Every year, more than 400,000 patients around the world get implants and 75% of them hop on the surgery waggon for cosmetic purposes, whereas 15% go through breast reconstruction after removal of breast tissue. While the majority of women enjoy a beautiful and satisfactory outcome, some struggle with breast implant pain and other symptoms. More often than not this is a sign of complication that needs medical attention. To find out more about the possible causes, take a look at the following article.

Why Are My Breast Implants Hurting?

There can be various reasons for pain in the breasts following augmentation. Some of them are more likely to occur within weeks post-op, whereas others will pop out years after the surgery. Before you go under the knife, make certain to add the following problems to your patient decision checklist.

Infection during or after the cosmetic procedures

On the rare occasion you do develop an infection, it will spark off a few days or weeks following breast augmentation. First, you will note your breasts are unusually warm and you will end up with a sudden fever. Needless to say, this is a condition that requires immediate treatment and, in most cases, the first line of defence is antibiotics. If that doesn’t do the trick, surgical removal of the implant devices may be further advised.

Unfortunately, an infection can happen despite doctors’ efforts to keep those cases to a minimum. Bacteria love foreign objects and breast implants are devices that don’t have blood supply on their own. Textured implants are even bigger captors of bacteria since their structure enables organisms to stick on more easily.

The risk of infection following an operation is assessed at 1% to 3%.[1] There are various factors that can contribute to this experience such as a weakened immune system, skin problems or some medical condition, among other things. In addition to that, smokers are more susceptible to infection, which is why it is vital that you avoid cigarettes for a certain period before and after your treatment to encourage fast healing.

Hematoma

This is a condition which usually occurs immediately after surgery and it becomes noticeable within 10 minutes of its onset. Blood from the incision site seeps into nearby tissues as a result of which a pool forms. This leads to bruising, hard lumps, and massive swelling of one or both breasts. A hematoma can also develop in those few weeks post-op. The treatment consists of making the bleeding stop.

Wound dehiscence

This is a medical term for when a wound cracks open before it has gotten the chance to heal. It takes place around the incision edges in the breast tissue if the sutures dissolve faster than normal. Lifting heavy things too soon after surgery can lead to such an outcome. An infection around the incision might also result in wound dehiscence. If you think your wound has come apart, make sure to seek help from a doctor. Don’t let it cause any more complications.

Capsular contracture in the breast tissue

If you are likely to run into an issue with breast implants, this is the most common one. It indicates a response of the immune system whereby a “capsule”, or thick scar tissue, forms in excess around the implant, leading to pain and breast shape distortion.

Don’t take this the wrong way – there is always going to be some scar tissue surrounding prostheses and this is a normal stage of the healing process. It’s the body’s way of isolating the foreign object so it doesn’t come into contact with any vital tissues. In fact, the scar that forms around the implant can help keep it from slipping and ruining the results.

However, sometimes the capsule becomes so hard that it starts to interfere with the item. The complication is almost exclusive to breast enlargement, with capsular contracture cases also associated with joint prosthetics. It can be mistaken for an allergic reaction.

Here is where it gets interesting. Until recently, it was believed that silicone implants contribute to a lot more capsular contracture incidents than saline – 4.8%-5.6%; however, new evidence[2] suggests that saline prostheses affect 20.8% of patients, surpassing silicone. The findings are confusing and call for more long-term research before any conclusions can be drawn.

Now, with respect to surface, it is estimated that textured surfaces carry a smaller risk of capsular contracture, unlike smooth surfaces. The data have been derived from the same study.

Another risk for capsular contracture is the type of placement. According to the above research, a subglandular placement is more likely to cause these complications than a submuscular one.

As a whole, excessive scar tissue grows in about 10.6% of breast implant surgery cases. There is a grading system that is used to assess its severity and grade 1 is asymptomatic. All the other grades manifest themselves in some form.

Breast implants illness

close up of a woman with hand on her chest

This is a relatively new disease that is getting on doctors’ radar. It has probably been around since the first silicone breast implants were used; however, it was not detected and recognised as an illness until recently. The problem is, it is difficult to prove since the symptoms are sporadic and vague, and oftentimes a number of other diseases need to be ruled out before the cause is discovered. In other words, it’s a diagnosis of exclusion.

When it affects multiple body parts, it can be confused with an autoimmune disease. If it presents as general malaise, patients are often told it’s “in their head”. Unfortunately, it’s not uncommon for symptoms to be downplayed and even disregarded. We need more research and reliable methods of testing and diagnosing the disease.

Scientific evidence doesn’t directly point to implants being a direct trigger of connective tissue diseases but more and more data suggest this is possible in rare cases. Yet, it can significantly affect breastfeeding, sexual response, nipple sensitivity, etc. Learn more about breast implant illness.

