Capsular contracture or just inflamed? (photo)

Question

A week ago I woke up to a painful left breast.I thought I had just slept funny. 2 days later my breast was larger and fuller than my right one. I called my surgeon in a panic & the nurse replied asking if I had felt ill or if I'd had a trauma to my breast. I said no, but I have been having night sweats. She said to go to my GP first & see if it was infection. He checked my glands temp etc & all fine. He gave me amoxicillin and in 3 days it seems more swollen but the pain isn't as bad. Help!

Ajay Mahajan, MD, FRCS (Plast) · Answer

You appear to have a collection of fluid (seroma) rather than a capsular contracture. Considering that you have had your surgery some time back, the reason for this fluid build up needs to be investigated. You
 should see your plastic surgeon who can arrange a scan for you. If you do have 
fluid build up inside, it is very important that cause for the seroma is
 determined. It is important that ALCL is ruled out as a cause for the seroma. It is 
equally important for you to understand that I am not trying to scare 
you as ALCL is a very rare condition but can occur following use of 
implants for breast augementation. Anaplastic large cell lymphoma (ALCL) is a rare type of non-Hodgkin 
lymphoma (NHL), a cancer involving the cells of the immune system. ALCL 
in the breast is rare; approximately 3 in 100 million women per year in 
the United States are diagnosed with ALCL in the breast. In total, the 
FDA is aware of approximately 60 case reports of ALCL in women with 
breast implants worldwide. The total number of implants worldwide is 
estimated to be between 5-10 million. FDA believes that women with 
breast implants may have a very small but increased risk of developing 
ALCL in the scar capsule adjacent to the implant. Because the risk of 
ALCL appears very small, FDA believes that the totality of evidence 
continues to support a reasonable assurance that FDA-approved breast 
implants are safe and effective when used as labeled. (source: U.S. Food
 and Drug Administration, Jan 2011)It is important that you ask 
your surgeon to send off the seroma fluid for analysis, within 2 to 4 
hours of aspirating it, to the lab to be analysed with Immune staining 
for CD 30. If your sugeon is not aware of this please do not hesitate to
 give him this information.

Jerome Edelstein, MD · Answer

Hello,Thank you for your question and photo. It is unusual and unexpected to have sudden swelling/pain/dramatic change in your breast. Capsular contracture does not present this way. I recommend that you continue to follow yup closely with your Plastic Surgeon in person.All the best

Marc Pacifico, MD, FRCS(Plast) · Answer

Dear JoolieMany thanks for posting your question. From your photograph it looks as if your surgery was some time ago, judging by the scars. Therefore it is unusual to have spontaneous late swelling. This coupled with your night sweats are of some concern, so please see your surgeon promptly.The most likely explanation is a seroma - a fluid collection - and this will need to be investigated to find out why it is happening.In all likelihood, you will need an ultrasound scan and fluid drained to be examined under the microscope. It might then require you to have surgery, for implant removal and capsule excision.I hope this helps

James Murphy, FRCS(Plast) · Answer

You need to see your plastic surgeon as soon as you reasonably can. The symptoms you are experiencing are not normal and you need to be examined by an experienced surgeon and investigated appropriately.

Christopher J. Davidson, MD, FACS · Answer

So sorry to hear about your troubles.  I would advise that you see your plastic surgeon as soon as possible.  This certainly is not normal and a capsular contracture does not typically spontaneously appear.  Definitely important to see your plastic surgeon immediately.

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Capsular contracture or just inflamed? (photo)

Answers (9)

Answer: Swollen breast

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Everything you need to know about Breast Augmentation

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