You probably have some contracture

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Contracture is expected to some extent after the placement of breast implants. It is a matter of degree and time, really. Frequently, the contracture is mild and we leave it alone. More severe contracture can raise the question of treatment. Silicone gel implants over the long term are very prone to contracture.

Surgical treament almost always reduces or eliminates the problem but it can recur particularly in breast reconstruction cases in which the patient has had mastectomy, radiation therapy, or chemotherapy.

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Capsular contracture, or hardening of your breast implants, may be mild or severe. If mild, one can generally leave it alone; however, if severe, the implant can get quite hard or firm and cause some discomfort. Additionally, the implant can look deformed and migrate upwards causing asymmetry of your breasts. In this case, many patients will benefit from open capuslectomy where the scar tissue is actually removed surgically.

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The reality is that all women who have implants will develop some scar tissue or capsule around the implant.  The degree of firming around a breast implant is categorized according to the Baker system: I: soft, natural; II slightly firm, implant edge not visible; III firm, implant edge visible and palpable; IV firm, painful and distorted.  Very few surgeons will recommend surgery for Baker capsular contracture grades below III.  Once a Baker IV capsule distorts the shape by making it more narrow, shift upwards and possibly have the breast tissue fall off it, surgery is the only option.  Lesser grades may be manageable with massage and or drugs such as Accolate or Singulair.  A surgeon who has an active interest and experience with breast implants will be able to evaluate you.  This diagnosis does not require any objective studies, such as a MRI. Good luck

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