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

Question

My breasts are normally very symmetrical. 2 days ago my right breast became sore & swollen with no other symptoms. I called the Dr's office where I had my implants put in (20 yrs ago) & they said this is probably mastitis caused from some other infection in my body and gave me a rx for Duricef. I am unaware of any recent infections (possibly a mild UTI, I get them often but haven't had any recent symptoms). Is there any other reasons or ideas of what may be causing this? Breast cancer or ALCL?

Shlomo Widder, MD · Answer

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

Austin Hayes, MD · Answer

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

Joseph G. Bauer, MD, FACS · Answer

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.

Harry T. Haramis, MD, FACS · Answer

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.

Larry Weinstein, MD · Answer

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...

Deborah Sillins, MD · Answer

From your photo it appears you may have capsular contracture develop on that side. This can cause the implant to be pushed upward. Another reason could be fluid accumulation around the implant. I would suggest an ultra sound to determine. I do not believe that is mastitis

Patricia A. McGuire, MD · Answer

There are a few possibilities for swelling years after placement of implants. Infection is a possibility which is why your doctor prescribed a course of antibiotics. The other possibilities are bleeding around your implant, capsular contracture, rupture in a gel implant, and ALCL, a rare lymphoma that can form in the capsule that surrounds an implant. You should see a board certified plastic surgeon for evaluation. Am ultrasound can show if there is fluid around the implant. If this is the case, a radiologist can place a needle and collect some of the fluid which can be sent for analysis and treatment determined depending on the results.

Steven Wallach, MD · Answer

The recent onset of swelling in the breast after 20 years can be from several things. The most common is an infection.   Best to be evaluated in person. Good luck.

Jason Pozner, MD · Answer

Breast swelling 20 years after implant placement is a concern. Mastitis and ALCL are both possible causes of breast swelling. An in office exam and follow up testing are required.

Tom J. Pousti, MD · Answer

I am sorry to hear about your concerns;  based on your description and photograph, it does not seem like mastitis. A fluid accumulation such as seroma is possible; encapsulation is also high on the list.  Definitely time to be seen by a well experienced board certified plastic surgeon in person. Best wishes.

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

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