Mentor smooth implants feeling extremely sore. Is it the implant that I am feeling under my skin?

Question

Hello, after having breast cancer in 2019, I had a double mastectomy with breast reconstruction using Mentor memory gel smooth profile xtra implants. The one side of my breast has been extremely sore and I can feel an area under my skin with tiny little nodule like bumps. Would this be the implant that I am feeling under my skin, even though it is a smooth profile implant ?

Ryan Rebowe, MD · Answer

It is possible that you are feeling the implant itself, as the skin from a breast reconstruction is typically very thin and the implant is almost always palpable. However, anything that feels like a "lump" or "bump" in a reconstructed breast should be evaluated immediately by your oncologic or plastic surgeon. While recurrences are very rare this is always a possibility and should be checked out as soon as possible. The other possibility is that what you are feeling is part of the natural scar capsule that surrounds the implant itself. If there is a concern from your surgeon, it can typically be evaluated by a simple noninvasive imaging test like an ultrasound.

David Branch, MD · Answer

I'm sorry that you're having such discomfort with your reconstructions. This may be the result of a capsular contracture or possibly a nerve that developed a neuroma. I would start with an MRI or ultrasound to evaluate for possible early implant rupture and to rule out unlikely malignancy. the tiny nodules are likely permeant sutures or granulomas around suture and can be removed if bothersome or visible. Hope this helps.

Derek Fletcher, MD · Answer

Breast pain after mastectomy and reconstruction with implants can have one or more causes. Nerve related pain following mastectomy often resolves with time and can respond well to medication. Implant related pain is influenced by the technique, implant size, type of implant, implant position, and how the implant is covered. Implants can be felt under the skin after mastectomy and sometimes the can feel like a nodule if there is a wrinkle in the implant shell. More often, small nodules represent sutures, wrinkles in acellular dermal matrices like AlloDerm, or fat grafting oil cysts. A detailed history reviewing which operation you had and a detailed examination are necessary to make an accurate diagnosis.

Daniel Barrett, MD · Answer

Dear kdur,
I understand your concern. However, without a proper assessment, it would be difficult to determine what went wrong. It is best that you visit your plastic surgeon for further assessment or ask for a second opinion. Only after a 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

Mentor smooth implants feeling extremely sore. Is it the implant that I am feeling under my skin?

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