I had BA 2 years ago and have had persistent pain in my left breast. My PS thinks it's scar tissue/muscle related.
Doctor Answers 5
Breast pains after augmentation
are rare but certainly occur. Consider a steroid injection to where it hurts the most. Most surgeons should be able to do this without harming your implant. Otherwise if you're convinced your implants are causing the pains, you can remove them. A capsulectomy with new implants will not guarantee resolution. So choose wisely.
Breast pain after BAM
It sounds like you have a contracture. I'm not sure about your question however. Implants do get contractures from time to time, and the rate will tend to increase over time. When a contracture gets to the point that you have constant pain and are on pain relievers, it is time to do something about it. It isn't good to be on Advil daily.
His presentation of options is correct. Another option is treatment with Vit. E and Accolate, which is off label, but sometimes it has been found to reverse contractures and their effects on the breast.
Obviously, an exam is required for appropriate diagnosis
I hope this helps.
Contracture vs. Nerve Injury
Pain two years after breast augmentation is certainly not common. Let’s presume that this is not generic perimenstrual breast pain that gynecologists spend so much time dealing with and assume this is related to your BA surgery. First, you want to make sure that you do not have a capsular contracture and that the implant and surrounding tissue remain soft. If not, that could be a cause of pain.
If it is still soft and the pain the constant and unremitting, one has to assume there is a problem with the nerve to the lateral breast and nipple areola, which is the nerve that arises from underneath the fourth rib on the lateral chest wall. If the pain is more laterally located, you need to be examined to see if there is any injury to that nerve, and you have developed a scar ball around it called a neuroma. If that can be identified by physical exam, then the fist step would be either desensitization by four-times-a-day massage or to consider a steroid injection precisely at the point of pain.
If the pain is more located by the nipple and the areola, the above is less likely to be helpful, and you should consider using some of the pain creams that can deplete substance P in the pain fibers. There are over-the-counter type medicines that have the active ingredient Capsaicin. You have to use it for at least two weeks to see if it is going to be helpful to you.
There are no other nonoperative measures I know of that you can employ. If those were unsuccessful, removal of the implants would have to be a consideration.
I hope this has been helpful.
Robert D. Wilcox, MD
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