Can I remove all my breast tissue and replace with only an implant?

Probably a bit soon to go the surgical route.  Maybe your regular doctor or gynecologist can place you on hormonal therapy for the problem.  Surgery would be a last resort and you will probably not find your surgeon recommending this approach.

Cana,
What you are describing is possible but you should meet with a board certified plastic surgeon to examine the breasts and make sure you don't have capsular contracture. You may also want to have your tuberous breast deformity corrected. Do you have any pictures? What implants do you have in now?
Daniel Barrett, MD, MHA, MSCertified, American Board of Plastic Surgery Member, Am. Society of Plastic Surgery

A simple answer  to your question is yes, however I'm wondering if you have tried other therapy such as nsaids like Advil to control the pain. I would try pain relievers prior to undergoing another operation. 

I would most certainly go and talk to your surgeon.  Your first option may be to simply remove the breast implants and see if your symptoms will improve.Best Wishes,Nana Mizuguchi, MD

Mastodynia or breast pain is fairly common. There are a number of causes ranging from the serious to the benign. The actual pathophysiology is dependent upon the cause and can be both intrinsic to the breast tissue or extrinsic (i.e. neuropathic pain).Breast pain is typically cyclic in nature varying with a woman's hormonal cycle. The pain commonly affects the upper/outer aspect of both breasts but can even extend into the proximal arm (remember the breast has a tail. This type of pain can generally be addressed with simple measures such as a supportive undergarment or anti-inflammatory medication. In rare cases, a physician may prescribe something for refractory pain.The more serious variant may be associated with a suspicious mass in the breast, nipple discharge or deformity and may be indicative of potential malignancy. In this case, patients with concerns should see their physician and imaging may be necessary.Your suggestion of removal of breast tissue is more commonly known as a subcutaneous mastectomy. A mastectomy is more commonly employed in the setting of a malignancy where all rather than most of the breast tissue is removed. In these cases, reconstruction is typically performed via placement of an implant. However, in the case of mastodynia, pain sometime persists even after all breast tissue has been excised.Subcutaneous mastectomy is a significant step. I would recommend evaluation by your primary care physician and breast surgeon as well to rule out more serious causes. You may also need evaluation with neurology in the rare case of neuropathic pain.

can certainly be done for you but you must be absolutely certain that your symptoms are from the tissue and not your implants.  Once its determined its your breast tissue, ideally, you would allow for medical intervention with hormones but if you simply want the tissue removed and are accepting of the results of an implant reconstruction and the prospect of possibly being flat chested if you have problems with the implants, you can have the procedure you ask about.

Yes...patients have undergone mastectomy procedures for intractable breast pain (mastodynia). Ideally, this would involve a subcutaneous nipple-sparing technique. The lost volume would need to be filled-out using a larger volume implant either immediately, or after the use of a saline expander to control the breast volume/shape during early healing. There are a variety of causes of mastodynia, and these should be explored in a thorough pre-operative work-up. Best of luck to you.

Thank you for the question and what you are describing is a subcutaneous mastectomy and YES it can be performed and is for mastodynia (breast pain) or high cancer riskDr Corbin

Although that it not commonly done, it is an option and in your case it may even be covered by health insurance. Mastodynia, or breast pain, is sometimes treated that way. Most insurance carriers would want to know you had tried nonsurgical options first, so see your MD for evaluation and treatment with nonsurgical methods for a few months before applying for insurance coverage.  

Dear Canadeah,Thank you for your story and questions. What you describe is mastodynia (breast pain).  This can be caused by various entities. Unfortunately without more information or a physical exam I can only offer limited but hopefully helpful advice/information:1) return if possible to your original Plastic Surgeon for a follow up. 2) a subcutaneous mastectomy can remove the majority (but not all) of your breast tissue. 3) yes, a implant can be placed after a subcutaneous mastectomy.  4) unfortunately in some woman the mastodynia continues even after removal of breast tissueMy best,R. A. Hardesty, MD, FACS, Bd. Cert. Plastic Surgeon