Will I Have to Get a Redo if my Implant Pocket is to Small? How Can I Tell if This is the Problem?

34 B pre op. 550cc silicone, under muscle. my right breast gave me pain about 3 or so weeks after, then out of no where it began to harden around the right side of the right breast. all the symptoms seemed to point to mondors disease, but when i lay on my stomach,on implant and get back up its soft for a second,then it turns hard again, feeling like maybe the pocket is to small and it pops right back out when i get up,i dont know..anyone?? i am now 3 months post op with the same problems.

Doctor Answers (11)

Revision

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Unfortunately, without a complete history and physical exam and through pre operative photography there is not enough information to make an informed plan, please consult your surgeon or another local board certified plastic surgeon


New York Plastic Surgeon
5.0 out of 5 stars 39 reviews

Too small of a pocket for implants

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Hello and thanks for the questions.  In regards if the pocket was too small, this is more than likely not the case.  What it sounds like you are describing is that there is still some swelling occuring on that breast and laying on it removes it temporarily.  I would definitely recommend seeking another visit with your PS and demonstrate what you are describing here.  Best of luck.  Robert Kratschmer, MD

Robert Kratschmer, MD
Houston Plastic Surgeon
4.5 out of 5 stars 10 reviews

Concerns after Breast Augmentation?

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I'm sorry to hear about the problems you have experienced after breast augmentation surgery. Unfortunately, despite your good description, it is very difficult to give you precise advice. Much of what should be done can only be determined after an accurate diagnosis is made; this diagnosis can only be made accurately after direct examination.

 Demonstrate your concerns to your plastic surgeon;  if still in doubt, seek a 2nd opinion in person.

 Best wishes.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 753 reviews

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Schedule a follow up visit.

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It is hard to advise you just by a description alone what you are experiencing.  The best thing to do is schedule a follow up visit.  Ther hardening sounds like it may be capsular contracture, but there may be things to do at home such as breast massage that may soften this up a little bit.  Best of luck. 

Otto Joseph Placik, MD
Chicago Plastic Surgeon
5.0 out of 5 stars 44 reviews

Problem?

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Without an actual exam or at least a photo, it is difficult to give useful advise. This does not sound like Mondor's disease which causes narrow bands in the breast fold from clotting of tiny veins, and which cause no symptoms. This does sound like capsular contracture, although I don't quite understand the description you have posted. 

My useful advise: arrange a visit with your surgeon for evaluation.

Thanks, and best wishes. 

Jourdan Gottlieb, MD
Seattle Plastic Surgeon
4.5 out of 5 stars 31 reviews

Implant pocket too small is capsular contracture

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By definition an pocket that was fine and now has become tight or small is capsular contracture. We cannot tell for certain without an exam, so have your surgeon take a look.

Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 29 reviews

Pain 3 months after surgery

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You really need to see your own surgeon. It is impossible to for anyone to tell you accurately what's going on without an examination.

Ronald Schuster, MD
Baltimore Plastic Surgeon
4.5 out of 5 stars 27 reviews

Breast Augmentation and Capsular Contracture

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It sounds like you have a capsular contracture.  It is very important for you to follow up with your plastic surgeon within the next week or so.  Capsular contractures can sometimes be treated with oral medication and massages if they are caught early.  Otherwise, they require additional surgery.

Best wishes with your recovery!

Patrick C. Wilson, MD
Huntsville Plastic Surgeon
5.0 out of 5 stars 5 reviews

Capsular contracture

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Of course without an exam, I can not be sure what is going on, but it does sound like a capsular contracture. Best to see  your surgeon.  Good luck.

Steven Wallach, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 17 reviews

This is not Mondor's. This sounds like capsular contracture.

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First of all, Mondor's thrombophlebitis is NOT a "disease," it is an inflamed, painful thrombosed vein (literally "thrombophlebitis") of a superficial epigastric vein below the breast(s) where a crease incision cuts through this vessel, which clots and becomes a tender "cord-like" structure. This is common, and resolves with time, warm compresses, and anti-inflammatory medications. Mondor's occurs just after surgery, not 3 months post-op. If you had Mondor's, this has resolved by now.

So something else must be going on!

Your description sounds as if the tightness is more or less constant, so muscle spasm is less likely. If you were simply having muscle spasms, the tightness would be intermittent, and you would have periods where your breast was soft. Sometimes the breast on the same side as your dominant hand, or the breast that had a little more swelling or bruising after surgery, has a higher tendency to have muscle spasm as a problem. This too usually settles by three months after surgery, particularly if your surgeon used smooth implants and had you do implant displacement (often inaccurately called "massage") exercises after surgery to keep your surgical pockets slightly larger than your implants.

But constant tightness 3 months post-op only fleetingly improved by hard pressure (laying prone on your breast with your full body weight) seems as if you may well be developing capsular contracture in that breast pocket.

See your surgeon, who may wish to consider Accolate or Singulair (leukotriene inhibitors) and VItamin E orally to halt or improve your tightness. This medication regimen works in about half of patients in whom it is tried, but if it does work, you have avoided an operation, which is necessary to try to correct capsular contracture in the remainder of patients in whom tightness continues or progresses. Best wishes and Happy Holidays! Dr. Tholen

Richard H. Tholen, MD, FACS
Minneapolis Plastic Surgeon
5.0 out of 5 stars 126 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.