One of my Breasts is Harder Than the Other - Why?

Hardness of breast implants after breast augmentation is usually due to excess scar tissue which has developed around the implants-known as capsular contracture.  The scar tissue forms a shell or capsule that can squeeze or contract the implant, occasionally causing pain and discomfort.  This complication occurs in about 10% of all patients who get breast augmentation. This condition usually develops within the first year after surgery but can occur at any time.  If it is detected early on, there are some medications that can help minimize the firmness, however, if it is established, you may need surgery to remove the excess scar tissue and replace the implant.

Please consult with a board certified plastic surgeon for more information on the management and treatment of capsular contracture.

Best wishes,

Dr. Bruno

It’s not unusual for patients who undergo breast lift or
breast reduction surgery to develop areas of fat necrosis. This occurs when
globules of breast tissue lose their blood supply and undergo necrosis. This
results in the small lumps and bumps that you describe.

These lesions are often the source of significant
anxiety and for this reason are rigorously investigated. It’s not unusual for
patients to undergo ultrasound and mammography to evaluate these lumps.

In the vast majority of patients who have fat necrosis,
resolution occurs without surgery. These lesions induce an inflammatory
response which results in their dissolution. In some cases massage may be helpful but even with this maneuver the majority will take 3
to 6 months to resolve. 

It is possible that you are developing capsular contracture. This is characterized my thickening of scar tissue around the implant and can cause pain and a firmer appearance of the affected breast. Please see your surgeon as soon as you can for proper diagnosis. Best of luck. 

Sudden changes in the breast could herald a capsular contracture, hematoma or even seroma. Recent concerns about the latter raised by the FDA suggest a possible evaluation for ALCL. See your doctor.

Sounds like you have a capsular contracture.  If your breast is hard and not painful then no treatment is recommended other than observation.  It is best to visit your plastic surgeon to get a good examination.

Dr. ES

ChelleG,

Capsular contracture is the contraction/tightening of the scar capsule around the implant.  All implants have a capsule around them (it's the body's natural way of dealing with implants).  However, sometimes (and we don't really know why and when) the scar tissues contracts and compresses the implant.  It's called capsular contracture.  Initially in can be felt, then seen, and finally it can become painful.

You should see your plastic surgeon to see if there is anything he can do (in case this is capsular contracture).  In the early stages asthma medication has been shown to be helpful, in later stages only surgery can reverse the condition.  Unfortunately there is no guarantee that it will not happen again.  Capsular contracture is one of the risks associated with breast implants (or any implants).

Sincerely,

Martin Jugenburg, MD

You probably are just noticing some gradual firmness that started months ago- the process is called 'capsular contracture' - the capsule around your implant is beginning to thicken and contract. This can ultimately distort the implant position and size. There are a couple of non-surgical options (Accolade) which might be tried with varying success. The surgical options to manage capsular contracture include capsulectomy and replacement with textured implants, preferably below the muscle in a fresh tissue plane. See you plastic surgeon for an opinion.

If one breast feels paritcularly harder than the other, you may be developing a caspular contracture and you should be evaluated by your surgeon.

Your description sounds like you are suffering from a capsular contracture of the right breast.  The literature reports this happening in approximately 10-20% of breast augmentation patients.  The degree of contracture is categorized by Baker grades I-IV , with IV being the most severe.  Although the symptoms you describe seem mild,  I would recommend visiting your plastic surgeon.

Best wishes,

Neil Zemmel, MD

It is possible to develop hardness in one breast several months or years after breast augmentation, and this may be due to the onset of capsular contracture. You are best advised to seek consultation with your plastic surgeon and consider treatment options.