5ft, 145LBs. I got 425cc. Arm and shoulder pain 2 years post op - should I consider a revision or explant?

Thank you so much for sharing your experience — and I want to first say that your symptoms are not something you should ignore, especially if they’ve lasted more than a year after surgery and are interfering with your quality of life. You’ve given very thoughtful details, and they help guide the conversation toward what may be going on.
1. Pain and Numbness Are Not “Normal” at This StageWhile mild tightness or nerve sensitivity is common early after breast augmentation, persistent arm pain, numbness, and weakness nearly 16 months post-op is not typical and should not be brushed off. The feeling you describe — like a blood pressure cuff squeezing the arm — raises red flags for possible:
Nerve impingement or irritation, either from the surgical pocket or muscle dynamicsImplant displacement or size-related compressionThoracic outlet syndrome, sometimes triggered or worsened by submuscular implantsOr even pectoral muscle over-activation, especially if you’re petite and received a relatively large implantYou deserve a full in-person evaluation by your surgeon.
2. Implant Size and Placement Matter — Especially in Petite PatientsYou mentioned you’re 5'0" and 145 lbs with 425cc implants — for many patients with smaller frames, this can create proportional challenges. If your implants were placed under the muscle, and the muscle is tight or overly activated, it can:
Squeeze the implant painfully during certain movementsCause functional limitations, like the jar-opening you describedLead to discomfort and even animation deformitiesIf you feel the size is simply “too much” for your frame now, that’s a valid concern — and you are not alone in having second thoughts.
3. What Are Your Options?
-Implant Revision (Downsize + Pocket Adjustment)
Replacing 425cc with a smaller, more appropriate implantPossibly moving to over-the-muscle placement (if not already)Releasing tight capsule or muscle (capsulectomy or muscle scoring)Goal: maintain volume, but restore comfort and function
-Explant with or without Lift
Remove the implants entirelyAdd a breast lift (mastopexy) if needed for shapeGoal: restore natural feel, reduce physical burden, eliminate implant-related discomfort
-Further Medical Evaluation
A neurological or musculoskeletal assessment to rule out nerve impingementImaging (MRI or ultrasound) may help evaluate capsule status, implant position, or compression
Wishing you relief and clarity as you move forward.

What you describe is not normal.
I suggest you get an evaluation for your symptoms.
Your plastic surgeon isn’t going to be able to do much for you other than to offer removing the implants.
Start with your primary care doctor and asked to be referred to a neurologist or orthopedic shoulder/arm specialist for an evaluation.
Best,
Mats Hagstrom MD