Can a Muscle Tear Occur from Receiving a "Bear Hug" After Breast Augmentation?

Question

I had breast augmentation 4 yrs ago. Recently I was injured when I received a "bear hug". Two days later I started to experience excruciating pain. I was unable to do normal daily activities, ie; open a door, carry a purse, extend arm, put on a jacket, walk (as a form of excercise), even deep breathing at times.I am wondering if I could have torn a pec muscle (as my implants are under the muscle).I am now in week three and still have pain; not as severe but still very painful. Any thoughts?

Armando Soto, MD, FACS · Answer

Hi there-

	I think that you probably have indeed experienced a closed capsulotomy, in which the connective tissue pocket that your implants are sitting in was torn be the force of the embrace, or "bear hug" you describe.

	Because this can have longer term implications for your breasts and implants, I recommend you visit your surgeon for evaluation and recommendations.

Vishnu Rumalla, MD · Answer

Thank you for your question. I would see your plastic surgeon because you are still having pain. You did not mention if these are silicone gel or saline impants. Your symptoms soound like you might have torn muscle or the capsule--tearing either can be extremely painful. If you have silicone implants your surgeon might order tests to confirm the implant did not rupture. Good luck.

J. Jason Wendel, MD, FACS · Answer

Obviously you will need to confirm any advice you get over the web with your plastic surgeon.  You can start with your primary care physician but he/she will likely refer you to your plastic surgeon because breast implants and associated complications are not something primary care doctors typically deal with regularly.

	A torn muscle is possible but it is more likely that your capsule broke around the implant. I do not know whether you actually ruptured your implant or not.  Saline implants when broken will deflate.  A ruptured silicone gel implant can be harder to detect. You didn't say what kind of implants you have.

	It would be best for you to see your plastic surgeon. If that is not possible, see another board-certified plastic surgeon in your area to be examined. You can also see your primary care physician as a start.

	Best wishes.

Ronald Schuster, MD · Answer

You probably tore the capsule surrounding the implant rather than the muscle. Take some Ibuprofen and apply some heat. It will take around 4-6 weeks until it feels back to normal. You may also want to take some vitamin E for about 3 months to help prevent a capsule contracture which might get triggered from the inflammation.

Steven Wallach, MD · Answer

A bear hug could have caused a tear in the breast capsule if it was a really strong one.  It sounds like you should go in to see your surgeon to be checked out.

Peter A. Aldea, MD · Answer

It would be best if you were evaluated by your Plastic surgeon. It sounds like the classic description of a Closed Capsulotomy, the blowing of the wall of the scar around the breast impant (capsule). By sudden hard crushing compression of the augmented breast the scar is stretched hard acres the implant and broken. The problem is that this may result in bleeding, implant rupture and occasionally in a portion of the implant being caught in the capsule crack (Barbell Defect). You may need an ultrasound  or a MRI to evaluate the implant and decide on the next step. 

	I hope all goes well.

Steven Schuster, MD, FACS · Answer

Believe it or not Debby, that's how it was discovered that a capsulotomy could release a capsule, what was referred to as a closed capsulotomy. We now know this can cause implant rupture and uneven capsule release creating a deformity. I would call your plastic surgeon and follow up with him. I would not attempt to give you advice over this web site as I can not evaluate you. In all liklihood it is a tear in the capsule and will resolve without any drastic measures. Good luck, Dr. Schuster in Boca Raton.

Tom J. Pousti, MD · Answer

Thank you for the question.

	It must have been some serious &ldquo;bear hug&rdquo;  to be causing discomfort 3 weeks later. For patients who describe &ldquo;excruciating pain&rdquo; that is disabling I would suggest evaluation by your primary care and/or plastic surgeon. Online consultation will not be helpful  enough...

	Best wishes.

Ronald V. DeMars, MD (Retired) · Answer

Many years ago (in the early 70's I think) a woman in Florida had hard breasts from capsular contracture after augmentation. She was at a party and had a big bear hug, actually heard a pop and had pain. The next day she noticed her breast was soft. That was the start of doctors physically squeezing very hard on hard breasts to pop or tear the tight capsule that was causing the problem. We no longer do that, thank goodness, but a big hard pressure on the encapsulated breast can easily tear that capsule or scar tissue sac. Sometimes there will be a liitle bleeding into the surrounding muscle or even a few torn muscle fibers. Generally the only treatment necessary is hot and cold alternating packs, ibuprofen and rest of the muscle from heavy exercise. It heals like a torn muscle over 4-6 weeks.

Can a Muscle Tear Occur from Receiving a "Bear Hug" After Breast Augmentation?

Answers (9)