Constant pain in one breast and can feel a hard piece on the bottom of implant - is the mesh aggravating my breast?

persistent pain and the sensation of a hard piece near the implant could be concerning. It’s crucial to reach out to your plastic surgeon promptly to discuss these symptoms. It’s possible that there may be an issue related to the mesh or implant that requires attention. Your surgeon can assess your situation, conduct necessary examinations, and provide guidance on potential causes and solutions.

Best of luck !

Hello LKH123,

Thank you for reaching out with your concerns about the constant pain in one of your breasts and the sensation of a hard piece at the bottom of the implant. Your suspicion that the mesh might be contributing to this discomfort is certainly worth exploring.

Pain in the breast area, especially in the context of implants and surgical mesh, can indeed be attributed to the mesh acting as an irritant. However, it's also important to consider that the implant itself could be a factor in your discomfort. Immediate consultation with your plastic surgeon or seeking a second opinion is crucial, as enduring such pain should not be a prolonged experience.

To get to the root of the issue, diagnostic tests such as an ultrasound, mammogram, or MRI might be necessary. These imaging studies, along with a thorough physical examination, can help in pinpointing the exact cause of your discomfort.

If it turns out that the mesh is the primary irritant, options like removal, replacement, or modification of the mesh could be considered. It's possible that issues such as anchoring sutures or surrounding scar tissue might be causing the pain. On the other hand, if the implant is implicated - whether due to a rupture, leakage, or scar tissue formation - an implant exchange might be necessary.

I encourage you to not endure this pain any longer and consult with a qualified plastic surgeon as soon as possible. A comprehensive evaluation will help determine the best course of action to alleviate your discomfort and restore your quality of life.

Wishing you a speedy resolution to this issue and a path to pain-free living.

Sincerely,

J. Timothy Katzen, MD, FASMBS, FICS
Plastic and Aesthetic Surgeon

Persistent pain and the sensation of a hard piece on the bottom of the implant are concerning symptoms that should be addressed promptly by your plastic surgeon. The presence of mesh in breast augmentation or reconstruction surgeries could be associated with complications, and it's crucial to seek professional medical evaluation.Possible issues that may cause persistent pain and discomfort include:1. Capsular Contracture: This is a condition where the scar tissue (capsule) that naturally forms around the implant tightens and contracts, potentially causing pain and distortion of the breast shape.2. Implant Rupture or Leak: If the implant has ruptured or is leaking, it can cause pain and changes in breast shape. This is more common with older implants, and it might require removal or replacement.3. Infection: Infections can cause pain, swelling, and other symptoms. An infection can occur around the implant or in the surrounding tissue.4. Issues with Mesh: If mesh was used during the surgery, it could potentially cause complications such as irritation or discomfort if not placed correctly or if there are issues with its integration.Given the complexity of breast surgeries, it's crucial to schedule an appointment with your plastic surgeon as soon as possible to have a thorough examination. They may recommend imaging studies, such as ultrasound or MRI, to assess the integrity of the implant and evaluate the surrounding tissues.Do not ignore persistent pain or changes in the feel of the implant, as it could indicate a potential issue that needs attention. If there's any doubt or concern about your breast implants, seeking professional medical guidance is essential for an accurate diagnosis and appropriate management.

You may be able to feel the mesh until it dissolves which takes up to 18 months. The pain could be related to different things, but may be from a small sensory nerve caught in scar tissue. If you have a specific location of pain, your plastic surgeon could try a nerve block close to the site for relief. Please discuss this with your surgeon.

It’s difficult to make an assessment based on limited information. The firmness, your feeling may very well be the mesh and surrounding scar tissue.
That may be a drawback to using mesh, but there are also advantages. I suggest you follow up with your provider or schedule in person second opinion consultations. For a second opinion, consultations always bring with you proper before and after pictures. If you don’t have before and after pictures, then ask your surgeon to forward the ones they took.
For a second opinion consultations, it would also be useful to have a copy of your operative report. This just like before, and after pictures are part of your medical records and are available to you upon request.
Best,
Mats Hagstrom, MD