia to insert the implant? I have my one year follow up next week with my surgeon, but I want another surgeons opinion if that is at all possible from the verbal description above. Thank you.

[drghaderi]

The pain you describe could be related to the issues you listed. To figure out which source is the culprit you would need a full evaluation. Your surgeon is the best person for that as he knows your history. Capsular contracture can cause prolonged pain. I would suggest discussing your concerns with your surgeon and viewing your after photos in progression to see if there has been any change from the immediate postop photos to now. Otherwise medical and surgical options for re-exploring the right breast pocket need to be discussed with your surgeon - specially if the pain is restricting your daily activities. Sometimes surgically releasing the contracted capsule will help relieve the discomfort. Capsular contracture can recur, however. I hope this begins to answer your question.

Dr. Ghaderi