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Surgery for Silicone Breast Implant Complication?

I had Silicone Breast Implants 6 months ago, and everything was okay until ten days ago. I felt pain like electric shocks in my left breast, and when I lift it up, I see what looks like a vertical vein that is rock-hard when I touch it. It extends downward for 3-4 cm from my scar line. My doctor said I need steroid injections, but when I took one, it didn't help with the pain. He said that I might need surgical intervention. Is it really likely that I need surgery for this?

Asked 39 months ago by Libra73 in Kuwait
Sort 19 expert answers by:
+2

Mondor's Disease

It sounds like what you're describing is Mondor's disease, although it typically resolves prior to 6 months. Re-operation is not the treatment of choice but anti-inflammatories, massage and careful monitoring. See your plastic surgeon and discuss your post-op problems in detail. I hope this helps.
Steven H. Williams, MD
San Francisco Plastic Surgeon
+2

Mondor's disease is probably the culprit

The symptoms described are most consistent with Mondor's disease or Mondor's thrombophlebitis. Thrombosis of a superficial vein leads to a cord-like structure in the vicinity of the fold incision. We have seen this in a handful of patients, but usually we see within one month of surgery. Seeing it as late as 6 months is possible but less likely. Either way, treatment should be conservative with anti-inflammatories and compresses. Each and every case we have seen resolved fairly... more
Francisco Canales, MD
Santa Rosa Plastic Surgeon
+2

Mondor's Disease Complicating Breast Augmentation

The differential diagnosis of a hard, painful vein on the breast following breast augmentation is a condition known as Mondor's disease. In this condition, the vein in the superficial aspect of the breast becomes thrombosed, or clotted. This is primarily a non-surgical disease that is best treated with warm compresses, observation, and non steroidal anti-inflammatory agents such as Motrin. The condition is akin to venous thrombophlebitis, which more commonly occurs in varicose veins of the... more
Raffy Karamanoukian, MD
Los Angeles Plastic Surgeon
+2

Conservative care is required, not surgery!

I agree with the majority of the other physicians: What you have described is inflammation to the superficial veins of the chest wall and breast which is known as Mondor’s disease. This typically responds to conservative measures of anti-inflammatory medication, warm soaks, and gentle massage. This problem is seen infrequently. In 23 years of practice, I have only seen a hand full of patients and no one has required surgery! Thanks for your question.
Stephen A. Goldstein, MD
Denver Plastic Surgeon
+2

Sounds like a Mondor's band

What you are describing sounds like a Mondor's band extending down from the breast. These are typically self-limited and respond to massage, Motrin and time. Early in a surgeon's career, they might think a scar release is necessary but time and experience with this teaches one that these bands resolve without surgery. On the other hand, without seeeing you, it could be something else...
Richard P. Rand, MD, FACS
Seattle Plastic Surgeon
+2

Mondor's or another infection.

If it as you say, then the suggestions below about Mondor's disease is appropriate and the treatment should be warm compresses and non-steroidal anti-inflammatory medications. If it is a localized infection then maybe your docotor is correct in his/her diagnosis and treatment. However, infection should be accompanied by redness and pain. Some people will have a low grade fever at the start. Good luck!
Robert M. Freund, MD
New York Plastic Surgeon
+1

Mondor's disease is not related to breast implants.

What you describe sounds like Mondor's disease, a painful inflammation of a superficial vein of the breast.  Most of the time it responds to anti-inflammatory drugs and is self'-limited.  It has nothing to do with your breast implants. 
Vincent N. Zubowicz, MD
Atlanta Plastic Surgeon
+1

Mondor's Disease - by history

I would have to agree with most Plastic Surgeons posting here that this sounds like mondor's disease - superficial vein thrombophlebitis--and will resolve with local local such as warm soaks, anti-inflammatories and close follow-up by your plastic surgeon. OF the 4 cases I have seen in 20+ years of practice, none have resulted in capsular contracture formation or need for surgical intervention.
Steven Schuster, MD
Boca Raton Plastic Surgeon
+1

Would avoid steroid injections on breasts

I agree with the diagnosis of Mondor's disease although this is a late presentation. Steroid injections could thin the tissue in the area and put you at risk for implant exposure in the future, so I would avoid them.
W. Tracy Hankins, MD
Las Vegas Plastic Surgeon
+1

Agree with Mondor's diagnosis but another possibility exists...

