What Does Capsular Contracture Pain Feel Like?

Question

I have pain in my left breast that feels like needles are poking around in there. I have silicone implants. Is this a normal feeling? Is this capsular contracture? My surgery was done 6 months ago.

Lewis Albert Andres, MD · Answer

Hello! Thank you for your question! Physical examination will determine if you have capsular contracture. The look and feel of hardness surrounding your implant is seen and/or felt.  At its worst, you experience pain. It may also cause distortion of your breast. What has caused it will be in question.  At 6 months Postop,it could simply be your nerves regenerating. Your surgeon will likely recommend implant massage and may add the medication Singulair.  If these fail, surgical correction may be suggested. It is a matter of surgeon preference as well as what is seen during your procedure that will determine whether or not a complete capsulectomy is performed. If significant capsule formation is seen intraoperatively, a full capule removal may be warranted with a drain in order to completely remove all of the tissue and allow better adherence of your breast back to its normal anatomic position down on your chest wall. Irrigating with certain medications may also be if benefit. If minimal contracture is seen, it may be possible to leave the capsule, or place cuts within the capsule to allow better adherence. It truly is dependent on what is seen with your capsule and the issues that may be causing you to have such a procedure (e.g., contracture from rutptured implant vs pain vs simple pocket adjustment, etc). Without knowing your issues and without an examination, it is difficult to tell you what may be the best thing for you. I tend to favor performing capsulectomies in order to create a fresh pocket, reshape the pocket, allow better shape and adherence of the overlying breast. I would discuss your issues with your plastic surgeon who will assist you in determining the right modality for you. Hope that this helps! Best wishes!

Austin Hayes, MD · Answer

It is difficult to say without examining you in person. Capsular contractures cause your breast to feel more firm. Pain is a symptom of a severe capsular contracture. If you have concerns, reach out to your plastic surgeon so that you can be examined in person.

Stephen T. Greenberg, MD, FACS · Answer

Thank you for your question.  Capsular contractures often cause discomfort for patients but there are always exceptions and instances when there is no noticeable discomfort.  Capsular contractures arise when the scar tissue, or capsule, that forms around a breast implant increases in thickness and constricts around your implant.  This constriction causes distortion of the implant and consequently the appearance of your breast, and can also cause your implants to feel harder and less natural.  If you are concerned that you may have developed a capsular contracture, I would recommend following up with your operating surgeon.  Seeing as how you are only 6 months post-op, the discomfort that you are feeling may be the result of returning nerve sensation, but even this should be followed up on in person so that you can be accurately evaluated and determine what is going on.  I hope you find this helpful and best of luck on your recovery.

Richard J. Bruneteau, MD · Answer

It’s not
unusual for patients to note hardening, distortion, and pain when they develop
capsular contractures. This pain is
typically described as a dull, achy sensation that accompanies the sensation of
tightness. The pins and needles sensation that
you describe is more indicative of nerve regeneration.This is a common occurrence following breast
augmentation surgery and usually resolves with the passage of time.Under these circumstances, it’s
appropriate to consult your plastic surgeon.Your surgeon can easily make this differentiation by performing a
physical examination.If early capsule
formation is noted, your surgeon may start you on a vigorous massage regimen.

Jerome Edelstein, MD · Answer

Capsular contracture is when there is abnormal scarring around your implant, tightening it and causing the breast to feel firm. The breast may also look abnormally round or elevated. This can sometimes be treated without surgery, but if the problem persists, you may need surgery. I recommend you go back to your surgeon to have your breast checked out as soon as you can. Best of luck.

Armando Soto, MD, FACS · Answer

Hi there-
Without examining you and knowing a few more details, it would be very difficult to say what might be causing your pains.
I would suggest you visit your surgeon and describe your problem to them. After an exam, they'll be much better able to give you information and advice.
In the meantime, I would continue to massage your implants periodically.

Paul Gill, MD · Answer

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

John P. Di Saia, MD · Answer

Hello,
Capsular contracture is progressive tightening / hardening of the breast related usually to silicone implants, although it can happen with saline filled implants as well. A feeling of "needles" six months after implant surgery may indeed be the nerves healing afterward. It might not be contracture. You need to see your surgeon for guidance here.

William B. Rosenblatt, MD · Answer

Capsules are not always painful - but they turn nice soft breasts into ones that feel like there is a tennis ball inside. Capsules make the implants take on a spherical shape and feel hard. 
If you are worried see your doctor.

Leslie H. Stevens, MD, FACS · Answer

What you are experiencing sounds more like the sensory nerves recovering from you surgery. If your implant is firming up or is starting to ride higher on your chest, this is a better indication of a capsular contracture. Try anti-inflammatories like Advil for now and see your plastic surgeon.

What Does Capsular Contracture Pain Feel Like?

Answers (11)

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