Helena Guarda, MD

From your question, it appears you have had a workup showing no cause for the enlarged lymph nodes. You also report having pain and capsular contracture on the same side. I recommend seeing a plastic surgeon for evaluation and implant removal/ exchange. It is not uncommon for capsular contracture to cause pain. During the procedure if the capsule is thick, which it most likely is given the contracture, it will be removed. You should discuss with your surgeon implant exchange. Your surgeon will examine you and determine if lymph node biopsy is best at the same surgery or waiting .

Please make sure you are evaluated and do not ignore the pain.

Wish you a speedy recovery 

Your situation is not uncommon. Many women have asymmetry of their breasts. Your right breast is smaller and appears to have tighter skin envelope below the nipple. On exam your surgeon would feel the skin quality and tightness. A dual plane breast augmentation would release this lower if needed and a larger implant can be used to reach better symmetry. During consultation the size and profile will be determined on your measurements and skin quality. I find it helpful when patients have their questions written so they can all be answered.

wishing you a wonderful outcome 

During your consultation your surgeon took measurements to determine which size implant would be best on your body frame. The 55cc difference will translate into slight increase in medial and upper pole fullness; this sounds like what you are hoping to achieve. Make sure to communicate with your surgeon your goals. It sound like your are on your way to great results.

Best of luck with your surgery

In your photo there is an additional crease in your breast. Physical examination should determine if this is muscle or skin only creating this crease. If this is scored and released during implant placement it should improve after your procedure.

Best of luck on your surgery

Lipomas are fatty tumors often enclosed by a small thin capsule. If not completely removed they will recur. Liposuction can be done and create a smooth appearance but the entire lipoma may not have been removed and it may recur. There are other nonsurgical techniques that have been used including Kybella and Coolsculpting with some success. Most small lipomas "pop out" through a small incision. 

I recommend consulting with your surgeon regarding the different options and which will provide the best outcome for you. It would not be unreasonable to remove one first to assess your healing before committing to all. Most insurance carriers will cover excision of lipomas if they are painful but will not cover these other techniques.

Best of luck

It is very common to find a rupture on mammogram from an old implant of this age. Many of the women I have treated have had some weight gain and increase in breast size from the time of their surgery.  This extra breast tissue allows for removal of the implant and possible breast lift if needed. 

During the surgery it is common to find the implant gel has leaked beyond the shell of the implant but is contained within the capsule. Removing the capsule from the muscle may injure a few muscle fibers but this should cause no effect to you. There may be some increased in pain postoperatively but generally well controlled and resolved with in normal healing frame. 

I recommend seeing a board certified plastic surgeon for consultation. If you information regarding your implant that is helpful to determine what size implant you have and how much breast tissue is present. You can then decide if you simply what the implants removed with a capsulectomy or a breast lift  or implant replacement.

Best of luck

thank you for your question and photo.

From your photo there is some swelling still present, the scar has widened and there are marks from what may have been sutures. I would recommend waiting a few weeks for the edema to improve and consider revision of the scar. This could be done  in the office under local anesthesia. A plastic surgeon should be able to help you

Best of luck

Unfortunately tension on the incision line has stretched the ear giving it this shape.. Depending on what the remaining results are, this may be corrected in the office under local anesthesia. Resecuring the underlying tissue will reduce the tension and the skin. I would return to your plastic surgeon and discuss your concerns and how they can be corrected.

Best of luck

Capsular contracture can cause deformity of the breast as well as pain. From the photo it appears your left implant has dropped. The right implant appears to be positioned properly, but it may be tight and causing you pain. I would recommend returning to your plastic surgeon and discussing your pain. On exam the implant will feel harder and tighter than the left. Massage techniques may help until you have decided how to proceed. 

Wish you a quick resolution 

It is important to remember that photos don’t always tell the whole picture and they can not substitute a personal exam. From your photos it appears the implants are now displaced laterally. This is not uncommon. A capsulorraphy, repair of the capsule,  can help bring the implants more centrally. This can be done when your have your implant is replaced. A breast lift would also help centralize your breast tissue over the implant. This is best determined on exam. 

I recommend returning to your plastic surgeon and discussing your goals and see which surgical option will get you there.