5 years after Breast Implants, I still have severe pain in one nipple, what is causing this?

Hello! Thank you for your question!  Breast procedures such as the
breast augmentation and breast lift/reduction certainly result in a more
shapely,
perky, and fuller appearance of your breasts. With any breast procedure
there is a risk, albeit very small, of change in
sensation to the area. The reported rate of sensation changes
(decreased, loss, or increased) is ~7% for lift/reductions and much
smaller for breast augmentation. In my experience, this rate is
reportedly much lower, but is higher when tissue is excised or the
amount of lift that is needed, so the breast reduction procedure has a
slightly greater risk. It can take up to a year for full sensation to
return. Re-educating your nerves to these areas by using different
textures when showering and putting on lotion often helps.It is one risk of such a procedure, and
one that you must consider, amongst others, as with any surgical
procedure. You should consult with a plastic surgeon well-trained in
breast procedures who will examine and discuss with you the various
risks and benefits of the procedure(s) and assist you in deciding if
such a procedure will be the right decision for you.  Consideration for downsizing or explantation should be discussed if the pain is still that significant.  See your surgeon and/or primary care for evaluation as well as possible imaging.  Best wishes!

Hi there. I'm very sorry to hear about the pain you're
experiencing. Has the pain been ongoing since your surgery, or has it developed
recently? Because 5 years have elapsed since your surgery, it's possible that
the nipple pain is unrelated to your breast augmentation. I suggest scheduling
an appointment with your plastic surgeon or your general practitioner in order
to determine the cause of your discomfort and effectively treat it. Best of
luck.

If you have pain this long after surgery, you should consider having this more thoroughly evaluated, and possibly surgery.  Any number of things may cause pain, and of course an in-person examination is the best way to narrow down the possibilities.  Having said that, one cause may be capsular contracture -- which is when excessive scar tissue builds up around the implant.  This typically requires surgery to excise the scar tissue and to replace with a fresh implant.  Sometimes capsular contracture can respond to medications like motrin/ibuprofen or accolate (an asthma medication, used off-label) and thus avoid surgery.The other cause could be a neuroma -- which is a jumble of scar tissue that has developed in the nerve to your nipple, probably due to trauma during the surgery.  A neuroma can sometimes be felt as a pea sized nodule, or an "electric-shock" sensation elicited by tapping directly on the trigger spot (it's called a Tinel Sign).  If the neuroma is excised, the pain can often be resolved.Those are just two of the leading likely causes.  I recommend a thorough evaluation -- there is no reason that you should have to live with this discomfort when good solutions can be found.  

Persistent pain 5 years after breast augmentation likely is an indication that the nerve was injured at the time of surgery.  In some cases as the nerve tries to heal the nerve fibers grow abnormally  causing a neuroma which can cause pain.  Medications like Neurontin can be used to reduce this neuropathic pain.  Asked your plastic surgeon for a neurology consultation.  If medication fails nerve blocks might be able to help.