Breast Became Hard Overnight and Implant Has Shifted After 11 Years? (photo)

Question

I awoke this morning to my breast being sensitive. I leaned up against something and noticed that it was hard as a rock. When I felt my breast, I could feel and also see the edge of the implant pressing against my skin just above my nipple. Like the implant has shifted. It's hard to see in the pics. What has happened and what do I need to do now? Will I need another surgery to have the implants replaced? I've had the implants for 11 years and when they were put in, I had a breast lift as well.

Jerome Edelstein, MD · Answer

Capsular contracture can cause the breast to feel firm and sometimes look abnormally round or elevated. I recommend you see your surgeon as soon as you can for a more accurate assessment.

William Franckle, MD, FACS · Answer

It is uncommon to have sudden changes in implant position, especially after 11 years. This can be caused by many different issues and needs to be evaluated by a doctor experienced with breast implants.

Steve Laverson, MD, FACS · Answer

Need more information to diagnose, including physical exam, and as a first step, high resolution ultrasound. Decreased compliance (hard consistency) could be capsular contracture, hematoma, seroma filling capsule, muscle spasm, infection, or another issue. May need lab tests, MRI, and to correct problem, re-operation may (likely) be necessary.

Ronald Schuster, MD · Answer

It is difficult to tell exactly what has happened. I've never seen a capsule contracture occur overnight. It is typically a gradual process over weeks, months or years, not hours. If you really had something happen that quickly I wonder whether or not you were lying on top of the breast which may have applied a lot of pressure and some sudden inflammation. It would be best for you to either return to your surgeon or see someone else soon. You need to be examined before any real advise could be given.

Neil J. Zemmel, MD, FACS · Answer

What you are describing does sound like a capsular contracture but they typically come on more gradually. This can cause that hard feeling and distort the shape of the breast.  I would definately recommend seeing your plastic surgeon for a full exam. Good luck.

	Kindest regards

	Neil J. Zemmel

C. Bob Basu, MD, MPH, FACS · Answer

It is possible you may be experiencing capsular contracture? But it is impossible to say based on your description alone.  Please see a board certified PS for an evaluation.

Darshan Shah, MD · Answer

It is really difficult to tell by the story and the photo what actually happened.

	 

	Possibiliteis include:  seroma, capsular contracture or rupture.

	 

	noticing the change acutely overnight is rare, but sometimes our minds don't pick up on a gradual change until we really stop to think about it.

	 

	I would see your plastic surgeon as soon as possible for a diagnosis.  A physical exam is essential in your case.

Jourdan Gottlieb, MD · Answer

Thank you for the question and the attached photographs. You were correct in that it is difficult to see in the photos, and indeed on not certain which implant is the one in question although I will assume it is the left one.

	This sounds like a capsular contracture. It can occur in a delayed fashion. It can occur rather suddenly.

	 

	For treatment options he would be well advised to have in person consultation with a plastic surgeon in your area. Chances are that treatment will be operation.

	 

	Good luck and best wishes.

Remus Repta, MD · Answer

Hello,

	It may be that you are developing or have developed a capsule contracture.  If this is the case treatment would involve removing all of the capsule and replacing the implants.  I think you would also benefit from re-doing your breast lift to reshape and lift your skin and breast tissue back on top of the implant.

	Dr Remus Repta

Stuart B. Kincaid, MD, FACS (in memoriam) · Answer

From your pictures it is hard to see exactly what your talking about, you need to go see a PS and most likely have them removed and replaced. Where your implants place under the muscle of above the muscle? Seeing a PS would be good, so you can get your options.

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