For women who have undergone breast augmentation, the experience is often about enhancing their appearance and self – confidence. However, in some cases, women may become aware of their breast implants in a way that they find uncomfortable or concerning – specifically, being able to feel the implants in their breasts. This can be a distressing issue, but understanding the causes and available solutions is the first step towards finding relief.
Causes of Feeling Implants in Breasts
Implant Type and Design
Saline Implants: Saline implants are filled with a sterile salt – water solution. They tend to feel firmer compared to natural breast tissue. Since they are essentially a fluid – filled sac, the edges can sometimes be more easily felt, especially if the implant is not covered by a sufficient amount of natural breast tissue. The fluid inside can also move around, creating a sensation that can make the implant feel more distinct. For example, when a woman lies down, the saline may shift, and she might notice a change in the shape and feel of her breast, making the implant more palpable.
Silicone Implants: Silicone implants are designed to mimic the look and feel of natural breast tissue more closely. However, depending on the type of silicone gel used (ranging from low – viscosity to highly cohesive), they can still be felt. Low – viscosity silicone gels may move more freely within the implant shell, similar to the way saline does, and this movement can be detected. Even with highly cohesive silicone implants, which are firmer and hold their shape well, if the implant is too large for the patient’s natural breast tissue volume, it can be felt as a distinct mass.
Insufficient Breast Tissue Coverage
Natural Tissue Thickness: Some women naturally have a relatively thin layer of breast tissue. When breast implants are placed in such individuals, there may not be enough tissue to adequately cover and cushion the implant. As a result, the implant can be felt more easily, both by the woman herself and during a physical examination. For instance, in women with a slender build and little natural breast volume, the implant may seem closer to the skin surface, making it more likely to be detected through touch.
Surgical Placement: The position where the implant is placed during surgery also plays a crucial role. If the implant is placed too close to the skin, rather than being properly positioned under an adequate amount of breast tissue or muscle, it will be more palpable. There are two main surgical planes for implant placement: subglandular (over the pectoral muscle) and submuscular (under the pectoral muscle). In subglandular placement, if there is not enough natural breast tissue over the implant, the risk of feeling the implant is higher.
Capsular Contracture
What is Capsular Contracture?: Capsular contracture is a common complication of breast implant surgery. After the implant is placed, the body forms a thin layer of scar tissue, called a capsule, around the implant. In normal circumstances, this capsule is soft and pliable. However, in some cases, the capsule can thicken and tighten around the implant. When this happens, the implant can feel harder and more prominent. The tightened capsule can also distort the shape of the breast, making the implant even more noticeable. Capsular contracture can be caused by various factors, including infection, bleeding during surgery, or an individual’s natural healing response.
Degree of Capsular Contracture: Capsular contracture is graded on a scale. Mild cases (Grade I) may not be very noticeable, and the implant may feel only slightly firmer than normal. But as the condition progresses to Grade II, the breast may start to feel noticeably firmer, and the implant may be more easily felt. In severe cases (Grade III and IV), the breast can become very hard, and the implant can be extremely prominent, causing discomfort and even pain.
Implant Rupture or Leakage
Saline Implant Rupture: If a saline implant ruptures, the salt – water solution will leak out. This can cause a sudden change in the feel of the breast. The breast may feel deflated or lumpy, and the woman may be able to feel the collapsed implant shell. Since the saline is absorbed by the body, the breast will gradually return to a size closer to its pre – implant state, but the presence of the deflated implant can still be detected.
Silicone Implant Rupture: A rupture in a silicone implant is more complex. There are two types of ruptures – a silent rupture, where the silicone gel remains within the implant shell but may start to leak into the surrounding capsule, and an extracapsular rupture, where the silicone leaks outside the capsule into the breast tissue. In both cases, the breast may feel lumpy, and the implant may seem more prominent. The leaked silicone can cause inflammation and scarring in the breast tissue, further altering the feel of the breast.
Implant Migration
Reasons for Migration: Implant migration occurs when the implant moves from its original surgical position. This can happen due to a variety of reasons. If the pocket created for the implant during surgery is too large, the implant may shift. Also, excessive physical activity, especially in the early post – operative period before the implant has fully settled, can cause it to move. In some cases, the breakdown of the supportive tissues around the implant over time can lead to migration.
Effects on the Breast Feel: When an implant migrates, it can cause the breast to feel uneven. The woman may notice a change in the shape of her breast, and the implant may be felt in an abnormal location. For example, an implant that has migrated upwards may make the upper part of the breast feel firmer and more prominent, while the lower part may feel relatively empty.
Solutions for Feeling Implants in Breasts
Surgical Interventions
Implant Replacement: If the implant type is the cause of the problem, such as a saline implant that is too easily felt due to its design, replacing it with a different type of implant may be an option. For instance, switching from a saline implant to a highly cohesive silicone implant may provide a more natural feel. In cases of implant rupture or leakage, replacement is often necessary. The surgeon will remove the damaged implant and replace it with a new one. The new implant can be of the same or a different type, depending on the patient’s preferences and the surgeon’s recommendation.
Capsulectomy or Capsulotomy: For capsular contracture, a capsulotomy or capsulectomy may be performed. Capsulotomy involves cutting the tightened capsule around the implant to relieve the pressure and allow the implant to return to a more natural position and feel. Capsulectomy, on the other hand, is the complete removal of the capsule. This procedure can be more invasive but is often more effective in treating severe cases of capsular contracture. After the procedure, the implant may feel softer and more natural, and the breast shape may improve.
Implant Repositioning: In cases of implant migration, the surgeon can reposition the implant back to its proper location. This may involve creating a new pocket for the implant or adjusting the existing one. The surgeon will also take steps to ensure that the implant stays in place, such as using special sutures or mesh to support the implant. After repositioning, the breast should regain a more normal shape, and the implant should no longer be felt in an abnormal location.
Non – Surgical Interventions
Massage and Physical Therapy: In some cases, gentle breast massage can help. For implants that feel a bit too firm due to mild capsular contracture or a normal healing response, regular massage can help soften the surrounding tissues and the capsule. Physical therapists can also provide specific exercises to improve the flexibility and mobility of the breast tissues, which may reduce the prominence of the implant. However, it’s important to note that massage should be done under the guidance of a healthcare professional to avoid causing any damage to the implant or surrounding tissues.
Monitoring and Wait – and – See Approach: If the issue is mild, such as a very early stage of capsular contracture or a slight awareness of the implant that is not causing significant discomfort, the surgeon may recommend a monitoring period. Sometimes, the body may naturally adjust over time, and the problem may resolve on its own. During this period, the patient will have regular follow – up appointments to assess the situation. If the problem worsens, then more aggressive treatment options can be considered.
Conclusion
Feeling implants in the breasts can be caused by a variety of factors related to the implant type, surgical procedure, and the body’s response. However, there are several effective solutions available, ranging from surgical interventions to non – surgical approaches. If a woman is concerned about feeling her breast implants, it’s important for her to consult with her plastic surgeon. The surgeon can perform a thorough examination, determine the underlying cause, and recommend the most appropriate treatment option to help her achieve a more natural – feeling and looking breast.
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