Why is One Breast Hard and the Other Soft?

Without more information on what type of surgery you had, it is hard to know what is going on.  However, assuming that you had breast augmentation in the past, you probably have some sort of capsular contracture around the firm breast.  I would address this with your surgeon if indeed you have had previous breast augmentation.

As you can see from the answers, the Real Self team of excellent plastic surgeons feels  you have given insufficient information to understand exactly what your question is.  Therefore, I am going to make certain assumptions in order to answer the question I believe you are asking.  I am going to assume that you had a breast augmentation, and that after the breast augmentation, one breast has gotten much firmer than the other side, and as it has gotten firmer, it has also gotten painful.  Assuming that this was not immediately after surgery and there is no bruising, I am going to assume it is not a hematoma, and that it is, in fact, what is called a capsular contracture on the hard side. 

The body's response to a foreign body, be it a splinter in your finger or a breast implant on your chest, is to form a scar around it.  This scar is your immune system's way of protecting you from this foreign object which is seen as an invader.  When this scar or capsule starts contracting inward, it forces your breast implant into a smaller and smaller space, which moves upward and becomes rounder and harder.  The nerve endings that surround the breast can sometimes be trapped within this scar capsule, which is normally the cause of the pain with the hard breast. 

Why this capsular contracture occurred just on one side and not both is the $64,000 question.  I believe the reason the capsular contracture happens on one side and not both has to do with deferential inter-operative factors working on the two breasts.  Blood around an implant and non-pathogenic bacteria around the implant or in the implant pocket are the two most common inter-operative causes of a capsular contracture. 

You need to return to see your plastic surgeon as he (there are no female plastic surgeons in Hawaii) has several modalities to decrease your pain and, potentially, cure your capsular contracture.

Although your
history is somewhat limited, it does suggest the presence of a capsular
contracture.For this reason, it’s
important to consult your plastic surgeon and have a treatment plan formulated
to deal with this problem.Whenever a foreign material is
placed inside your body, it will generate a reaction from the surrounding
tissue.This typically results in the
formation of a fibrous capsule that surrounds the breast implant.With time, the capsule tightens and undergoes
contraction.When this occurs following
breast augmentation, we call it a capsular contracture.All patients have some capsule
formation.Indeed, absence of capsule
formation might result in the implant shifting.When capsule formation results in a contracture, patients may experience
hardening of the breast, distortion of the breast, and breast pain.Capsule formation can occur at any time and,
as time goes on, the incidence slowly increases.When it occurs, patients note firmness of the
breast; as it goes on, this may be accompanied by pain and progressive
distortion of the breast.The breast may
shift in an upward direction and develop an abnormal shape.The cause of capsular contracture is
not totally understood, although multiple theories exist.When capsular contractures occur, there are
several treatment options.In mild
cases, medical management and massage may be necessary.In severe cases of capsular contracture,
surgery may be necessary.This may
require release of the contracture by performing a capsulotomy or removal of
the capsule by performing a capsulectomy.Treatment has high satisfaction rates and most patients are ultimately
happy.

This depends on how long after your surgery it's been. If you are just weeks after surgery, then this could be due to swelling affecting one breast more than the other, which will gradually resolve in the next few weeks and months. If it's been several months or years after surgery, then this could be an indication of capsular contracture. Capsular contracture causes the breast to become firmer, tighter and elevated. You may also feel pain. Not having more details about your situation, the best advice for you is to see your surgeon for an assessment.

Why is One Breast Hard and the Other Soft? This may be an indication that you have formed a capsular contracture on the harder side.

Sounds like your right breast has developed a capsular contracture (internal scarring).  You should check with your surgeon to determine the manner in which to proceed.  It is correctable.

Dr. ES

To answer this question, we really need to know what procedure you had, when  you had it, etc.  Assuming that you had breast augmentation, there may just be swelling, but there also may be a hematoma (blood collection) in the implant pocket.  You should have your plastic surgeon take a look and see what needs to be done.  Good luck.

A number of reasons cause an overly firm breast after surgery. The first question is how long ago was your surgery? Compression of the tissues is typical in the weeks right after surgery and one breast may be firmer than the other. Allow about 4 months for the tissues to relax, soften and even out. Recent hardness can be a sign of capsular contracture. This may require surgery depending on how severe your condition is. It is important that you have your surgeon examine you if your surgery was long ago. 

Thank you for your question.  Capsular Contracture is one of the main risks of breast augmentation.   Classic signs are:
1.  hardness/tightness of the implant
2.  change in implant position (typically migrates towards the collarbone)
3.  increased pain and stiffness on the associated side.
Based on your description, you should see a board certified plastic surgeon for evaluation of capsular contracture.    If present, I would recommend a capsulectomy (removal of scar tissue) and implant exchange.  
Factors to consider:
1.  If your implants are above your muscle, you may want to consider switching to underneath the muscle, which lessens the risk of capsular contracture.
2.  If your implants are above the muscle and you desire to keep them there, you may benefit from the use of a textured implant.
Dr. Gill

Why is one breast hard and one soft?  It could be related to the implant volume infused, or the difference between the two breasts, or a capsule, or a hematoma, to name a few. Can't say without more history and an exam.