Cohesive Gel Implants Swelling After Doing Push Ups

I had breast augmentation surgery 2 1/2 years ago. These are the cohesive gel implants. The other day i was doing push-ups and felt something pop or strain. A day later, one of my breasts is swollen, twice the size of my other breast. Since then I've had a mammogram and an MRI; but both showed no tears nor ruptures in the implant. I am experiencing no pain nor any bruising at all--just swelling. What do you think is going on?

Doctor Answers 7

Sudden swellling left breast

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It looks as if your left breast is considerably more swollen and I am somewhat surprised that your MRI did not show this.

I have observed this in 3 patients:

  1. One I drained and obtained clear fluid with no growth of bacteria or fungus on microbiology studies. I placed her on antibiotics and over a month it resolved and she did well.
  2. Another, I surgically explored with findings of blood. I suspect she injured a blood vessel which bled into the capsule.
  3. The other I drained and obtained clear yellow fluid which did not grow out any bacteria, bu the patient went on to develop a hard capsule

Did you MRI show fluid, blood, or swollen tissue?

You could ask your surgeon to use a seroma cath or liposuction cannula to obtain fluid for a diagnosis but you do risk damage to the implant.

Surgical exploration will likely be the best method to diagnose and treat your condition.

Chicago Plastic Surgeon
4.9 out of 5 stars 86 reviews

Breast swelling following breast augmentation

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What you describe most likely represents a resolving hematoma, or seroma.  This should be clearly evident on the MRI, unless it had resolved by the time the MRI was performed.  An ultrasound-guided needle aspiration or surgical exploration may be indicated if there is a fluid collection evident.  If however, the implants are intact and there is no fluid collection, I would tend to advise observation only.

Glynn Bolitho, PhD, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 15 reviews

Risk of infection and capsular contracture is higher

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Seromas are thankfully infrequent and can many times, according to the literature, be observed to allow possible spontaneous resolution. If the fluid is characterized as blood from trauma then the proper treatment is surgical evacuation. Even with careful sterile drainage, there is small risk of infection and capsular contracture.

Pop and swelling with breast implants

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Thanks for your question -

Your symptoms could be as the other plastic surgeons describe but it could very likely be a rupture of the capsule around the implant. (This is not the same thing as a rupture of the implant shell).

After breast augmentation your body forms scar tissue around the implant. This is typically a soft pliable envelope around the implant but in some situtations can be thick and painful. Sometimes after trauma or strong muscle action (the latter is much rarer) the capsule can tear or rupture. This can cause some displacement of the implant.

The key here may be comparing the position of the implant to the ribs or pectoralis to see if there is considerable asymmetry. If the shape is bothersome scar revision may be indicated.

Discuss these issues with your surgeon.

I hope this helps.

There must be fluid around your implant

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If this was a sudden change, the only likely explanation is fluid around the implant -either a hematoma or a seroma or an infection. All will need exploration and drainage surgically to resolve the swelling and to find out what happened. The MRI should have shown fluid around the implant - did you hear that in your report? Ask your doctor about this.

Re-exploration of the pocket....

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It’s extremely unusual for patients to develop severe swelling two and a half years following breast augmentation surgery. There are very few conditions that can cause sudden onset of severe swelling at this late date. These conditions include infection, seroma formation, and hematoma formation. Regardless of the cause, this situation requires treatment as soon as possible.
Re-exploration of the pocket will hopefully clarify the situation.If infection is present, the implant may require removal.Hematomas and seromas should be removed, as well, to prevent the development of secondary complications.
Although your MRI studies have demonstrated that your implants were structurally
intact, it’s surprising that it did not demonstrate a fluid collection.
It’s important that you consult your plastic surgeon.Your surgeon should be able to formulate a treatment plan that will address your concerns.This plan will most likely involve re-exploration of your breast implant pocket.

Cohesive Gel Implants Swelling After Doing Push Ups

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It appears in the photo that you had a hematoma or seroma. It is strange that the MRI did not show. Consult with your surgeon as he or she knows the scope of the surgery and the specifics about you.

Kris M. Reddy, MD, FACS
West Palm Beach Plastic Surgeon
4.5 out of 5 stars 56 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.