I have had pain/discomfort in my left breast steadily for over 3 mos. I have saline implants (under the muscle) for 9 yrs now. There's no apparent deflation or hardening. Mammogram & ultrasound results came back normal (despite some calcification). The doctor said he did not see anything wrong with my implant and it could possibly be costachondritis. But the pain does not go away w/ NSAIDS & is in my breast. My surgeon is retired and the office is 6 hrs away. What steps should I be taking? MRI?
What Can Cause Pain/discomfort in Breast 9 Years After Breast Augmentation? Do I Need to Replace my Saline Implants?
Doctor Answers 8
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.
Breast pain 9 years after saline-filled breast implants
One of the advantages of the saline-filled breast implant is that you don't have to wonder whether it's intact or run any tests on it. It's either obviously intact or it's obviously not. In your case you can be sure it's fine. From your description you can also be sure the problem is not in the capsule around the implant as this is not contracted or abnormal feeling. Therefore the pain must be coming from the breast or the chest wall or the tissues around the breast even if nothing can be seen or felt or demonstrated on tests. It is not that uncommon for women to have pain in or around their breast (s) that is not diagnosable or specifically treatable. I would treat the pain for symptoms and follow up with breast tissue checks or whatever test is recommended for the breast tissue if the problem persists. Another option to check into endocrine or GYN hormonal levels.
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.
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Breast pain nine years after Augmentation
There are many causes of breast pain, most of them are benign. A capsular contracture of an implant can be painful, but if your implant is soft, movable and in good position you do not have a capsule. Inflamation of a rib or the chest wall can cause discomfort, as in a costo chondritis as you mention. Cysts of the breast can be painful and can vary with hormonal swings. Caffiene can trigger breast pain ,either in beverages or choclates. If your implants remain fine I suggest you go to your gynecologist or to a genral surgeon specializing in breast to get to the root of your problem. Good luck!
Breast Pain after Breast Implants
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.
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.
Pain in the breasts 9 years after augmentation probably has nothing to do with breast implants.
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.
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