Swelling, hardening and pain in breast 5 months after breast augmentation. What could be the cause? My doctor isn't sure (Photo)

Capsular contractures can occur, but because of the circumferential 360 capsule squeezing in on itself, capsular contractures which can cause hardness and pain never cause enlargement because the word contracture means to pull in, not to push out.The symptoms you describe would seem to go along with a seroma or infection.  If you were my patient, I would make a small incision at the base of your inframammary fold after getting radiologic studies to show if fluid is present.  This drainage using a Seromacath with blunt tip would allow both in dwelling drainage and levage to occur, and also allow a culture and sensitivity to be sent to pathology.I recommend you follow your surgeon's instructions.

Dear 7296321,Thank you for your question. Capsular contracture does not occur overnight, it is a gradual process that occurs overs week to months. Other causes of swelling pain and warmth (fluid collection, infection) would be extremely rare and unlikely 5 months after surgery. In addition to the above, any change in implants so quickly would warrant an MRI in my opinion. That will tell you if you have fluid, or if there is rupture of the implant.Good luck,Nirmal R. Nathan, M.D.

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Your photo and description indicates that you may have a capsular contraction.  They are uncommon this close to surgery, but not impossible.  Continue to follow the advice of your plastic surgeon to determine the best course of action for you.