9 Years Post-op - I Am Having Pain, Implants Are Soft. Causes?

The pain is in both breasts but it is intermittent. They still feel soft, although they were always kinda firm because they were placed under the muscle. My right breast is rounder and my right nipple is a little higher than the left nipple. Could this be capsular contracture or maybe something else? Should I call a plastic surgeon? Thank you for any advice in advance.

Doctor Answers 11

Examination Required

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To detect capsular contracture and the reason for your intermittent pain you should see a Plastic Surgeon who is experienced in breast surgery.

  • Preferably someone who is certified by the American Board of Plastic Surgery.

Los Angeles Plastic Surgeon

Breast pain at 9 years after augmentation

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There are so many different reasons for pain in a breast, but without an exam and thorough discussion, it is impossible to tell.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Pain post aug

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This pain may be do to the capsule.I wonder if the pain comes with your period because women's breasts many times will swell after or during their periods and this may cause traction on sensory nerves in the capsule causing pain.

Robert Brueck, MD
Fort Myers Plastic Surgeon
4.9 out of 5 stars 69 reviews

Changes in 9 year old implants.

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It is very difficult to diagnose your problem without an exam. If your implants are saline, a rupture would be noticeable in the decrease of breast size. Capsular contracture usually leads to a firmer implant, distortion of the breast, and possible pain. My recommendation is to follow up with your plastic surgeon for a physical exam to evaluate the state of the implants.

David Bogue, MD
Boca Raton Plastic Surgeon
5.0 out of 5 stars 26 reviews

Breast Augmentation, Breast Enlargement, Breast Implants

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It is impossible to answer your question in specific terms without examination and more questions.  You should always seek out the opinion of your plastic surgeon.

It is possible that you have some degree of capsular contracture.  It is possible that you have fibrocystic breasts.  Do you consume coffee, tea, chocolates?  Sometime this will contribute to the breast pain.  try not having there things and see if you are better.

Jay H. Ross, MD, FACS
Palm Harbor Plastic Surgeon

Breast pains after 9 year old implants.

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Because you are feeling pain in both of your breasts on and off, the best thing for you to do just to be on the safe side right now is to see a plastic surgeon.  If you have silicone implants, imaging testing may be required to make sure that the implant is in tact. 

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 86 reviews

Misshapen breast after breast implant and capsular contracture

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You have visible capsular contracture on the right side although it does not appear to be that severe. This manifests as a more visible breast implant outline on the right vs. the left. You need to have radiologic studies if the implants are silicone. If there is any evidence of silicone implant rupture part of your surgery may be covered by health insurance. The surgery would be capsulectomy and implant replacement with a new implants.

Aaron Stone, MD
Los Angeles Plastic Surgeon

Mastodynia 9 years after breast augmentation

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capsular contracture is a very plausible  possibility please go and visit your plastic surgeon for follow up and advice.

Erel Laufer, MD
Dunedin Plastic Surgeon
4.7 out of 5 stars 35 reviews

Breast pain 9 years post-op should be checked.

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Particularly if you have been pain-free until recently, new breast pain, even if intermittent, may be a sign of capsular contracture or other problem. You say your breasts are soft, but have always been "kind of firm" because of submuscular placement. If this firmness has increased to any extent, you may well have developed capsular contracture. A visit to your plastic surgeon is recommended, even if just for reassurance!

The two main causes of capsular contracture are bleeding (minor trauma or injury), or bacterial contamination (such as bacteremia from dental work, occurring at the same time as minor bump or bruise to the breast allowing bacteria to enter the space around the implant, and biofilm-induced capsular contracture resulting). Regardless of cause, if capsular contracture is present, your surgeon will be able to discuss treatments ranging from oral leukotriene inhibitors (Accolate or Singulair) plus Vitamin E, to surgery (capsulectomy) to remove the offending scar capsule, enlarge the pocket, and (hopefully) allow healing of a softer capsule.

Because of the potential for minor injury to the breast (such as an inadvertent bump or bruise, or even an elbow during the night) coinciding with bacteremia (such as from dental work, including cleaning) causing capsular contracture, I do recommend oral antibiotics the night before and two hours before dental work to minimize these risks. Like wearing seat belts, you aren't necessarily planning on being in a motor vehicle accident, but just in case, you have your seat belt on, and may save your life! I firmly believe that 50 cents worth of antibiotics won't break the bank, won't cause resistant bacteria, and are very unlikely to have any adverse or side effects--but may just prevent the need for an expensive, painful, and not-always-successful operation to treat symptomatic capsular contracture! I recommend this for all of my breast enlargement patients on a lifetime basis, and recognize that I am in a minority of plastic surgeons who recommend this. I have, however, seen several cases of dentistry-induced capsular contracture, and despite recent relaxation of ADA (American Dental Association) guidelines for antibiotic prophylaxis, still make this recommendation to all of my breast implant patients.

The asymmetry in appearance may well have been present before your augmentation surgery, and careful review of your pre-operative photographs (with your surgeon) will help you see this, or it could indeed be a result of capsular contracture on one or both sides causing these early but visible changes.

A visit to your surgeon is recommended, but I would NOT recommend an MRI prior to your visit. MRI can incorrectly show implant "rupture" in 21% of cases (FDA data) where intact and normal implants are found at surgery! I recommend plastic surgical evaluation, and if surgery is necessary for any reason, your surgeon can with 100% accuracy determine at the time of surgery if there is any implant damage, rupture, or leak, and replace it. Both implant manufacturers offer free lifetime replacement if there is implant damage, and may provide help with surgical costs. BTW, the newest (5th generation) silicone gel implants from both manufacturers are cohesive, and cannot leak or rupture, so I believe this is further reason to NOT obtain potentially misleading MRI scans.

Richard H. Tholen, MD, FACS
Minneapolis Plastic Surgeon
4.9 out of 5 stars 263 reviews

Late breast pain after breast augmentation

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Capsular scar tissue comes to mind first.  However, many women wear the wrong size or type of bras.  A new activity in the gym can lead to soreness.  A muscular skeletal imbalance can be the culprit.  Please see a plastic surgeon for an evaluation.  Are you up to date regarding a recent mammogram?

H. Michael Roark, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 16 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.