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

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?

Doctor Answers 12

Implant swelling

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.

New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

Right breast capsule contracture

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  

Shlomo Widder, MD
McLean Plastic Surgeon
4.8 out of 5 stars 124 reviews

Swelling I left breast 20 yrs. after augmentation surgery

I would initially consider the necessity to see a Board Certified Plastic Surgeon ASAP.  This condition is certainly worthy of careful evaluation.  You may have an infection of the breast, or more commonly a seroma.  The symptoms are very different, as well as your medical physical findings when they would be fully evaluated.  Very simply, be aware that a proper medical and surgical evaluation is necessary.  Please don't delay about this.
Good luck to you.
Frank Rieger M.D.  Tampa Plastic Surgeon

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

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

Austin Hayes, MD
Portland Plastic Surgeon
5.0 out of 5 stars 32 reviews

Unilateral breast swelling

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.

Joseph G. Bauer, MD, FACS
Atlanta Plastic Surgeon
4.3 out of 5 stars 23 reviews

Unilateral breast swelling

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. 

Harry T. Haramis, MD, FACS
Montclair Plastic Surgeon
3.7 out of 5 stars 19 reviews

Unilateral breast implant swelling

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. 

Jason Pozner, MD
Boca Raton Plastic Surgeon
4.7 out of 5 stars 45 reviews


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...

Larry Weinstein, MD
Morristown Plastic Surgeon
4.9 out of 5 stars 11 reviews

Swelling of breast

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

Deborah Sillins, MD
Cincinnati Plastic Surgeon
5.0 out of 5 stars 11 reviews

Infection around the implant

Mastitis is infection of the breast tissue but from you photo I think this is more likely infected fluid around the implant.  I would advise having a breast US to determine the cause of this and finding a plastic surgeon who is familiar with these types of breast implant problems if it involves the implant.  Saline implants should be changed out every ten to fifteen years in my experience in order to avoid these types of problems.  You will need total capsulectomy without any reimplantation for at least six months as well as appropriate antibiotics and antifungals.  Duricef does not cover many of the organisms that we see with this.  I would suggest Cleocin.

Susan Kolb, MD
Atlanta Plastic Surgeon
4.2 out of 5 stars 28 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.