Implant rupture into surrounding breast tissue

Sometimes implants rupture and deflate. This can happen during a mammogram or with a biopsy. Normal ageing is a contributing factor. And in some cases, the prostheses may be ruptured with a surgical instrument during an operation. Whether they will deflate right away or over the course of some time, sooner or later it will become evident. You will know it as soon as you start losing volume from the chest area.

It should be noted, though, that silicone implant ruptures may not be as easy to detect as the devices filled with a saline solution, reason being it doesn’t lose shape as quickly. Nevertheless, you will probably notice hard knots around the breast or you will start having numbness, tingling, pain, swelling, and even burning sensations in the breast area after a while. When it comes to implant rupture, the only way to fix that is to replace the flawed items.

The US FDA advises that patients have magnetic resonance imaging (MRI) as often as necessary to check for possible ruptures in their breast implants. Ideally, that’s going to be once every 3 years.

Shelf life of breast implants

A silicone gel-filled implant that was inserted 2 years ago is in much better condition than the one you received 8 years ago. Time takes a toll on us and everything around us. Breast implants get old just like we do, only their shelf life rarely extends beyond 10 years. Studies have shown that 12%-15% of people with saline implants go back to having surgery within 5 years post-op.

In terms of silicone gel-filled implants, a good 33% of people had to have revision surgery within 11 years of the initial treatment where one or both implants were replaced. This is why plastic surgeons advocate for implant removal within a decade of the original procedure.

Enlarged lymph nodes after breast implant surgery

In some women, the surgery might bring about enlarged lymph nodes (lymphadenopathy) around their armpit area. This is known to happen both in patients with ruptured implants and those with intact ones. If the condition doesn’t give rise to any symptoms, it may be left alone. That said, a specialist will surgically remove it should it cause pain.

Breast cancer and breast implant pain

Pink ribbon on woman t shirt, breast cancer awareness month

Another uncommon but possible occurrence following breast implant enhancement is rare cancer called anaplastic large cell lymphoma (ALCL). A kind of T-cell lymphoma, it starts from white blood cells. Under a microscope, it appears underdeveloped. There are several types and breast-implant associated one is the one that is of particular interest here.

Science believes it develops as a reaction of the body to foreign objects. It tends to stay encapsulated into the tissue surrounding the prostheses, but there are cases in which it can ooze into nearby tissues, turning an already complicated situation into a real challenge.

Breast cancer will trigger pain in the breasts, hardening, and asymmetry. It can befall patients at any point after breast augmentation. Science still has not answered the question if it is saline or silicone implants that bring about a bigger risk of breast cancer but there seems to be a slight prevalence in silicone breast implants.

The disease can be slowed down with chemotherapy and implant removal.

Toxic shock syndrome (TSS) and breast implant pain

This is a very rare occurrence with breast implants but since it’s life-threatening, it needs to be mentioned. It happens as a result of a bacterial infection. Symptoms are varied and begin when these bacteria secrete dangerous toxins in the bloodstream.

According to a study from 2019[3], there are only 16 incidences of toxic shock syndrome on a global scale, which means it’s not so common.

How Do I Know If Something Is Wrong With My Breast Implant?

What does a damaged breast implant feel like? Your doctor should tell you what symptoms to watch out for. Unless you are dealing with the so-called “silent rupture”, it’s hard to ignore when something is off with the silicone breast implants. There will be changes in the breast size as well as the shape of one or both implants. Swelling and even pain in the area are expected too. Plus, your breasts may get abnormally firm and not feel natural to the touch.

As far as saline breast implants, it’s much easier to know something is amiss with them because it shows more readily. A yearly physical examination with your plastic surgery specialist will also help rule out any potential complications that may not be as evident to you as you think.

FAQ on Breast Implant Surgery and Breast Pain

Before we wrap this up, here are some burning questions people often ask.

What are the early signs of capsular contracture?

If capsular contracture is at play, the breasts will feel firm and painful, coupled with a tight sensation. As well as that, you may notice asymmetry in the chest wall.

Can breast implants cause pain after many years?

Yes, you may get breast implant pain years after breast augmentation surgery. There are different reasons and you should by all means visit your doctor and check out what is going on.

Could implants make you sick?

Although it happens rarely, there are breast implant patients who are faced with an infection after their surgery. It occurs when bacteria slip into the breasts during the surgical procedure or if the incision site is not taken good care of.

What are the symptoms of breast implant illness?

Symptoms range from general fatigue to joint pain, dry mouth, depression and anxiety. For many individuals, systemic symptoms resolve once the silicone gel implants are eliminated.

Do breast implants cause connective tissue disease?

Studies have not yet been able to establish a potential link between breast implant surgery and an excess of connective tissue disease. Still, there may be such cases.

Resources:

  1. https://www.hopkinsmedicine.org/health/conditions-and-diseases/surgical-site-infections
  2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4579163/
  3. https://pubmed.ncbi.nlm.nih.gov/31268945/