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

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!

Many suggest removing and/or removing and replacing your implant every 10 years.  The swelling you are now having is concerning and you need to have this evaluated immediately by your plastic surgeon.  

In person exam is essential, as well as diagnostic imaging may be needed. I suggest that you schedule an in person exam with your Operating Surgeon to go over the options

Thank you for sharing your excellent question.  Unfortunately this significant change in appearance deserves to be evaluated in person by your surgeon or a local ASPS board certified plastic surgeon. The exam should help provide you with a diagnosis and treatment plan moving forward.  Best wishes!

Dear mds0214,
I understand your concern. Sudden change in size and shape of breast is not normal. However, without a proper assessment it would be difficult to determine what is wrong. It is best that you visit your plastic surgeon for further assessment. Only after thorough examination you can get proper recommendations and advice.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

The risk of ALCL is exceedingly low. While this is concerning, this is by no means a guarantee of disease. To date, there have only been a few hundred documented cases (as compared to the millions of implants in circulation).
That being said, the recommendations for evaluation of sudden swelling of the breast (especially in the presence of textured implants) include:
-Diagnostic US
-Sampling of peri-prosthetic fluid and testing for CD30 and ALK
If positive, treatment includes explant and capsulectomy. This is curative.
As always, discuss your concerns with a board certified plastic surgeon (ABPS).
Donovan Rosas MD
Board Certified by the American Board of Plastic Surgery
Member: American Society for Aesthetic Plastic Surgery, American Society of Plastic Surgeons
RealSelf Top 100
RealSelf Hall of Fame

This sudden change in breast size needs to be investigated medically to determine whether it is a physiological or pathological problem.  Breast size can change with hormonal factors.  It you are not experiencing other symptoms such as redness, heat, lumps, nipple discharge, changes in nipple appearance, the alteration in breast size may be innocuous. I would recommend that you see a board certified PS to determine if a mammogram or ultrasound should be scheduled. Results of the exam and tests will let your PS know if the implant needs to be removed.