Pain and Extreme Sensitivity 3 1/2 Years After Breast Augmentation?

This type of pain is unusual three years after breast augmentation and probably isn't related to your breast implants. The type of pain that you describe suggests inflammation or irritation of one of your sensory nerves. This can occur for a variety of reasons including surgical injury, scar entrapment, neuroma formation and peripheral neuropathies.It's important that your symptoms be thoroughly investigated to rule out more serious problems. For instance, it would be appropriate to obtain a mammogram to rule out breast cancer. There's a good chance that these evaluations will be negative, and no cause for your symptoms will be identified. Under these circumstances, implant removal may be an option, but there's no guarantee that this will be effective.For this reason, it's appropriate to consult a pain management specialist. This physician should be able to develop a treatment plan that helps minimize your pain and discomfort. This plan may include massage, sensory re-education, nerve blocks and pharmacologic management.

Hello! Thank you for your question! Your symptoms sound like your
nerves regenerating. 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.  You are very remote from your procedure - you should discuss this with your surgeon and/or primary care.  Consideration for downsizing or explantation should be discussed if the pain is that significant.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.

IF you pain has persisted for more than 3.5 years, I doubt that it will resolve at this point in time. The most likely cause is stretching or distention of the nerves to the nipple., In some instances a supportive bra can be quite helprul in alleaviating this discomfort. It may be an indication of other underlying conditions and should be evaluated. Timely mammograms are also essential.

Unfortunately, it is very difficult to diagnose
the source of your discomfort without an in-person examination.  I would recommend that you schedule an
examination with your plastic surgeon to ensure that the source of your pain is
correctly diagnosed.

It’s been quite a long time after your surgery. Unusual changes in sensation, particularly pain or throbbing, can be indication of capsular contracture, a complication that refers to excessive scar tissue encapsulating the breast implant. It usually occurs on one side only, but both breasts can also be affected. I recommend you see your surgeon.

After a breast augmentation most sensory changes return to normal within 6 months. Occasionally however it may take up to 2 years to fully regain normal sensation. When pain and sensory changes extend past this expected recovery time other sources of pain, discomfort and sensory alteration should be explored. If present, underlying causes of neuropathies (functional peripheral nerve disturbances) such as diabetes mellitus need to be appropriately managed. Local conditions causing prolonged pain would include an entrapped nerve or the formation of a neuroma. Nerve entrapment or compression could be the result of a capsular contracture. Treatment in this situation may be a release or removal of the capsule. When nerves are injured it is possible to form a neuroma at the end of the cut nerve. A neuroma is a growth consisting of nerve fibers. If a neuroma is present pressure on or movement of the neuroma can result in pain along the distribution of the nerve. When conditions such as these are suspected it is best to proceed with conservative management for 6 months. This may include massage, desensitization, and sensory reeducation techniques. Specialists in pain management are able to direct this type of care. If conservative treatment fails surgical intervention may be necessary. Sometimes sometimes the offending nerve can be localized with a nerve block. The nerve block is placed in the vicinity of the suspected nerve. If pain is relieved immediately it is likely the targeted nerve is the source of the problem. Following localization of the suspected nerve a surgical approach can be considered. If you have pain or sensory alterations extending beyond the expected recovery time it is best to consult your plastic surgeon so that he or she can thoroughly evaluate you and help direct the appropriate care. Good luck.

Dear Dancer, Thank you for your post. In general, most women who have a disturbance in nipple sensation, whether it be less (hypo-sensation), or in some cases too much (hyper-sensation), the sensation goes back to normal with 3-6 months. Occasionally, it can take 1 - 2 years to be normal. Extremely rare, the sensation never goes back to normal. This is extremely rare in augmentation alone, more common in lift or reduction but less with a smaller lift like a crescent lift. Signs that sensation is coming back are needle type sensation at the nipple, itchiness at the nipple, or 'zingers' to the nipple. The number of women that lose sensation is much lower than 10%, closer to 1% in a simple augmentation. In some cases the same occurs with contraction where some women have no contraction and some women have a constant contraction of the nipples. Unfortunately there is no surgical correction for this. Massaging the area can help sensation normalize faster if it is going to normalize, but will not help if the nerve does not recover. In women with hyper-sensitive nipples, this will go away with time in most cases. Usually 3 months or so. In the interim, I have them wear nipple covers or 'pasties' to protect them from rubbing. It is unlikely that down-sizing the implant will cause regaining sensation. Down-sizing the implant may cause saggy breasts, however, and may necessitate a breast lift. Physical therapy with de-sensitivity techniques can help with this issue.  In your case with quite prolonged sensitivity, it could be that a capsule has developed and wrapped around the nerve compressing it.  This may be relieved with a capsulotomy.Best Wishes,Pablo Prichard, MD

Thank you for the question.

You should be seen by your plastic surgeon to rule out issues such as encapsulation and/or breast implant displacement and/or neuroma.

Best wishes.

It s unusual for someone to have pain and nipple sensitivity so long after breast augmentation. I suggest that you see the plastic surgeon who performed your surgery for an evaluation. There may be several causes of pain and sensitivity; for example, you may have formed a capsule that is causing pain and irritating the nerves that supply your nipple. A thorough history and physical examination should help your doctor to devise a plan to help you find relief. If the pain is severe, persists and does not respond to treatment, you may consider removing your implants in an effort to relieve your symptoms. 

Any pain more than several weeks is too long following breast augmentation.  As stated by others, a nerve may be stretched, or a neuroma, or a thickened capsule (capsular contracture).  A visit to your plastic surgeon and a possible capsulectomy or exploration may be a possibility.