How to Conduct a Breast Self-Exam With Breast Implants

Woman With Breast Implants Conducts Self Breast Cancer Exam

October is Breast Cancer Awareness Month, which means it’s the perfect time for an updated how-to guide for performing an at-home breast self-exam. If you’ve had a breast augmentation, you may be wondering how your implants will affect your self-exam process. As a board certified cosmetic surgeon who has performed thousands of breast augmentation procedures, I’m going to walk you through how to perform a breast self-exam with breast implants.

Why should I perform a breast self-exam?

Breast cancer is the second most common cancer found in women. While you should regularly have your breasts examined by a medical doctor, self-exams are an important (and convenient) early warning system for detecting breast cancer. The National Breast Cancer Foundation reports that 40% of diagnosed breast cancers are detected by women who feel a lump during a self-exam. Having breast implants should not stop you from performing a self-exam, but there are some unique factors to be aware of.

Will breast implants make it harder for me to detect changes?

Regardless of whether your implants are submuscular or subglandular, they shouldn’t hinder your self-exam process; in fact, implants can actually help you perform a self breast exam by pushing your breast tissue forward and away from your rib cage. In both submuscular and subglandular implants, your breast tissue is situated on top of the implants, allowing you to feel your breast tissue for lumps and any other changes (I’ll discuss exactly what to look for further down).

Performing a breast self-exam with breast implants

The method for examining your breasts after you’ve had implants will be slightly different than before you had them. The biggest change you will need to make following augmentation is getting to know your implants. Your cosmetic surgeon can help you with this, showing you how to feel for and identify the edges of your implants (as well as any scar tissue around the implant) so that you can differentiate between your implant and your breast tissue, and monitor any changes in either.

5 step self-exam with breast implants

  1. Lay down. Many women with implants find it best to lie down on a flat surface for self-exams.
  2. Extend the arm of the breast you are examining upwards. This can help you better feel the upper/outer section of the breast as well as the armpit.
  3. Holding your fingers in a flat position, press firmly and gently to systematically feel all of your breast tissue, armpit, and nearby areas. The goal is to thoroughly check for lumps and other abnormalities (I’ll get into these below).
  4. Gently squeeze your nipple-areolar complex to check for discharge.
  5. Include a visual check in your monthly self-exam. This is likely to come naturally as you enjoy your new look! A visual exam isn’t a substitute for feeling for lumps, but it can help you see if anything else looks out of the ordinary. For example, a visual exam might help you detect swelling that only exists in one breast, or a change in your breast’s pore size.

One note of caution: If it has been less than 6 months since your augmentation, make sure you follow your surgeon’s advice in caring for your breasts. I ask my newly augmented patients to skip breast self-exams for 6 weeks, and after that, recommend they proceed very carefully, avoiding excessive pressure. When conducting a self-exam during this time, you should also consider that your breast tissue may still be slightly tender or swollen from surgery.

What should I look for when performing a breast self-exam?

When conducting a breast self-exam (whether you’ve had a breast augmentation or not), you want to look and feel for any tissue abnormalities in and around the breast and/or nipples, including:

Lumps

Lumps are most often harmless, yet tender fluid-filled cysts. If you find one, however, you’ll want to have a doctor examine it to be sure it isn’t a solid mass that can sometimes be more concerning. The good news is that doctors can often use a simple ultrasound to discover the nature of a lump, and breast implants don’t interfere with this process at all. Cysts are more common in premenopausal women and can fluctuate with hormone cycles.

Tenderness in the breast or nipple

Some breast pain is completely natural and often occurs in premenopausal women before and during their periods. It is also common for breast augmentation patients to report an increase in premenstrual breast pain after their surgery. This is normal and should subside after your implants have settled, which takes about 6 months. Breast implants don’t exacerbate or lessen cyclical breast pain in the long term.

But, if you are experiencing unusual pain or tenderness in one or both breasts or nipples that doesn’t seem connected with your normal menstrual cycle or immediate post-operative healing, it’s important to see a doctor.

