Dear Patient: the best option is to go see your Plastic Surgeon and, if you are still in pain, get a second opinion. It is very hard to determine what is going on without a proper examination. Make sure your Plastic Surgeon is Board Certified and is a member of the American Society of Plastic Surgeons (ASPS).

Published on Jul 11, 2012

Breast implants can form scar tissue around them, and this can be painful. This can start in the first year and is likely related to blood around the implant. Issues with implants after 3 years could be a delayed capsular contracture; however, other issues could be animation deformities from the pectoralis major muscle. Implants placed under the muscle can move with muscle contraction, though inappropriately released muscle can cause issues with the implants.

Published on Jul 11, 2012

Thank you for your question. I am sorry for your discomfort. The pain you are experiencing is most likely related to the implant causing pressure or stretching of nerve endings. Depending on the size and placement of the implant, you may also be experiencing a gradual attenuation or thinning of the soft tissue from the pressure of the implant. That would explain the recent appearance of the flap or droop. If your breast tissue is not adequately supporting the weight of the implant, and you are experiencing some degree of "bottoming out," then you may want to consider a secondary surgery to reinforce the breast tissue and possibly changing the implant. I hope you feel better soon.

Published on Jul 11, 2012

The key here is the fact that you have a painful red mark. This means that you have an area of inflammation. Also, pain is rarely a normal long-term finding after a breast augmentation, and tends to say that you have a potential surgical problem. It sounds like you need a more thorough evaluation. You need to see if you have a capsule contracture, a possible infection, or possible erosion of a buckle or wrinkle in the implant that is irritating your soft tissue. I would suggest an MRI as the best one-step test to closely evaluate what is happening there. A trial of antibiotics is also a reasonable investigative tool. My most effective regimen is a two-week course of Levaquin.
If your problem responds to the antibiotic, it pretty much tells you that you have an infection. At any rate, you may need to face up to considering surgery to correct the problem. If your present surgeon is not willing to investigate further, I would seek a board-certified surgeon with known experience with breast implants.

Published on Jul 11, 2012

Not sure what you are describing with the flap/droop. Gravity does affect things over time, so it could be the culprit.

Published on Jul 11, 2012

Without a physical examination or a photograph of your breasts, it's hard to say what the condition is. The first that comes to mind is the "Snoopy" deformity, where the breast implant is sitting too high beneath your breast and the areola and nipple are falling beneath the center of your breast. If that's the case, you'll need a lift to revise. If you're having pain 5 years after an augmentation, it's also possible you're forming a capsule and could need a capsulectomy. I would suggest a second opinion that includes a physical exam. Best of luck.

Published on Jul 11, 2012

Thanks for your question, but at this time, Dr. Stein would need to see you for a another opinion and examination, in order to determine what is going on with your condition. You should be asking your surgeon, and if not sure about the next step, you should seek another view point on your status.

Published on Jul 11, 2012

Thank you for your question. Unfortunately, without an examination, it will be difficult to give you good advice. Sometimes when there is breast implant malposition, it may cause discomfort. Best to be examined by a plastic surgeon for best advice.

Published on Jul 11, 2012

Thank you for sharing. You should see a board-certified plastic surgeon who can direct you. If you are looking for a second opinion, only an in-person consultation can help; an online forum cannot make the assessment for you. Consider a local second opinion. Best wishes!

Published on Jul 11, 2012