Post-Implant Removal Breast and Abdominal Pain
Mild breast pain after implant removal is expected and normal, but new abdominal pain is not a typical post-operative symptom and requires evaluation to exclude complications.
Expected Post-Operative Breast Pain
Some degree of breast pain following implant removal is common and expected. The ACR guidelines note that postsurgical breast pain can result from scar tissue formation, nerve regeneration, or focal nerve injury, and is more common in patients who had postoperative complications like infection or hematoma 1.
- Breast pain after implant surgery (including removal) occurs in approximately 31-49% of patients, with submuscular implant placement historically associated with higher pain rates (50%) compared to subglandular placement (21%) 2
- Most post-surgical breast pain is intermittent and improves over time with supportive care 2
- Pain related to nerve regeneration and tissue healing is a recognized part of the normal recovery process 1
Management of Expected Breast Pain
First-line treatment includes NSAIDs and supportive measures:
- Ibuprofen or naproxen are recommended as safe and effective analgesics for breast pain 3
- Acetaminophen is an appropriate alternative when NSAIDs are contraindicated 3
- Wearing a well-fitting, supportive bra helps alleviate discomfort 3
- Applying warm or cold compresses to the affected areas provides additional symptom relief 3
Concerning Features Requiring Evaluation
New abdominal pain is NOT a typical post-operative symptom after breast implant removal and warrants investigation. While breast pain is expected, abdominal pain suggests potential complications or unrelated pathology that needs assessment.
Red flags requiring immediate evaluation include:
- Development of fever, erythema, warmth, or other signs of infection suggesting mastitis or abscess 3
- Severe, focal, or worsening breast pain that could indicate hematoma or infection 1
- A new palpable mass or area of increasing focal tenderness 3
- No improvement in breast pain after 48-72 hours of appropriate supportive treatment 3
- Any abdominal pain, which is not an expected post-operative symptom and may indicate referred pain, infection, or unrelated pathology requiring separate evaluation 1
Timeline for Reassessment
- Reassessment should occur within 24-48 hours to evaluate response to supportive measures for breast pain 3
- If symptoms persist or worsen, or if abdominal pain develops, escalation to clinical evaluation with possible imaging is warranted 3
- The ACR notes that noncyclical breast pain may require additional evaluation to exclude underlying pathology, though cancer risk with isolated pain is extremely low (0-3%) 4
Common pitfall: Dismissing all post-operative pain as "normal healing" without distinguishing between expected breast discomfort and concerning features like new abdominal pain, fever, or worsening focal tenderness that require prompt evaluation 1, 3.