Why is One Breast Hard and the Other Soft?

Why is my right breast hard and its so painful? But my left breast looks and feels soft...

Doctor Answers 14

Capsular Contracture?

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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.

Firmer Breast

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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.

Signs of Capsular Contracture

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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

Paul S. Gill, MD
Houston Plastic Surgeon
4.8 out of 5 stars 94 reviews

Why Is One Breast Hard And The Other Breast Soft?

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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.

Could be caused by a variety of reasons

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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. 

Ronald Levine, MD
Toronto Plastic Surgeon
4.6 out of 5 stars 25 reviews

Why is One Breast Hard and the Other Soft

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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.

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

Hard and soft

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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.

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

Internal scarring

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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

One breast hard and the other soft

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Unfortunately you have a capsular contracture on the hard side. The cause could be bleeding in that side or to small a pocket formed. Seek in person advise.

From MIAMI Dr. B

Reason for a Soft breast on one side and a Hard Breast on the other

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While you state that one breast is soft and the other is hard you do not state WHAT OPERATION you had done, nor WHEN was it done. Knowing these facts and especially seeing a photograph would have been very helpful.

Obviously, if both breast were healing the same way, they would have the same size, look and feel the same way. Something is wrong.

IF this was in the immediate post-surgery period, I would be concerned of bleeding on one side. This may be manifested by an increased size, pain and bruising on that side.

IF you had a Breast Augmentation months or years ago, a sudden increasing hardness on one side would suggest a capsular contracture-scarring around the implant which makes the implant appear very round and higher on the chest.

I would advise you to see your surgeon. This is more urgent if you had recent surgery and may have a bleeding on one side.

Peter A. Aldea, MD
Memphis Plastic Surgeon

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.