Problem with my implant? Muscle tear or capsular contracture?

Question

I had an anchor lift with implants 3.5 years ago. 2 months ago I felt I tore my pectoral muscle trying pull ups at the gym. No workouts since then but the pain is getting TERRIBLE now radiates to my shoulder and neck and is constant. My breast is swollen and now breast is about 1/4th inch higher than the other. Made apt with surgeon finally week 8. He said it could be contracture or just a tear. I am to keep going to ortho doc and PT follow up withnsurgeon in a month. Any ideas what I should do?

Jerome Edelstein, MD · Answer

Please take it easy and do not do any physically demanding activities to minimize the risk of further damage. All you can do is wait, but I recommend you see your surgeon as soon as possible. Best of luck.

Thomas Fiala, MD, FACS, FRCSC · Answer

Based on your history, a muscle strain or tear would be the #1 diagnosis. Rest - no gym at all -, use heat, and anti-inflammatories, and give it about 4-6 weeks to heal. Follow-up with your surgeons, as you mentioned.

Curtis Wong, MD · Answer

You can usually tell the difference with contractures usually not hurting until well established with deformity versus acute symptoms following an event you clearly recall. Regardless, you do need a face to face visit with your surgeon. In the meantime, resting that side and anti-inflammatories are simple things you can do while waiting. Wishing you the best...

Steven Wallach, MD · Answer

It sounds like by your description that you had a muscle tear.  A capsular contracture is a clinical diagnosis and an exam would often be definitive.

Jeffrey Zwiren, MD · Answer

The medical history that you give seems to point to a musculoskeletal problem and not a capsular contracture. With rest and time it is likely to get better. If the tightness of the breast gets worse then it could be a capsular contracture. Your plan to follow up with your plastic surgeon and an orthopedic surgeon seem reasonable.

Lisa M. DiFrancesco, MD · Answer

Thank you for the question. It sounds like a musculoskeletal problem and not capsular contracture. It may be helpful to get an MRI before you follow up with your plastic surgeon.

Pablo Prichard, MD · Answer

Dear Liz,

	Thank you for your question.  It seems unlikely that this is a problem with the implant as it occurred immediately after straining a muscle during pull-ups.  It sounds more like a muscle tear.  Pain from a capsular contraction is more gradual in onset and not immediate such as this.  An MRI will identify if you tore a muscle or if there are any problems with the implant.

	Best Wishes,

	Pablo Prichard, MD

Jourdan Gottlieb, MD · Answer

This sounds like a problem with the musculoskeletal system rather than something related to the breast surgery. My advice would be to continue with physical therapy and orthopedic evaluation. 

	All the best.

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