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?
Surgery for Silicone Breast Implant Complication?
Doctor Answers (19)
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.
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 quickly with the above therapy. No surgery has been needed by my patients, although I have heard of surgeons who like to excise the thrombosed vein.
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 lower extremity.
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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.
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...
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!
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.
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.
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.
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 can become enlarged/inflammed. Typically this will resolve on its own, but you will want to be certain that you're not having any other issues with the breasts such as a lump/infection/etc.
Close communication with your plastic surgeon is key!