Breast implants are a common choice, but chest pain after augmentation can be a concern. While breast implant procedures are generally safe, chest pain may arise from various factors, both directly and indirectly related to the implants. Understanding these potential causes is important for anyone considering or living with breast implants, as it helps identify when professional medical attention is needed.
Direct Implant-Related Causes
Chest pain linked directly to breast implants often stems from issues with the implant or the body’s reaction. A common cause is capsular contracture, where the scar tissue that naturally forms around an implant tightens excessively. This capsule can squeeze the implant, leading to firmness, breast distortion, and pain or tightness in the chest. While some scar tissue is normal, capsular contracture affects about one in six women, with pain typically associated with more severe tightening. This complication can develop months or even years after surgery.
Another direct cause of chest pain is implant rupture or leakage. A saline implant rupture is usually obvious, as the breast visibly deflates, and pain may accompany this change. In contrast, silicone implant ruptures are often “silent,” meaning they may not present with immediate symptoms. However, a ruptured silicone implant can still cause chest pain, hardened lumps, changes in breast shape or sensation, and inflammation if the silicone gel migrates. Implants in place for 10 or more years have an increased likelihood of rupture.
Some individuals report chest pain as part of Breast Implant Illness (BII). This patient-reported condition encompasses a wide range of systemic symptoms, and while chest pain is among those reported, scientific research is still examining the direct causal link between implants and BII. Symptoms associated with BII can vary greatly and their onset can occur at different times post-implantation.
Post-Surgical and Musculoskeletal Causes
Chest pain can also arise from factors related to the surgical procedure or the implants’ physical interaction with surrounding tissues. Immediately following breast augmentation, some chest tightness, soreness, and discomfort are normal. This initial pain typically subsides within weeks to a few months as the body recovers and tissues adapt to the implants.
The placement of implants, especially under the pectoral muscles, can lead to muscle strain or irritation. This may result in chronic or intermittent chest pain, as muscles can experience tension or damage from surgical dissection and constant implant pressure. Additionally, overly large implants can exert excessive strain on surrounding tissues, contributing to discomfort.
Nerve irritation is another potential source of chest pain after breast augmentation. Surgical incisions and implant pocket creation can sometimes irritate or compress chest wall nerves, such as the intercostal or thoracic nerves. This can manifest as neuropathic pain, described as numbness, burning, tingling, or shooting sensations. In most cases, these symptoms improve as nerves heal and regenerate.
Costochondritis, an inflammation of the cartilage connecting the ribs to the breastbone, can also cause chest pain in individuals with breast implants. While not directly caused by the implant, the presence of implants might exacerbate this condition or make symptoms more pronounced due to increased mechanical friction. This pain can sometimes be mistaken for implant-related issues or other conditions.
When to Seek Medical Attention and Diagnosis
Seek medical attention if chest pain persists, worsens, or is accompanied by other concerning symptoms:
Pain that does not resolve within the typical recovery period.
Pain accompanied by fever, redness, swelling, or heat in the breast area.
Noticeable changes in breast appearance, such as alteration in shape, size, firmness, lumps, or distortion.
Symptoms like shortness of breath or a feeling of chest heaviness or tightness.
A thorough medical evaluation typically begins with a detailed review of your medical history and a physical examination. To determine the cause of chest pain, your doctor may recommend various imaging tests, including mammograms, ultrasounds, or magnetic resonance imaging (MRI). MRI is particularly effective for detecting silent silicone implant ruptures. Blood tests may also be performed if infection or other systemic issues are suspected.
During the diagnostic process, doctors consider a differential diagnosis, evaluating and ruling out other potential causes of chest pain unrelated to breast implants. This comprehensive approach ensures that conditions like cardiac or gastrointestinal problems are assessed and addressed, providing an accurate diagnosis.
Addressing Implant-Related Chest Pain
Once the cause of implant-related chest pain is identified, various management and treatment options are available. For some causes, conservative management may be sufficient, involving over-the-counter or prescription pain medications and anti-inflammatory drugs. Physical therapy, including massage and strengthening exercises, can help address muscle strain and improve mobility. In cases of capsular contracture, non-surgical approaches like external ultrasound therapy or certain medications might be considered.
If conservative treatments are not effective or the underlying issue is more severe, surgical interventions may be necessary. For capsular contracture, surgical options include capsulectomy (removal of the scar capsule) or capsulotomy (scoring the capsule to release tension). For implant rupture, severe contracture, or persistent pain unresponsive to other treatments, implant replacement or explantation (complete removal) might be recommended. In some instances, an en bloc removal, where the implant and its surrounding capsule are removed together, is performed.
Regardless of the treatment approach, regular monitoring and follow-up with your plastic surgeon or healthcare provider are important. This ongoing care allows for assessment of treatment effectiveness, management of lingering symptoms, and early detection of new concerns. Patients are also encouraged to perform regular self-examinations.