NEED PROFESSIONAL HELP!!! Pain after auto accident in my back, directly behind breast wall (I was rear ended)

I was involved in an auto accident 3 months ago (7/27/12). Since then I have experienced some of the worst pain I have ever felt in my life.  I have had a total of 5 MRI's (neck, spine, breast, thoracic and shoulder) and a full X-ray work up and the only thing they found was a ruptured breast implant on the right side.  The issue here is that all of the pain I am feeling is on the left side.  The pain can best be described as a shooting, sharp, nagging, intense, pinching, sometimes burning pain.  Another strange thing is that the actual pain is not felt in what most people would call the breast.  The pain is located in the area of the left, middle portion of my back radiating to my left side.  It sometimes sends shooting pains into my spine and I have had a few time when it was SOOOOO sensitive to the touch until I would scream when my fiance or chiropractor tried to massage or lightly rub it.  Most doctors I've been to (chiropractor, internal medicine, urgent care, orthopedist and my oncologist) ask me if there is anything that makes the pain worst and I tell them all the same thing, Yes, not taking my pain pills makes the pain worse.  I have taken 2 cortisol shots in my back, they last a few days and then the pain comes back.  A little background on me.  I was diagnosed with breast cancer at the age of 37 (in 2009).  2.5 months after my diagnosis, I underwent a double mastectomy with reconstruction.  In 2010, I had the breast implants put in along with a toatl hysterectomy (I am a BRAC-1 gene carrier).  I had been doing great until the accident in July of this year.  I could lift my arms, execise, wear 5 inch heels (although I am 6 ft tall) and in general never had any issues.  If any one of the doctors can give me some insight into what might, and I say MIGHT very cautiously, have happened I would really appreciate it.  I will be going to my plastic surgeon on Wednesday (10/24) and would like to go armed with questions because I am tired of hearing "There's nothing wrong".  I also have another question.  Since I am a larger woman, I would like to have bigger implants (I was a DD before my double mastectomy) but was told my insurance company wouldn't pay for anything larger than a C cup.  Is there anyway my doctor or myself can advocate for bigger implants, preferably D cups?  The replacements will come from Mentor since I have a guarantee on them.  Thank you guys and I will be waiting on some professional insight.   BTW, I've read where this one lady ruptured her implants in a car accident.  I don't know how feasible this is, but could this be a option?

Doctor Answers 2

Implant Rupture and Upsizing Breast Implants for Reconstruction

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    In general, blunt force trauma does not cause implant rupture.  Also, if one or both of the implants ruptured, upsizing implants during replacement could be considered. 

Size limit for recontruction??

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No comment on the pain. I would not expect much expertise from a plastic surgeon regarding the sequelae of your injury.

As far as your reconstruction goes, I have never heard of any size limitation for breast reconstruction. Whether your carrier will pay for another reconstructive operation for size change alone is something I cannot answer, but usually they will cover replacing a failed implant.

Thanks, very best wishes.

Jourdan Gottlieb, MD
Seattle Plastic Surgeon

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