Could This Be Capsular Contraction?

I had saline breast implants done UNDER the skin ontop of the muscle two's ago and i had ABSOLUTLEY NO PAIN following my surgery but now in my right breast i have this sharp tearing pain and that's the only way i can describe this pain.when i move my breast is certain positions it feel's like something is tearing,i can also feel what feels like a knot or tube when i tighten my chest muscle.What could this be?The picture is two weeks after,to me both breast dont look the same.Is it just me? this photo was taken two wks after's the side with the tattoo.The tattoo was done 2 years ago.

Doctor Answers 16

Breast Implant Capsule or Normal Healing

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Based on this one view and not knowing the exact time frame from the surgery date, your breast could represent mild capsular contracture or an implant that is high-riding.  What you describe as far as your symptoms appears to be capsular comtracture starting to form. This is much more common when implants are placed above the muscle that is why it is important to perform a "dual-plane" or sub-perctoral placement of your breast implants. It is common in breast augmentation to get occasional twinges or pulling discomfort or pain. This can be temporary but can also be due to the scar bands and capsule (which is essentially internal scarring) pulling on the muscles, nerves, and ligaments of the breast or chest wall which will worsen with movement.

Since you describe no pain after surgery, this is also common with implants placed above the muscle. However, it is also possible to have little to no pain and a less than 24 hours recovery with implants placed under the muscle as well. In what is called the flash recovery breast augmentation, you can have sub-muscular implants and reover in less than a day.  You may need your implant , if not now, at some point converted to sit at least partially under your chest muscle which ultimately is safer, has less chance for capsular contracture, and appear more natural.

Always, choose a board certified plastic surgeon to perform your cosmetic surgery.

Hope this was helpful

Beverly Hills Plastic Surgeon
4.1 out of 5 stars 105 reviews

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 95 reviews

Shooting Pains Soon After Augmentation are Normal

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It's common to have shooting pains in the first weeks - months after augmentation.

The nerves get quite a stretch from the augmentation and will send out shooting pains from time to time, until the nerves can grow to accommodate the implants.

This is not a typical sign of capsule contracture.

Paul C. Zwiebel, MD
Denver Plastic Surgeon
4.7 out of 5 stars 46 reviews

Shooting pains after breast implant augmentation surgery is common especially between 10 days-3 weeks

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Your breasts look reasonably even to me but that does not explain the pain. Two weeks after surgery it is not uncommon to experience shooting pain called dysesthesias. Give it 4-06 weeks for the possibly irritated nerves to calm down. Keep in touch with your surgon

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

Is it capsule?

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I think your problems come from saline on top of the muscle and be oversized.You have a capsule and as it forms it can contract and cause pain.From you photos it looks as though your breasts are very tight.Massage may help and taking a non steroidal anti inflammatory for a few weeks may help such as motrin.

Robert Brueck, MD
Fort Myers Plastic Surgeon
4.9 out of 5 stars 70 reviews

Breast pain after implants.

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It is unclear from your question the time frame you are discussing after your surgery. You would be best served discussing this situation with  your surgeon to get an answer that is specific to your case.

Paul Vitenas, Jr., MD
Houston Plastic Surgeon
4.8 out of 5 stars 117 reviews

Too early for capsular contracture

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I am a bit unclear as to the timing of your surgery. If it truly was 2 weeks ago, this is far too early for capsular contracture. Pain associated in the early postoperative period is either directly related to the procedure or to an early complication such as a hematoma. It is difficult to evaluate from the picture you have provided. I recommend you follow up with your surgeon and express your concerns.

David Bogue, MD
Boca Raton Plastic Surgeon
5.0 out of 5 stars 26 reviews

Capsule contraction can certainly first appear as tenderness in the breast and if you are concerned I would certainly advice you

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Thank you very much for your enquiry, it does like as if the side with the tattoo is slightly higher and slightly more prominent in its upper portion than the left breast.

Capsule contraction can certainly first appear as tenderness in the breast and if you are concerned I would certainly advice you to see your surgeon so that they can assess the area and advice whether you have got the capsules. As you know there are many different options for treating capsules and it would be sensible to discuss this in forward with your surgeon.

Early capsular contracture

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Since your surgery was only two weeks ago, it is too premature to classify this as capsular contracture.  Your breasts look fairly symmetric; remember that every person has some degree of asymmetry which is natural and this may become more noticeable after breast augmentation.  I recommend following up with your plastic surgeon if you are concerned.  Usually in the early postoperative period massaging can help soften your implants.  You may also want to ask you surgeon about starting vitamin E and Singulair to help prevent capsular contracture.

Best wishes,

Dr. Bruno

William Bruno, MD
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 412 reviews

Capusular contracture has specific timing and findings

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From your question it is unclear when your surgery occurred. The photos was done at 2 weeks post surgery. At this point in time, it could not be capsular contracture. Capsular contracture usually takes at least a few months to form. The pain you are feeling may be discomfort from the healing if yor are still at an early stage.

If you had your surgery more than 6 months ago, capsular contracture is possible; common findings include a firmer feel than the other side, and the implant may look like it has moved upwards, and the shape of the implant looks more round and might look smaller as well. 

The knot may be anything from the implant valve, to your own breast tissue.

Bottom line: to see your plastic surgeon and have an evaluation.

Best regards,

Lawrence Tong MD FACS FRCSC

Lawrence Tong, MD
Toronto 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.