What would cause unilateral breast swelling 20 years after saline breast implants? (photo)

Dear princess,  Thanks for submitting your picture and sorry for your trouble.   From observing your picture, it appears that you have severe  capsule contracture with, possibly, fluid collection. If the breasts were symmetrical until few days ago, malignancy is very unlikely. It is more likely for you to have  capsule contracture due to 'Biofilm', which can be caused by dental work or infection like UTI etc. 'Biofilm' does not appear as a flagrant infection (fever, chills, redness, sweling etc) , so antibiotics will not bring any improvement. The correct treatment is complete capsulectomy (scar excision) and replacement of implant. At the same time a capsule specimen and seroma fluid can be sent to the laboratory for ruling out  ALCL (very unlikely) .   If you elect to go back to your original surgeon, make sure that he is experienced wit capsulectomy surgery, which is a very tedious procedure. Otherwise, consult with other experienced board certified plastic surgeons who , indeed, have vast experience in performing that procedure.                 Best of luck,                                     Dr Widder  

Swelling 20 years after breast augmentation is certainly not normal. Make sure to see a board-certified plastic surgeon can evaluate you in person.

Thank you for your question and for your photograph. Breast swelling 20 years post augmentation is certainly cause for concern. This is a situation that  would require an in person exam to determine what is going on. I would recommend that you schedule an appointment with your plastic surgeon. Best of luck.

An exam and consultation with a/your plastic surgeon is recommended to evaluate your presentation. A capsule contracture, seroma, or other process may require tests and/or surgery with discussion of your options and expectations. 

Fluid collection as in a seroma requires a check as soon as possible by a qualified ASAPS board certified plastic surgeon. I have patients with saline implants without problems for over 25 years. Age of the implant is not an indication for change. More often body change, weight change is a reason for changing implants. If you had textured Allergan saline implants an ultrasound is possibly indicated. It is possible you have mastitis or capsular contracture. However late seroma, one must be wary of ALCL. Good luck...