Understanding breast augmentation surgery

Breast augmentation is a type of cosmetic surgery that alters the size or appearance of the breasts. It is often performed by inserting implants, though it can also involve the removal or reshaping of natural breast tissue. While some people choose breast augmentation purely for aesthetic reasons - such as to enhance volume, improve symmetry or restore shape lost through weight changes, pregnancy or ageing.

Many individuals seek breast augmentation to help rebuild their sense of self after undergoing a mastectomy due to breast cancer. For others, the surgery is part of a wider plan to improve body confidence and self-esteem, particularly if they’ve long felt unhappy with the size or shape of their breasts. In some cases, breast augmentation may be recommended or considered to help balance body proportions. In other cases, breast revision surgery may be performed to relieve physical discomfort, such as chronic back or shoulder pain caused by asymmetry or underdevelopment.

The method used to insert the implant will depend on several factors, including body shape, implant type and personal preferences. In general, there are a few common approaches to making the incision. These include placing the incision in the fold beneath the breast, around the edge of the areola, or in the underarm area. Each option has its own advantages, such as discreet scarring or better control over implant placement.

What causes persistent nipple hardness after breast implants?

If nipple hardness continues for an extended period after breast implant surgery, it is often linked to a combination of physiological factors and the specifics of the surgical procedure. Below, we expand on the potential causes to help you understand why this issue may persist after breast augmentation. Breast augmentation patients often experience changes in nipple sensitivity, which can include both increased and decreased sensitivity.

Nipple sensitivity

During breast implant surgery, the highly sensitive nerves may be stretched, irritated or in some cases, damaged. This can lead to heightened nerve sensitivity as they attempt to recover.

In many cases, this heightened sensitivity diminishes over time as the nerves regenerate and the body adapts. However, if the nerve recovery process is slow or incomplete, the heightened sensation, including hardness, may persist. Factors that can impact nerve recovery include the extent of nerve disruption during surgery, the positioning of the implants, and individual nerve health prior to surgery. For some women, damaged nerves may result in either prolonged sensitivity or even changes in sensation, such as numbness or tingling.

Capsular contracture

Capsular contracture is a known complication of breast implants and occurs when the body forms scar tissue around the implant. While a thin layer of scar tissue is a normal response, in some cases, the tissue tightens excessively, squeezing the implant and the surrounding tissues. This can cause unusual hardness in this area.

This excessive tightening can affect the breast’s natural feel, appearance and sensation. The increased pressure caused by capsular contracture may compress or irritate nearby nerves, potentially contributing to nipple hardness. Capsular contracture is classified into different grades, and in some cases the condition may require surgical intervention to correct. In severe cases of capsular contracture, breast implant removal may be necessary to alleviate chronic pain and other symptoms.

Some factors that increase the likelihood of capsular contracture include bacterial contamination during surgery, the type of implant used and the surgical approach taken. If you suspect this complication, it’s important to seek medical advice promptly to prevent further discomfort or complications.

Surgical technique

The surgical technique used during a surgical breast procedure will affect how the body responds post-surgery. Techniques involving incisions near the nipple or extensive dissection close to the nerves are more likely to disrupt nerve pathways, increasing the likelihood of prolonged nipple sensitivity.

The placement of the implant also makes a difference. Implants positioned under the pectoral muscle may affect the surrounding tissue and nerves differently compared to implants placed directly under the breast tissue. While experienced surgeons aim to minimise nerve impact, the complexity of the procedure and the individual’s anatomy can make it challenging to avoid all nerve-related effects. Some patients may opt for a breast lift as an alternative to implants, which can offer a more natural appearance with potentially fewer nerve-related complications.

Additionally, the use of textured implants in the past has been linked to increased inflammation around the implant, which could exacerbate nerve sensitivity or contribute to capsular contracture. Modern surgical techniques and smoother implant surfaces have reduced these risks, but past practices may still impact individuals who had surgery some years ago.

Individual healing responses

Each person’s body responds uniquely to surgery, and this individuality can significantly influence recovery. Factors such as overall health, age and genetic predisposition can determine how the nerves and surrounding tissues heal.

Some patients may experience rapid nerve regeneration and a quick resolution of nipple sensitivity and hardness, while others might have a slower recovery process. Factors like smoking, poor nutrition or pre-existing medical conditions can further delay healing and exacerbate post-surgical issues, including prolonged nipple hardness.

