Pain and swelling a year after exchange

HernRuns

I had DCIS and choose to have a double mastectomy with expanders then exchanged for textured implants in August 2018. I was very lucky and had no chemo or radiation. Since Then I have run multiple half marathons, a trail marathon, 2 50k’s and a 50 miler. I do 2 to 3 days of strength training too. This August 2019 I experienced severe pain around the implant and extreme swelling of the right breast. The pain went away after 4 to 5 days and the fluid was aspirated (130cc) and tested. All tests were negative. No infection, no cancers and no trauma indicators. After two weeks everything was normal again. A month later it happened again but on the left breast! My doctor cannot figure out why this has happened and if it will keep happening. He has never heard of this happening! Has anyone had this happen to them?

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Smcdzn

I had 60 cc of fluid removed from my right mastectomy site. No cancer or lymphoma cells but an abundance of neutrophils from an infection. I have textured implants. PS recommends replacing the textured implant with a smooth implant. All of this happened 2-3 weeks after my first covid vaccine. I’m scheduled for surgery April 8th. I hate going through this again and wonder if I should leave the textured implants in or not

DiveCat

@smcdzn

You are replying to an older post and should have your own but...

Textured implants can result in a heightened inflammatory response for some. In a way, they designed to irritate the tissue in everyone to create a scar tissue response that “grabs" the implant. But this reaction can be more for some than others due to various and personal factors. There is also some theories that the textured nature makes it easier for them to grab onto bacteria, etc but I have not updated myself on those anytime lately.

There is the rare, but increased risk in textured versus smooth implants, of BIA-ALCL which can present as swelling, inflammation, etc: https://www.fda.gov/medical-devices/breast-implants/questions-and-answers-about-breast-implant-associated-anaplastic-large-cell-lymphoma-bia-alcl). From my reading chronic inflammation can increase risk of BIA-ALCL.

I had textured Allergan 410s placed in 2015 (swapped out smooth ones for them). I closely followed the information coming out on BIA-ALCL as it developed and in November 2019 switched to smooth implants again. I never had as extreme reaction as you did in that I needed draining but I did notice occasional swelling and irritation towards outside upper breasts (nearer to and into armpits) and with already having a thyroid disorder linked to immune issues diagnosed ~2016-2017 AND having had my surgeries to reduce risks of cancer, I thought it was best choice for me and my PS was fully on board too. Same one who had placed the 410s but was also closely following the developments and participating in education about textured implants.

My concern for me was also that the heightened inflammatory response may lead to to other inflammatory/auto-immune issues, not necessarily BIA-ALCL. When your body is in a prolonged inflammatory response it can really cause other long term issues. Like I said I already had an issue and did not want to make it worse

Obviously it's a personal decision and many women have textured implants and no issues and also had opted not to choose them. The guidance is that if you aren't having issues, there is no need to do anything at all. But if you are having issues then I would seriously consider removing and replace (assuming still want implants) as suggested by your own doctor.

My swaps have been very easy surgery and recovery wise. Nothing like the original surgery