Left Breast As Hard As a Rock 10.5 Years After Breast Implants?

I had breast implants 10 1/2 years ago. About 7 months ago my left breast started getting hard in the corner. It has now progressed to the entire breast. I went to my ob-gyn and had an exam. She said she had felt 10,000's of breast and had never felt one as hard as mine. She sent me for a DM and US and the doctor found pockets of fluid on the outside of my implant. She said the implant was intact but is sending me for a MRI. What could be causing this? Neither doctor has ever seen this before.

Doctor Answers 7

Left Breast As Hard As a Rock 10.5 Years After Breast Implants?

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Sorry to hear about the complications you have experienced. Capsular contraction can be a very frustrating complication for both patients and surgeons.  In my practice, I have found the most success treating these difficult problems utilizing techniques such as sub muscular pocket conversion (if relevant), capsulectomy, use of fresh implants, and the use of acellular dermal matrix.  Acellular dermal matrix is a biologic implant that carries the ability to become integrated into native tissue. It is made by taking a full thickness section of skin from a donor source ( human, porcine, or bovine in origin).  I hope this, and the attached link ( demonstrating a case utilizing acellular dermal matrix) helps. 

Capsular contracture

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It sounds like you may have capsular contracture.  I recommend a visit to a Board Certified plastic surgeon who can examine you and advise you on how to proceed.  

Mennen T. Gallas, MD
Katy Plastic Surgeon

Capsular contracture treatment and prevention

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I would agree.  An MRI is not going to change the fact that the treatment for capsular contraction (baker grade 4) is surgery.  A removal and replacement of the implants with new implants placed in the subpectoral pocket (under the muscle) if they are not there already and also maybe considering the use of a biologic dermal matrix (or "biologic")  such as alloderm or strattice would also be a consideration for prevention of recurrent capsular contraction.

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You need surgery, not an MRI.

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An MRI will provide information, but will it change what needs to be done here?

You have Baker 4 capsuolar contracture, and late, unilateral capsular contracture is usually related to one of two things--a mild to moderate trauma to the breast causing bleeding and progressive capsular contracture, or bacterial contamination (say from dental work) after a minor trauma to the breast sufficient to allow bacteremia to enter the breast pocket.

In either case, unless you plan to keep one hard and one soft breast, you absolutely require surgery by your plastic surgeon, and a MRI does not help me make that decision at all.

You likely require complete capsulectomy, copious irrigation with Betadine or Adams triple antibiotic solution, re-enlarging your pocket, and a new implant. If fluid is noted around the implant, sending the fluid tor histologic diagnosis will rule out (the extremely rare) likelihood of ALCL. For more information about this, click on the link below.

BTW, this is not all that unusual, and your OB may have unnecessarily worried you. A referral back to your plastic surgeon would have been better, and less costly. You still need surgery even without these tests. Best wishes! Dr. Tholen

Richard H. Tholen, MD, FACS
Minneapolis Plastic Surgeon
4.9 out of 5 stars 263 reviews

Capsular Contracutre

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Yes, I agree, you need to see a board certified plastic surgeon.  It sounds like you are describing capsular contracture which is very rare but can happen after breast augmentation.  You will likely need a surgery to remove the scar tissue and possibly replace the implants.  However, without seeing you in person it is impossible to give you a diagnosis.  The MRI which your doctor ordered will give some useful information.


Good Luck.

Severe hardening or encapsulation of breast implant

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You should obtain a consultation from a board certified plastic surgeon regarding the encapsulation of your implants.

With hardening of this magnitude, surgery will be necessary to help the problem.  This may involve removal of the implants, the scar tissue around the implants, and possibly adjustment of the internal capsules.

An MRI would typically show if the implant has ruptured, but there are other conditions that should be considered as well, and your surgeon will be qualified to determine whether these apply.

Although an MRI is helpful in showing if there is rupture of the breast implants, surgery is necessary anyway to fix this problem, and often a mammogram alone suffices before surgery.

Brent Moelleken, MD
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 194 reviews

Hard Breast

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Sorry to hear about your breast hardening.  Capsular contracture is the most common cause of breast hardening after implants.  Since you said you had fluid around your implant, this could be due to trauma, irritation of the capsule from excessive exercise or there is a rare possibility that this could be Anaplastic Large Cell Lymphoma.  It sounds like your doctor is doing the proper workup and the MRI is likely to give you the answer.   Hope it goes well.

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.