What is this pain after breast implant removal?

Question

I had DC 23.5 year old submuscular, ruptured silicone breast implants removed on Jan. 28, 2010. I believe the implants were removed first and then the capsulectomy was done. Severe pain and bleeding post-op. 3 weeks later, I am still experiencing pain. It is located in the breast under the arm; it is quite hard. Hard to sleep on my side, and it feels hard inside. Is this muscular pain, do I need PTherapy, and how long will it last?

Jed H. Horowitz, MD, FACS · Answer

Many patients report the recovery and healing is much more easier than the original breast augmentation procedure. Your pain should be manageable. However, in this case, it is best to consult with your doctor and see them for an #evaluation. The sooner the better to assure you are not experiencing an infection or anything else that can impact your healing and final results.  At any time during your post-op #healing you have any concerns, do not hesitate to contact your doctors to further inquire.

Ankit Desai, MD · Answer

You should consider other more serious causes of chest pain. If you are in good health and have no other causes of pain like heart related pain, reflux, costochondritis, or peptic ulcer disease, you may have pain related to irritation of your nerves. Neuropathic pain or nerve related pain maybe caused by irritation or scar tissue or maybe a pressure related phenomenon. Rest assure, there are several treatments for pain due to breast implants. If you do have pain, begin massage to the area of pain to help desensitize the area. If at least 6 months and preferably 12 months have passed after your breast implant surgery, some modalities that may help resolve your pain are:

	1. Local Steroid injection to area of pinpoint pain

	2. Flector transdermal NSAID patch

	3. Intercostal nerve block

	You should consult with your plastic surgeon to determine what is most appropriate for you and your particular signs and symptoms. Good Luck, Ankit Desai, MD - Jacksonville Plastic Surgeon

Otto Joseph Placik, MD · Answer

It is difficult to tell without knowing more about the surgery. You may have a small hematoma or nerve pain secondary to entrapment.

Farbod Esmailian, MD · Answer

Sounds like you had a difficult surgery done. It is not uncommon to have some discomfort under the arm area after such procedures. If you feel a mass then I would suggest seeing your plastic surgeon to see what the problem is, otherwise what you are feeling will likely resolve in the next month or two.

Siamak Agha, MD, PhD, FACS · Answer

It is possible to have some lingering pain if you bled post- operatively. This should however continue to subside over the course of the next 3-4 weeks. Also PT, massaging and warm pads should help. You may also want to discuss this with your surgeon.

Steven Wallach, MD · Answer

Pain after implant and capsule removal can occur post-op and some have the pain longer than others. Without an exam I can not be certain what is the etiology of your pain, see your surgeon.

Peter A. Aldea, MD · Answer

Removal of old gel implants and the surrounding capsule is always a challenge. To ease the task we always try as much as possible to stay just outside the scar capsule and separate / peel the implant capsule unit from the adjacent breast and chest tissues. Although this works sometimes, in many cases the scar in entered and we need to remove the implant and liquid silicone gel separately, wash the pocket and then complete the removal of the hard capsule, if needed. Drains are usually used because the pockets continue draining fluid until everything adheres together. Although there is post-operative pain - 3 weeks is out of the ordinary and there MAY be something else going on. I suggest you see your surgeon and have him/her evaluate you.

Susan Kolb, MD - Account Suspended · Answer

In my experience, this pain is due to infection and we always get bacterial capsule cultures for this reason at the time of explantation, as this is very common due to the large number of positive cultures in ruptured implant capsules.  The pain in your axilla in probably an infected lymph node.  I would also recommend antifungals such as Diflucan and Nystatin oral solution with the antibiotics, as without them, your are at a very high risk of Candidiasis with fatigue, muscle aches and mental clouding.   PT is not the answer.

What is this pain after breast implant removal?

Answers (8)

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