Sure sounds like Mondor's disease; probably not related to your breast surgery this far out, by the way. But, it also could be swelling in the milk line. From an embryologic standpoint, there is a line from the chest to the pubic area in the region where other mammals such as dogs have multiple nipples. Although we humans usually don't have multiple nipples along this line, there is a remnant of this tract. With drastic fluctuations in hormones or followng chest surgery, this ligament... more
Brian K. Brzowski, MD
Salt Lake City Plastic Surgeon
+1

Mondor's disease

I agree with the previous diagnosis of your issue. Surgical intervention is rarely if ever required. Non-steroidal anti-inflammatory medication, warm packs and rest as mentioned by the other surgeons here is the treatment of choice. Close follow-up and frequent examination to make sure it is resolving is the best course to follow. Good luck.
Bahram Ghaderi, MD
Chicago Plastic Surgeon
+1

Non-steroidal anti-inflammatory drugs, rarely surgery

Most likely Mondor's disease. The treatment is non-steroidal anti-inflammatory drugs, warmth, and rest. Rarely thrombous removal is needed. In general, this will improve on its own. Good Luck
Hisham Seify, MD, PhD
Los Angeles Plastic Surgeon
+1

Sounds like Mondor's Disease, but...

Hello, You likely have Mondor's disease as the others here have mentioned, but make sure your surgeon follows you in the office until this resolves. There are less likely things like scarring/capsular contracture that only proper follow-up will exclude.
John P. Di Saia, MD
Orange Plastic Surgeon
+1

Sounds Like Mondor's Disease To Me

This sounds like Mondor's Disease which is a self limiting harmless clot in a veign below the breast. It can be quite impressive looking (not to mention scary looking and uncomfortable) to wee when it is a long involved vein. Treatment is usually supportive and includes warm moist heat, and Advil. Steroids, injections around an implant, and surgery all carry risks that must be weighed carefully in treatment.
Scott E. Kasden, MD
Dallas Plastic Surgeon
+1

Another possibile idea...

Follow-up with your doctor is important because there are alternative causes which can better be determined by in-person exam. Mondor's disease is vein inflammation. Another possibility for a hard band extending downward from an inframammary incision would be related to the surgical closure of the deep fascia layer. These bands are rarely painful and usually go away with time and massage, but steroid injection would be an alternative. Good luck.
Sutton Graham II, MD
Greenville Plastic Surgeon
+1

Mondor's

A painful cord extending down from the fold or incision under the breast is called Mondor's Disease. It is caused by a thrombophlebitis of the superficial vein running vertically down the mid-chest. Mondor's Disease is temporary, and usually resolves over the course of a few weeks. Steroid injections should not be required, nor is re-operation necessary. Non-steroidal anti-inflammatory medications and warm compresses generally speed the resolution.
Athleo Louis Cambre, MD
Los Angeles Plastic Surgeon
+1

Give it some time before additional surgery

You most likely have a Mondor's cord, which is usually attributed to inflammation due to clotting in a vein, though in the case of breast implant surgery it may be something different. I have seen it several times and have never had to do surgery for it, though your case sounds a bit more severe than usual. I would give it some more time and even another injection before surgery.
Richard Baxter, MD
Seattle Plastic Surgeon
+1

Seems like Mondor's disease

Sounds like you have Mondor's disease which is basically a superficial thrombophlebitis which is often self-limiting and usually responds to anti-inflammatories and warm compresses.
Steven Wallach, MD
Manhattan Plastic Surgeon
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