I had a second revision on right breast on March 17. It is still swollen and I have a small lump in the right upper outside that I noticed yesterday. I was instructed not to massage for 3 weeks, but am concerned about scar forming before that. Any thoughts? How long does the swelling last? Thanks in advance!
How Long Does Swelling Last After Open Capsulotomy?
Doctor Answers 10
Upper Breast Lump Following Revision
Postoperative swelling, especially after capsule procedures can last several weeks. This lump could be a collection of blood or fluid, or even a reactive lymph node. In the presence of swelling, it may be difficult to ascertain the nature of this lump. Nevertheless, I recommend visiting your surgeon promptly, especially if this lump increases in size quickly.
Capsules and swelling
After a capsulectomy or for that matter any surgery will leave residual swelling for several months after surgery.
You didn't mention having a drain
It is not my practice to use drains for primary augmentations but I do use them frequently in capsulotomy and capsulectomy patients. I am usually surprised how much they drain and I am always glad I used the drain. I will bet you have fluid around the implant. This might be absorbed by your body or it might need evacuation if it is more than a small amount. An ultrasound would help to determine this. They could also drain it under ultrasound guidance to protect the implant. Much fluid, left around the implant, could incite the beginnings of another capsular contracture.
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Most capsulotomy swelling should be gone within a month
Some swelling after capsulotomy is expected, but usually most is gone after about a month.
Scar tissue formation would not be dependent directly on massage. The massage will help keep the pocket open and stretch the spasm muscle.
Capsulotomy swelling can last a few weeks or more
Swelling after surgery can last a while and it is difficult to know without knowing more about your case. Some of these cases are simple and others require more surgery. The longer operations tend to have swelling that takes longer to subside.
The capsule will not recur in such a short period of time. It takes longer to form.
Too early to tell
At 10 or 12 days out from your surgery it is too early for you to develop a new scar contracture. The small lump may be a lymph node that is reacting to the trauma of surgery. Follow up with your surgeon for updates on your progress. Good luck!
Too early for a recurrence
It is possible that the lump that you are feeling is swelling in the breast tissue itself and not related to the formation of a new capsule. At 10 days the breast would be expected to be firm but it is unllikely that an abnormal capsule is already reforming. If an extensive capsulectomy or capsulotomy was performed then post operative swelling is expected. Your surgeon is in the best position to determine the next appropriate step for you. He understands where the capsulotomy was performed and what physical findings are normal and which are abnormal.
There shouldn't be a lot of swelling after capsulotomy
There should not be much swelling after a capsulotomy. If there is a lot and that breast is much larger then the other, you might have a fluid collection. The small "lump" may represent fluid or, be a bulge from the implant resulting from the capsule being opened in that area. If the "lump" feels like the rest of the implant, that is what it probably is. I am sure you have or will be seeing your surgeon about this!
You probably have some liquid in your right breast.
Hi. You need to have a sonogram of your breast.
If you do have fluid (a seroma), an experienced interventional radiologist can aspirate the fluid out with a needle under ultrasound control without risk of puncturing the implant. So you don't need another operation.
If you do have fluid, it should not be left in, because you will get a capsular contracture.
I would recommend not massaging your breast. It will not help, and might be harmful. I am sorry to give you a contradictory opinion. I know this is very confusing. But I do have a lot of experience, so I think I am giving you good advice.
Swelling means you may not be ready for massage
Capsulotomies can sometimes be more traumatic than the initial augmentation. In revision surgery, many times we use a drain to remove serous fluid that could remain behind. It is not unusual to be sore and have some residual swelling at 3 weeks. We don't recommend massage if the breast is still swollen and painful. You are right to be concerned about the scar forming again and you should be in close contact with your surgeon. There are some other measures we use from time to time: extrenal ultrasound and some oral medications that may help with the capsule formation. Discuss all options with your doctor as he/she is just as interested in not having that scar tissue form again.
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.