18 months post op and still experiencing pain and firmness, what can be done to correct this?

Your symptoms suggest the presence of a capsular contracture. Your surgeon can confirm this with a brief examination. Treatment options can be non-surgical through the use of medications such as montelukast. If the capsule is long standing or significant, a capsulectomy may be recommended. Your surgeon can make recommendations and guide your through treatment if necessary.

Dear Capri 88,
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, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

You may have developed a capsule. Please go back to your surgeon and be examined. Sometimes this can be treated nonsurgically with medication and external ultrasound treatments.

Hi Capri88
Sorry you're experiencing issues so far out from your surgery ! Based on your brief description there are a few possible explanations. You could be experiencing capsular contracture or sometimes the anatomically shaped implants can shift from their ideal position, both can cause pain and change in breast contour. You would need to visit your plastic surgeon for a physical exam to confirm the diagnosis! hope this helps.