Why is my Right Breast Swollen, Tender and High Up on my Chest 6 Years After Saline Breast Implants?

I had saline implants 6 years ago and recently my right breast has become swollen tender and is high up.my plastic surgeon said it might be capular contraction but when i went for an ultrasound today,they only found leakage.my surgeon said it cant be a ruptured implant because it would have deflated so now he thinks its seroma or an infection,says to wait 2 weeks to see him.will i have to have my implants removed and for how long,why is my surgeon not putting me on antibiotics any input please

Doctor Answers (11)

Right Breast Swollen, Tender and High Up on my Chest 6 Years After Saline Breast Implants

+1

If you have silicone gel implants, there would be no deflation, just a leak of the implant material; if they are saline, then a leak would deflate the implant and make your breast smaller.  From you description, you have an infection until proven otherwise; this may include a capsular contracture and a seroma.  You should be seen sooner rather than later.  If you surgeon is not available, I would recommend getting a second opinion. You indeed may need your implants out.  Good luck!


Newport Beach Plastic Surgeon
5.0 out of 5 stars 86 reviews

A deflation is unlikely

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A deflation is unlikely as that would cause the implant to become smaller rather than larger. The most likely cause of your problem is capsular contracture. There are some rare conditions that can cause late seroma around an implant. Infection seems unlikely. If they found fluid around the implant in the previous ultrasound, I would advise sampling that fluid under ultrasound for both pathology and cultures. You may need removal of the capsule and replacement of the implant.

John Squires, MD
Denver Plastic Surgeon
5.0 out of 5 stars 51 reviews

Why is my Right Breast Swollen, Tender and High Up on my Chest 6 Years After Saline Breast Implants?

+1

At 6 years a seroma would be very unlikely. Capsular contracture would be my first thought or if you had a recent dental infection the implant cold have been seeded with bacteria.  Sometimes a rare carcinoma can occur. I think a physical examination and an exploration are warranted soon.

Thomas Guillot, MD
Baton Rouge Plastic Surgeon
5.0 out of 5 stars 5 reviews

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Augment and swelling 6 years later

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Without an exam it is difficult to say but if you have an infection then the implants should be removed for a few months before replacing them.

Steven Wallach, MD
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Issues 6 years after augment

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I would strongly doubt the presence of a seroma presenting six years after surgery.  If you have a slow leak, this would cause a deflation and not the swelling and tenderness.  The ultrasound can be followed up with an MRI.  I would also have concerns about carcinoma which needs to be ruled out as well as capsular contracture.  You should have treatment expeditiously.  Best of luck to you.

Robert L. Kraft, MD
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Swollen, painful breast 6 years after a breast augmentation

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Sorry to hear that you are experiencing difficulties with your implants.  Unfortunately, it is difficult to determine the cause of your problems without a physical examination.  However, since it is several years since your original surgery, an infection or seroma without any preceding trauma is unlikely.  More likely causes do include capsular contracture or possibly a rare type of cancer (known as ALCL).  The typical treatment for both capsular contracture and ALCL is surgical removal of the implant and capsule.  I would definitely recommend that you see your plastic surgeon and discuss potential causes of your discomfort and potential treatment options.  Good luck!

Anureet K. Bajaj, MD
Oklahoma City Plastic Surgeon
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Breast Swollen, Tender And High Up On Chest 6 Years After Augmentation

+1

A firm breast that rides high on the chest after augmentation is very typical of a capsular contracture. Having said that a new significant seroma around the implant this far out from your original surgery, without any antecedent history of trauma to the area, one must entertain the possibility of cancer until proven otherwise. While infection is not out of the differential diagnosis and is a close second, you did not specify if you had erythema (redness) or were experiencing fevers or chills. In any case, I would recommend an expeditious work up with at a minimum an evaluation of your periprosthetic fluid (fluid around the implant). Should this be an infection, removal is certainly indicated. Good luck.

Pedro M. Soler, Jr., MD
Tampa Plastic Surgeon
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Breast swollen and tender 6 years post augmentation

+1

without an examination I feel that it would be very difficult for a surgeon to tell you exactly what is going on. It can be a capsular contracture, it can be an infection that "seeded" the pocket. Typically with an infection the swelling will increase and the area will get reddened. I would recommend closer follow-up than 2 weeks.

Antibiotic choice is difficult without a known organism or bacteria to treat. Without redness, your surgeon may feel that it is not. I would get a blood count and sed rate to see if you have an infectious process going on.

I would also recommend a second opinion if you feel you are getting no where with your surgeon. I do agree with your surgeon if it is a saline implant and you leaked it would go flat.

Rick Rosen, MD
Norwalk Plastic Surgeon
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Development of seroma six years after breast augmentation needs attention.

+1

Six years after breast augmentation the development of firmness in the breast is almost always due to capsular contracture. In this particular case the diagnosis of "seroma" has been made. This could be a very unusual infection or a very rare type of malignancy. It needs to be addressed promptly.

Vincent N. Zubowicz, MD
Atlanta Plastic Surgeon
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Seroma or Infection and No Antibiotics 6 Years after Breast Augmentation

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    Any concern for infection should be evaluated in person to determine if intervention is needed.   Antibiotics would be appropriate as well.  Kenneth Hughes, MD Los Angeles, CA

Kenneth B. Hughes, MD
Los Angeles Plastic Surgeon
5.0 out of 5 stars 220 reviews

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.