Tightness, Pulling and Pain After Breast Reconstruction- What Can I Do?

Question

I had reconstruction with textured silicone implants April 2011. I had continued tightness across my chest, with pulling sensations that did not get better for over 4 months. I had the implants switched for smooth silicone, and now, 2 months later I still have tightness and pulling. It feels like the muscles at top of implant just wont loosen up. I have these feelings every day, all day and am constantly aware of my implants. I am trying Singulair but so far, no beneficial result.

Aldona J. Spiegel, MD · Answer

From the symptoms that you describe, the cause of your tigtness is most likely the pectoralis muscle that is being stretched by the underlying implant, in combination with capsular contracture. Simply exchanging the implant will not resolve this problem. It is now possible to change the location of the implant to be over the muscle and line the breast pocket with collagen to prevent capsular contracture. It is best for you to be evaluated by a board certified plastic reconstructive surgeon who is familiar with this technique.

Fredrick A. Valauri, MD · Answer

The origin of symptoms that you describe requires future evaluation of you concerns through a consultation with your breast reconstruction surgeon and a second opinion consultation with a different surgeon.

	Based on the information provided by your question there may be a number of explanations for your symptoms.

	These include breast implant scar contracture, stretching and pulling of the pectoral muscle  by an overly large implant, or because the submuscular pocket is not large enough.

	These are not uncommon for the implant expander techniques, and can be exacerbated, if the breast tissues are radiated.

	While not for everyone, there are techniques that don't use breast implants called flap breast reconstruction using your own natural, warm, soft skin and fat tissues may be the solution to your problem.  

	These flaps include.TRAM flap and DIEP Flap Breast reconstructions.    See    nybreastreconstruction.com

Samir Shureih, MD · Answer

The fact that your surgeon put you on singulair means to me that he/she is thinking of capsular contracture.

	If you had radiation that also will give you the symptoms.

	if no radiation and the skin is adequate and the implant is not oversized, then the use of acellular matrix may solve the problem.

	If there is radiation or recurrent capsular contracture then a flap reconstruction.

Tightness, Pulling and Pain After Breast Reconstruction- What Can I Do?

Answers (3)