I am having my 24 year old over muscle silicone polyurethane coated implants removed on the 29th of this month. I am traveling to Dallas for surgery. I notice that the right one now has started to hurt and when I lie down on my stomach I have this very odd pain under that breast. What could this possibly mean?
Breast Pain and What Could It Mean?
Doctor Answers 1
Breast Pain and Capsular Contracture
Capsular contracture results from an overzealous immune response to a foreign body. In the case of breast implants, capsular contracture can cause painful distortion of the implant and overlying breast tissue. The Baker scale is used to determine the severity of this response:
Grade 1: Soft, natural appearance
Grade 2: Palpable firmness, natural appearance
Grade 3: Firm, distorted appearance
Grade 4: Firm, distorted and painful
Longstanding implants and subglandular silicone implant placement can increase the risk of developing capsular contracture. In cases of implant rupture, localized scarring and silicone granuloma formation can also elicit breast pain (Baker Grade 4).
Breast implants can be evaluated for rupture with MRI and ultrasound. The FDA currently recommends that an MRI be performed 3 years after silicone implant placement, and every 2 years thereafter.
Removal of the breast implants and the surrounding breast capsules (capsulectomy) should be expected to relieve the symptoms associated with capsular contracture. Drains are often placed to decrease the risk of seroma formation postoperatively. Following implant reomoval, the breast may sag (breast ptosis). This can be corrected at an interval (generally 6 to 12 months) with a bilateral breast lift (mastopexy).
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