Implants for 19 years. 1 week ago my right breast began hurting and overnight doubled in size. Do I need it removed? (photo)

I would find a plastic surgeon who is board certified in your area to discuss this.  Late onset swelling could be an issue and could perhaps be one of the first signs of BIA-ALCL.  You would need get the fluid studied and then you will need surgery for remove and replace with possible removal of the entire capsule.Just remember ALCL is extremely rare and very unlikely in your situation but that is the one thing I would want to rule out.Hope that helps.

Thank you for your questions and pictures! It looks like something is going on in that right breast but it is impossible to know what without a physical exam, history and imaging. I recommend following up with your surgeon or another board certified plastic surgeon to discuss what you should do next, good luck!