I had a breast augmentation 2 years ago. In the last week my left breast has felt tight. No pain, no change in shape, nothing out of the ordinary. It just feels tight. I had gone two years without even noticing I had breast implants (they became a part of me) but now I can "feel" the left one. What could it be?
Breast Augmentation 2 Years Ago - Started Feeling Tight a Week Ago
Doctor Answers 23
Breast Starting to Feel Tight
Your story sounds like a beginning capsule contracture, a tightening of the tissue around the breast implant.
See your Plastic Surgeon as soon as possible to see if the process can be halted or improved.
Breast implant firmness/capsule
It possible that you are experiencing mild capsular contracture that may develop at any time after breast augmentation. The cause of this excessive scar formation is unknown and patients sometimes require revision and replacement of the implant if it progresses to become very uncomfortable.
Please make certain that you have undergone a thorough breast examination by your physician and yearly mammogram if indicated by your age. Other medical processes must be ruled out and implant integrity should be evaluated.
Dr. Pedy Ganchi
See your surgeon
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Changes in breast augmentation at two years
Capsule contracture -- contraction of the normal capsule (not "encapsulation") is still a rather mysterious process in plastic surgical medical science. From a pathophysiology/medical science standpoint, it is hard to imagine how a smooth surface implant that was healed and doing fine in a normal capsule could change on one side without bacteria or some irritant introduced into the space in or around the capsule (essentially a scar tissue layer). Possibilities include access via the bloodstream or through the breast tissue ducts.
It is not clear after only a week that capsule contracture is what is going on but early treatment with certain drugs or antibiotics has been suggested and tried. Another possibility is that the problem is in the breast tissue around the capsule (fluid retention, inflammation) and is a breast tissue problem rather than an implant or capsule contracture problem. I have also seen what seems to be symptoms from nerve irritation or stretching rather than capsule contracture. Breast tissue or nerve symptoms might resolve without treatment but anti-inflammatories would be worth trying along with observation over a menstrual cycle or two and could resolve it.
It sure sounds like you may be developing an early capsular contracture around the left breast implant. All patients develop a capsule around their implants, but a few can develop a tighter contracture around their implants. The best treatment for now is restarting a more vigorous massage of your implant four times a day(one minute per time). Take your hand and start massaging your implant inwards, outwards, up, and down in an effort to "loosen it up". It is usually best to consult with your plastic surgeon to review the best massage technique. If the tightness becomes worse or produces pain, surgery may be necessary, so it's wise to start your massage as soon as possible. Best wishes.
Michael Vincent, MD, FACS
Characteristics of capsular contracture
If you are beginning to experience unilateral tightness of a breast, after a 2 year "honeymoon", I concur that the scar envelope around your implant may be getting thicker. All breast implants elicit a "foreign body" reaction or capsule, which is graded as a Baker I-IV stage. The lower the stage are preferable. Surgery (open capsulectomy or capsulotomy) will be recommended for Baker IV capsular contracture, whereas you may be eligible for medical management of less severe stages. Some modalities include massage or a course of treatment with Accolate or Singulair, which are used in an "off label" method.
Patients will offer the following observations about capsular contracture: a) my breast feels tight or firm; b) my breast seems to be getting narrower and rising up below my collar bone; c) my nipple is pointing down. The natural history of breast capsular contracture is steady progression. The pathogenesis of capsular contracture is unknown but the rates vary from 2-20%, so 2-20/100 women will have another procedure due to accumulation of scar tissue around their implant.
Please consult with your PS to get their input on your observations. Good luck.
Tightness after Breast Augmentation, from San Diego
Likely early capsular contracture. See your plastic surgeon, and consider a course of Montelukast or Zafirlukast.
May also consider mammogram and/or MRI to image the devices and check for rupture.
Capsular contracture in Breast Augmentation
Tightness after breast augmention.
Unexplained tightness which cannot be explained by recent exercise or activity is concerning for capsular contracture. I recommend making an appointment with your plastic surgeon for a thorough examination and treatment options.
See your surgeon for a yearly breast check up.
In my practice, my patients come back for yearly breast check ups. This enables the patient to make sure everything is still ok. You should call your PS and schedule a check up just to be safe.
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.