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

This is not a typical reaction.  I encourage you to make an appointment with a board certified plastic surgeon right away for an evaluation.  An examination is needed to determine the cause of the swelling and the correct treatment.

Great question!  This could be due to several reason.  I would seek a consultation with your original surgeon or a board certified plastic surgeon in your area for an evaluation and examination.  He/she can then guide you from there.Best of luck and hope this information helps!
- Dr. Roger Tsai  @DrRogerTsai
Board Certified Plastic Surgeon

Thank you for this very important question. Please do not hesitate in getting this evaluated by a local plastic surgeon and make SURE he or she is board certified by the American Board of Plastic Surgery so they know how to properly assess and treat the possibilities. If there was no trauma to the area or anything else to explain this change, it needs to be evaluated from something serious like a malignancy. A late-onset fluid collection (seroma) could be the first presenting sign for ALCL and this needs to be evaluated with ultrasound and fluid drainage to be evaluated for a special study (CD30+). If this proves to be negative, you can look into other possibilities, imaging (MRI) and discuss removal and replacement of your implant as well as other options.Please don't wait. Call someone today. Best of luck....Dallas R. Buchanan, MD, FACSOwner & Board-Certified Plastic SurgeonVIVIFY plastic surgery

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!