Difficulty breathing after breast surgery

Question

Hi! Im 26 and I had my second breast lift with implants three months ago. Since 2 weeks after my surgery, I started having trouble breathing, really bad, it has caused me panic attacks. I’ve gotten tested for everything. D-dimer for clots, multiple chest X ray, spirometries, everything says I’m fine. I’ve been on treatment for allergic asthma for a month and a half because we thought it could be that but it’s not helping at all. Could it be the weight of the implants? Thank you for your answe

Daniel Barrett, MD · Answer

Dear cinthyagb,

I understand your concern. 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 or ask for a second opinion. Only after a 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

Ellen Ozolins, MD · Answer

Thank you for your question. The weight of your implants could contribute, but other possibilities, such as muscle tightness, capsular contracture, or psychosomatic effects, should also be considered. Large implants can exert additional pressure on the chest wall or diaphragm, making breathing feel harder, especially when lying down. Muscle tightness may lead to a sensation of restricted breathing, especially during deep inhalation. Early capsular contracture (formation of scar tissue around the implant) could give a feeling of tightness or pull in the chest. Also, surgical trauma or swelling may irritate nerves around the chest, causing sensations that mimic breathing difficulty. Work closely with your surgeon to exclude all these causes, share your symptoms, ask for an evaluation of the implant size and placement, and request imaging (ultrasound or MRI) to check for capsular contracture or other structural issues. If your current surgeon cannot identify the issue, consult with another surgeon for another perspective.

Ted Eisenberg, DO, FACOS, FAACS · Answer

Unlikely the weight of the implants are related. Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author. RealSelf Distinguished Hall of Fame Inductee. Philadelphia, Pa., USA

Camille Cash, MD · Answer

If you are experiencing difficulty breathing when laying on your back and your implants are large, they may be contributing.  It sounds as if you are following the appropriate channels to ensure there is no pulmonary embolism which is important.  I encourage you to discuss your concerns with your surgeon.

Connie Hiers, MD, FACS · Answer

If you have large implants, you may be feeling the weight on your chest. You did not state the size of your implants. If they are large, over 450 cc's, consider going smaller.

James Knoetgen, III, MD · Answer

Difficulty breathing after a breast lift with implants is a concerning symptom that should be taken seriously. While some level of tightness or discomfort is expected due to swelling, bandaging, or the pressure from the implants, significant breathing difficulty could indicate a more serious issue. Here’s a breakdown of possible causes and what to do:

Common Causes

1.	Swelling and Compression: Post-surgical swelling in the chest area, combined with tight bandages or compression garments, can create a feeling of restricted breathing.

2.	Muscle Tightness: If the implants are placed under the muscle (submuscular placement), tightness of the chest muscles may contribute to discomfort.

3.	Anxiety: Post-surgical anxiety or stress can sometimes mimic difficulty breathing or exacerbate feelings of tightness in the chest.

4.	Pain Medications: Certain medications prescribed for post-operative pain, like opioids, can cause shallow breathing as a side effect.

Serious Concerns
1.	Pulmonary Embolism (PE): A rare but serious complication where a blood clot travels to the lungs, causing sharp chest pain, shortness of breath, and a rapid heart rate. Immediate medical attention is required.

2.	Pneumothorax (Collapsed Lung): This is uncommon but could occur if the pleura (lung lining) is accidentally punctured during surgery. Symptoms include sudden chest pain and difficulty breathing.

3.	Fluid Accumulation (Seroma or Hematoma): If fluid or blood collects in the chest area, it may press against the lungs and interfere with breathing.

4.	Infection: Severe swelling, redness, fever, and difficulty breathing may indicate an infection, which needs urgent treatment.

What to Do

1.	Contact Your Surgeon Immediately
o	Report any breathing difficulties to your surgeon as soon as possible. Be prepared to describe your symptoms in detail.
2.	Seek Emergency Medical Attention
o	If you experience severe shortness of breath, chest pain, or rapid heart rate, go to the nearest emergency room or call emergency services.
3.	Follow Post-Operative Instructions
o	Ensure you are wearing your compression garments correctly and following your surgeon's guidelines for pain management, activity, and rest.
4.	Practice Relaxation Techniques
o	If anxiety is contributing to your symptoms, try deep breathing exercises or meditation to help relax your chest muscles.

When to Worry

•	Severe, persistent shortness of breath
•	Chest pain that worsens with deep breaths
•	Swelling in one leg or sudden leg pain (a potential sign of a blood clot)
•	Fever, chills, or worsening redness around the surgical site

Your surgeon is the best resource to evaluate your symptoms and guide you toward appropriate care. Don’t hesitate to reach out, as timely intervention can prevent complications.

Difficulty breathing after breast surgery

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