My right saline breast implant has pain and hardness - 20 years post-op.

I had saline breast augmentation over 20 years ago and for the last few days I feel hardness at the top of the breast above the nipple with pain. I do not remember if they put the implant under or over the muscle. My breast look normal Should I be concerned.

Doctor Answers 12


Hello, I recommend evaluation by a board certified plastic surgeon. You may be developing issues with a capsular contracture vs other etiologies. Best recommendation would be eval with further recommendations by your surgeon.

Dr P

My right saline breast implant has pain and hardness - 20 years post-op.

At 20 year post op you should consider having the implants removed and replaced.   Most likely you have developed a capsule contracture (CC). Capsule contracture is treated with surgery. Consult with a board certified plastic surgeon for an in person evaluation.

Robert E. Zaworski, MD
Atlanta Plastic Surgeon
4.9 out of 5 stars 57 reviews

Possible Capsule Contracture

Hello and thanks for posting. After 20 years and with the symptoms you have listed, it is most likely that you have developed a capsule contracture (CC). Capsule contracture is treated with surgery, but your breast pain will likely persist although it might be lessened by the surgery. One option is to change out the breast implants while some patients also wish to remove the breast implants altogether. If pain reduction is a priority, I usually encourage breast implant removal. Best, Dr. ALDO

Aldo Guerra, MD
Scottsdale Plastic Surgeon
4.9 out of 5 stars 197 reviews

Pain in Breast Many Years After Breast Augmentation #breastaugmentation #breastimplants

  • It is possible that you have developed a capsular contracture after your breast augmentation.  However, there are other possible explanations for your pain.
  • I'd recommend meeting with a board certified plastic surgeon to be evaluated. 
  • A capsular contracture refers to an abnormal thickness/hardening of the normal scar tissue around a breast implant.
  • This occurs in a small minority of breast augmentation patients.  To treat capsular contractures, plastic surgeons need to perform a capsulectomy.  A capsulectomy removes this scar tissue and leaves patients with a soft breast. 

New breast pain and hardness

Thank you for your question and sorry you are dealing with this. Any new onset change in the way your breasts feel or look should be taken seriously. I recommend having your ob/gyn or primary care doctor have you obtain a mammogram first to evaluate the status of your breasts. You can then follow up with a plastic surgery if it appears that the issues is solely implant related. Best of luck. 

Patrick L. Basile, MD
Jacksonville Plastic Surgeon
5.0 out of 5 stars 74 reviews

My right saline breast implant has pain and hardness - 20 years post-op.

Thank you for sharing your question.  Because this has been a noticeable change in your breast firmness I would advocate you seeing your ob/gyn for an in-person evaluation.  This is a case of better safe than sorry.  Hope this helps.

Nelson Castillo, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 45 reviews

Breast implant pain and hardness

Most likely, you have developed capsular contracture around your breast implant. Since breast implants are foreign bodies, the body walls off the implant by forming a capsule. All breast implants have capsules around them. The capsules range from soft and hard to see or feel to hard and painful. Over time, the capsules tend to become harder and more painful. My advice to you would be to get a mammogram first so that you can rule out any breast disease. If there is no breast disease, then I would assume that you have capsular contracture. The capsular contracture can be corrected by removing the breast implants, performing a complete capsulectomy (i.e., removing the capsule), and then either replacing the implants or lifting the breasts if you have decided you no longer want to live with breast implants.


It may or may not be related to the implant capsule.  You should be evaluated with a mammogram/ultrasound to better assess this area. 

My right saline breast implant has pain and hardness - 20 years post-op.

YES! Acute onset of pain, hardness is unusual. Best to seek in person examination from a boarded private practice PS in Miami. Plus obtain a US/Mammogram ASAP.


Any change in your breast implants/breast should be evaluated by a physician.  It is most likely implant related but still needs to be checked out.  You will be fine.

Best Wishes,

Nana Mizuguchi, MD

Nana N. Mizuguchi, MD, FACS
Louisville Plastic Surgeon
4.7 out of 5 stars 46 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.