What Can Cause Pain/discomfort in Breast 9 Years After Breast Augmentation? Do I Need to Replace my Saline Implants?

We occasionally see patients who develop breast pain several
years after breast augmentation surgery.In the vast majority of patients this type of pain isn’t related to
breast implants unless capsular contractures are present.Instead, this type of pain is usually related
to musculoskeletal strain.In the
vast majority of cases, conservative management is appropriate and results in
resolution of symptoms. In the short term, analgesics and muscle relaxants may
be appropriate as well.If this
pain fails to respond to conservative management further investigation is
appropriate.In some cases this may
require mammography and possibly MRI studies.Under these circumstances, it’s appropriate to consult a board certified
plastic surgeon, general surgeon or possibly a pain management specialist.

one of the reasons for pain could be capsular contraction but you say the implants are soft and scans have not shown any things. MRI is advised at this stage to look at the implants and capsule. Musculoskeletal discomfort can always be a cause of pain but they should settle down with analgesics and anti inflammatory.

Hi, For your guidance, as with any man-made object implanted in the human body, device failure can occur.  It is possible that an implant can rupture causing silicone gel to be released from the implant.  Implants also can rupture during the removal process.  If implant rupture has occurred, it may not be possible to completely remove all of the silicone gel that has escaped.  The implant shell material of textured breast implants may be impossible to remove completely.  Calcification around implants can occur and may require removal of the scar tissue surrounding the implant (#capsulectomy).  It may not be possible to completely remove the scar tissue that has formed around a breast implant, implant parts, calcifications, or silicone gel.  Additional surgery may be necessary in the future. Find a new board-certified surgeon that has extensive experience with your case. Best of luck! #RealSelf100

Dear Nat24,I'm very saddened to hear you are having a difficult time and pain with your breast implants. I think it would be wise to have a follow up appointment with your initial plastic surgeon to address the problems you are having. 
If that is not an option, I would consult with a plastic surgeon that will take time to listen to your concerns and examine you.  
I understand your concern. However, without a proper assessment it would be difficult to determine what is wrong. Only after thorough examination you can get proper recommendations and advice. Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Hello,Once your pain has been worked up (it sounds like you've done this) and there is no other medical cause found, I would recommend have implant removal with capsulectomies. Sometimes the capsule can harden and can cause discomfort. 9 years is approaching the time that many women will have their implants replaced, so having them replaced with excision of the capsule could relieve your discomfort.However, there is no guarantee that this will relieve your pain. But if you've ruled other causes out, it's a good next step.  Discuss this with a plastic surgeon in your area and he/she will be able to go over all the options with you. Best wishes,Dr. Blagg

At this time, I would certainly NOT remove the implants.  You need further evaluation and I think a MRI is the next step.  Try to localize the pain to your breast, the chest wall or the pocket of the implant.  You need to discover factors that precipitate the pain or make it worse.  Your signs and symptoms may lead to the cause.

Best of Luck,

Gary Horndeski, M.D.

 

I doubt your breast pain is related to the implants.  If your surgeon is retired, make an appointment to see a plastic surgeon that is not and get his opinion. 

The most common cause of pain 9 years after breast augmentation is usually capsular contracture or scar tissue forming around the implant. This can certainly be on one side only. This can be determined on an exam by a Plastic Surgeon and would require surgical capsulotomy or capsulectomy to relieve.. A rib related source of the pain is possible ( costochondritis that you mentioned) , especially if there does not appear to be any capsular contracture on exam.. In that case , a MRI might be beneficial if no other source of the pain can be determined..Dr. Price

Hi Nat24, There are many possible causes of breast pain, some possibly related to your implants, but most probably not. You've done your due diligence seeing a doctor and mammograms and ultrasounds are a good first step, but the only definitive test is an MRI. Now that your surgeon is retired, you need to do your research and find a new board certified plastic surgeon with a lot of experience to do a full exam and help you figure this out. If you have exhausted all other possibilities, you can certainly remove the implants and the scar tissue in your breasts to see if that eliminates your pain. If not, you can always replace them at any time. Surgery should be a last resort in my opinion, but work with an experienced physician to see what some other options may be first. Good luck.

Unfortunately, it is very difficult to diagnose
the source of your discomfort without an in-person examination.  I would recommend that you schedule an
examination with your plastic surgeon to ensure that the source of your pain is
correctly diagnosed.