A change in your skin texture or temperature

Look for skin puckering or dimpling, thickened skin with enlarged pores (like an orange peel), scaly or flaky skin, and any other changes in your breast skin texture. An itchy, warm breast can also be indicative of breast disease. If you see any of these signs, have your breasts looked at by a medical professional.

Implant-related changes

Women with breast implants also need to monitor their breasts for implant-related changes. Increased tightness, firmness, pain, or movement of your breast implant upwards on your chest can all be signs of capsular contracture. If you notice any unusual change in the feel of your implants, let your cosmetic surgeon know.

Change in breast size

A swollen or shrunken breast is a red flag. While it is normal for women with implants to experience some swelling in the breasts following a breast augmentation, late onset swelling 6 or more months after your augmentation can be a sign of ALCL (I’ll discuss this more in detail further on) or other concerns. Conversely, a shrunken breast can be a sign of an implant rupture. Either way, it’s important to make an appointment with your doctor ASAP if you observe a change in breast size that seems out of sync with normal breast size fluctuations caused by your menstrual cycle or weight changes.

Inverted nipples

It is natural for your nipples to retract and even become flush with your areola as you age, and some women are simply born with inverted nipples. But if your nipple suddenly turns inward, this could be a symptom of breast cancer, and you should contact your doctor.

Nipple discharge

If you’re pregnant or breastfeeding, nipple discharge can be completely normal. However, nipple discharge is also one of the earliest indicators of breast cancer. The discharge is often whitish in color and may be very slight. Contact your doctor if you are experiencing nipple discharge and are not pregnant or breastfeeding.

Changes near your breasts

A thorough self-exam should include areas surrounding your breasts. Your breasts have a “tail” that extends upwards, towards your collar bone, and outwards towards your axilla (armpit), and tumors can occur in this area as well. Thus, when examining this area, it’s a good idea to feel upwards until you reach the collarbone and outwards until you reach into the axilla. If you feel lumps, unusual tenderness, or see any of the other changes mentioned above, have your areas of concern checked by a doctor.

A note about fibrocystic breast tissue

Fibrocystic breasts are breasts that always feel dense and lumpy. This is a very common condition and doesn’t necessarily mean that the breasts are cancerous. Once your doctor helps you establish which lumps are noncancerous, you can use these as benchmarks to observe any changes in the natural landscape of your breasts.

Since breast implants are placed under your breast tissue, you can still have fibrocystic breasts following an augmentation.

How often should I perform a breast self-exam?

You should perform a breast self-exam at least once a month at the same time each month—ideally, 3 to 5 days after the start of your period when your breasts are least likely to be sore, swollen, or lumpy. I recommend my patients put a recurring reminder on their calendars to make it easy to stay on schedule.

If you are prone to skipping self exams, take time to regularly examine your breasts when bathing or dressing: according to the American Cancer Society, most women discover symptoms while performing these routine activities.

Can breast implants cause cancer?

In 2016, a very rare form of cancer called Breast Implant Associated Anaplastic Large Cell Lymphoma, or BIA-ALCL, was reported by the World Health Organization. BIA-ALCL is a type of non-Hodgkin’s lymphoma, rather than breast cancer.

BIA-ALCL develops in the scar tissue surrounding breast implants and is found almost exclusively in those who have or have had textured surface breast implants; it is rare, and fully treatable by removing the breast implant and associated scar tissue capsule.

To date, the FDA has not found any definitive correlation between breast implants and breast cancer. If you are concerned about breast cancer, your surgeon will discuss all possible risks associated with breast surgery during your consultation.

What should I do if I feel a lump?

If you find a lump in your breast during a self-exam, schedule an appointment with your doctor, but don’t panic8 out of 10 lumps are not cancerous. As previously mentioned, many lumps are harmless, fluid-filled sacs called cysts.

Interested in Breast Surgery in Las Vegas?

If you are considering breast augmentation or any other breast enhancement surgery, I invite you to contact my practice, Cosmetic Surgery of Las Vegas. As a board certified cosmetic surgeon, I have decades of experience safely performing breast augmentations and helping women fall in love with their bodies. Schedule a consultation online or by calling 702-363-0240 today.

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