When implants are removed with or without capsule, do the lymph nodes stop swelling?

Question

I have 22 year old saline implants under the muscle. I have had swollen painful lymph nodes for almost 2 years in the left axillae. When you physicians remove the implant, do the lymph nodes stop swelling? Or, does the capsule need to be removed to alleviate symptoms? I am struggling between removing the implant vs with or without the capsule. Both implants are intact. The left has a slight contracture with chronic pain on that side. All sonograms, ultrasound and lab work negative.

Michele A. Shermak, MD · Answer

Hello!Painful lymph nodes under your arm need to be evaluated sooner rather than later. Lymph nodes are not typically related to a breast implant. They could be a sign of issues in your breast tissue. You should see your doctor about getting a mammogram to check your breasts for any suspicious findings. I see your ultrasound is negative. You may need a fine needle aspirate of the enlarged nodes to see what is going on.

Kenneth Hughes, MD · Answer

Swollen lymph nodes are a sign that something is wrong somewhere in your body.  Your PCP can determine the cause of the swelling. Following infection, lymph nodes can remain permanently enlarged.  They should be small, have a rubbery consistency, and non-tender. If the cause is not associated (sonogram, ultrasound, and lab work negative) with the 22 year old saline breast implants , there is no need to remove them with or without the capsule.

Trevor M. Born, MD · Answer

Dear Kim_BeeThank you for your question!  I am sorry that you are having difficulty .  Were your implants silicone?  Have you had an ultrasound of the lymph nodes? MRI of the Breasts?With Warm RegardsTrevor M Born MD

Farbod Esmailian, MD · Answer

The cause of the swelling should be determined or at least everything else should be ruled out.  If the swelling of the lymph nodes is the result of your breast implants then a removal would be all that is needed.  A capsulectomy is not necessary unless the capsule has thickened and leaving it could lead to issue with fluid accumulation.I would discuss this further with your surgeon and make certain that everything else has been ruled out for the cause of the swelling.

Nelson Castillo, MD · Answer

I would continue to work with your surgeon regarding the cause of the swelling to ensure the appropriate diagnosis.  If the implants are the cause, then it should resolve with removal of the intact implant material.

Daniel Barrett, MD · Answer

Dear Kim Bee,
if you have thick capsules or capsular contracture, then implants and capsules should be removed together. Otherwise, you can get only removal of implants. If you are considering a surgery, I would suggest you to consult a board-certified plastic surgeon. Only after a thorough examination you will get more information and recommendations.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Camille Cash, MD · Answer

Swollen lymph nodes can occur for many reasons.  Having the implants removed with or without the capsule many not have an impact on the swelling.  I recommend beginning by looking for the cause behind the swollen lymph nodes by visiting with your PCP.

Connie Hiers, MD, FACS · Answer

There can be many causes for lymph nodes to swell that are not related to implants. If your nodes have been swollen for a while, I would suggest getting them biopsied. Saline implants are not as reactive as the old gel implants since your body does not see saline as a foreign material. I would suggest evaluating the lymph nodes first.

Helena Guarda, MD · Answer

From your question, it appears you have had a workup showing no cause for the enlarged lymph nodes. You also report having pain and capsular contracture on the same side. I recommend seeing a plastic surgeon for evaluation and implant removal/ exchange. It is not uncommon for capsular contracture to cause pain. During the procedure if the capsule is thick, which it most likely is given the contracture, it will be removed. You should discuss with your surgeon implant exchange. Your surgeon will examine you and determine if lymph node biopsy is best at the same surgery or waiting .
Please make sure you are evaluated and do not ignore the pain.
Wish you a speedy recovery

When implants are removed with or without capsule, do the lymph nodes stop swelling?

Answers (9)

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