Sudden changes (especially otherwise asymptomatic changes) warrant evaluation by your surgeon and a workup that may necessitate imaging.

New onset, periprosthetic fluid collections may or may not be a cause for concern. Patients with textured devices and similar symptoms should be worked up for BIA-ALCL. This is an exceedingly rare lymphoma (less than 600 cases worldwide, at last count) which is associated with textured devices. Patients will develop fluid collections, Sampling reveals CD30+ and ALK+. Treatment is explant and capsulectomy. This is curative.

As always, discuss your concerns with a board-certified plastic surgeon (ABPS).

Published on Jul 11, 2012

It may be that you have developed a fluid accumulation around the implant, leading to the swelling and pain. This can be due to a benign inflammatory reaction to your implants and rarely an unusual type of cancer. It would be best to consult with a plastic surgeon or breast general surgeon for an evaluation that will likely involve radiologic examination as with ultrasound, mammogram and/or MRI.

Published on Jul 11, 2012

Thank you for your question. I'm sorry you are experiencing this acute change. You should be evaluated by a board-certified plastic surgeon as soon as possible. You may have a developed a seroma, a fluid pocket around the implant, and a capsular contracture, scar tissue around the implant. If there is fluid around the implant it should be evaluated to determine what caused it. This can be accomplished with a breast ultrasound and aspiration (removal) of the fluid for cytology and culture.

Published on Jul 11, 2012

It is difficult to say exactly what is going on, but one thing is very clear to me: you need to make an appointment with your physician and get examined. If the physician who placed your implants is no longer in practice, ask your primary care physician for a referral and get properly evaluated. The sudden increase in size and discomfort are a concern, and I would not spend any more time wondering, but would instead get seen and examined so that you can move forward to a resolution of your problem and answers to your questions. Hope this helps.

Published on Jul 11, 2012

This hardness most likely is a capsular contracture. Please consult with a board-certified plastic surgeon. If it truly is a capsular contracture, it can be corrected either with or without new implants. An examination will help to determine the best course of action.

Published on Jul 11, 2012

Thank you for your question. Unfortunately, these can sometimes be symptoms of what is known as a capsular contracture. Luckily it is nothing to worry about medically, but it can cause the one or both breasts to become hard/firm and sometimes painful over time. The national average contracture rate in the United States is 14-16%, and plastic surgeons still are unclear as to why the buildup scar tissue can form around the breasts so many years after having surgery. Luckily there is a solution: by replacing the implants and covering it with strattice. Many surgeons do not specialize in treating capsular contractures with using strattice, so it’s best to do your research on contractures and strattice to find the best surgeon who can revise your breasts.

Published on Jul 11, 2012

Rather then speculate here on this forum, I recommend you make an appointment with your doctor. When you had this happen 2 years ago, what ended up being the explanation? In some cases, situations like this can be the development of a capsular contracture. I would first see your regular primary doctor for an evaluation. You may need an MRI/ultraSound.

Published on Jul 11, 2012

I recommend you give your plastic surgeon a call. There are multiple issues that could be causing the swelling and pain, but it is not possible to tell what is causing it without being seen in the office.

Published on Jul 11, 2012

Hi, it's not a pulled muscle; it's probably capsular contracture. Please visit a few ABPS certified/ASAPS member surgeons who specialize in revision breast surgery. Best of luck!

Published on Jul 11, 2012

If it's 3 x larger I would get a ultrasound and mammogram to rule out fluid collection and underlying malignancy. A plastic surgeon or Belfast surgeon is the first stop. Just make sure they are in network with your insurance.

Published on Jul 11, 2012

You have a capsular contracture. You might have fluid around the implant accounting for the size difference? You need surgery to fix that. Take out the implant and scar capsule and put in new implants. If there is anything unusual with the scar capsule, they could send it to get it checked out. Your PS might also suggest some ways of preventing a CC this time.

Published on Jul 11, 2012