Additionally, hormonal fluctuations or stress during recovery can heighten sensitivity in the body, potentially amplifying the perception of nipple hardness. Even if the underlying cause is resolving, these factors might prolong the sensation.

The importance of choosing a skilled surgeon to prevent prolonged hard nipples after implants

Prolonged nipple hardness after breast implant surgery can occur when nerves around the areola are affected during the procedure. This is more likely if the surgery is not performed with care and precision. A board-certified plastic surgeon will use methods that reduce disruption to nerve pathways and surrounding tissue, helping to support more comfortable healing.

To reduce the risk of this and other complications, check that the surgeon is registered with the General Medical Council (GMC) and is a member of the British Association of Aesthetic Plastic Surgeons (BAAPS). These affiliations indicate specialist training and adherence to professional standards specific to cosmetic procedures. It is also worth asking how often they carry out breast augmentation, what their outcomes have been, and to see examples of previous surgeries.

What are your surgeon's legal obligations?

Your surgeon has standards they're expected to follow throughout the breast augmentation process:

• Before surgery: the surgeon must explain all potential risks, including the likelihood and extent of risks such as scarring and how that may affect your nipple sensitivity. They must present you with an expected healing timeline of when nipple hardness is likely to dissipate, outline realistic outcomes and assess whether you are a suitable candidate for the procedure. They are also required to discuss any alternative options so you can make an informed decision.
• During surgery: the procedure must be performed to accepted professional standards, using appropriate surgical techniques and maintaining proper hygiene. The surgeon must also take steps to protect your safety throughout.
• After surgery: the surgeon has a duty to monitor the healing process, checking for signs of complications such as infection, implant movement or tissue damage. If any issues arise, they must act with appropriate treatment, corrective surgery or escalation - this may involve changing the aftercare plan or referring you for further medical attention.

If your surgeon fails to adhere to these obligations and you suffer unexpected side effects as a result, you may be entitled to compensation. Cosmetic Surgery Solicitors can assist if you are experiencing long-term issues after surgery and suspect it was not carried out properly. We support patients who believe their surgeon did not meet their duty of care. If negligence has occurred, we can help you pursue compensation for the complications and distress caused.

What action should I take if I suspect negligence?

If you suspect that your cosmetic surgeon failed to meet their duty of care and you’re experiencing complications such as prolonged nipple hardness, unexpected scarring or ongoing pain, it’s important to act promptly. The first step is to gather clear evidence that supports your concerns. This may include:

• Medical records and surgical notes: these can provide insight into how the procedure was planned and carried out, and whether standard practices were followed.
• Photographs: images taken before and after surgery are useful for showing physical changes or complications that were not anticipated or explained in advance.
• Written communication: emails, letters or messages between you and the clinic can highlight what information you were given about risks, aftercare and recovery.
• Diary or personal notes: keeping a record of your symptoms, how they developed over time and the impact on your daily life can help to support your claim.
• Second medical opinions: an independent assessment from another qualified plastic surgeon can help confirm whether the issues you’re facing are linked to poor surgical performance or aftercare.

Once you have collected this information, contact a solicitor who specialises in cosmetic surgery negligence. Cosmetic Surgery Solicitors can review your case, determine whether your surgeon may have breached their legal obligations, and help you claim compensation for the complications and emotional distress you’ve experienced. Taking legal action can also provide a clearer path towards getting the corrective treatment and support you may now need.

FAQs

Why are my nipples hard after implants?

It’s common to experience nipple hardness after breast implant surgery. When you undergo breast augmentation, it’s important to set realistic expectations about the recovery process, including initial discomfort and nerve sensitivity. For most women, this sensation improves over time as the nerves settle and adjust to the changes following the insertion of breast implants.

What can I do if I believe my nipple hardness is due to surgical negligence?

If you feel your surgeon’s actions or lack of care contributed to persistent nipple hardness, it’s important to seek advice. Cosmetic Surgery Solicitors specialise in helping people affected by negligent cosmetic surgery. We can assess your case and help you pursue compensation for the distress and complications caused. Contact us for guidance on your next steps.

Seek our legal advice

While nipple hardness can be a natural part of recovery, it may also point to poor surgical practices or inadequate aftercare. If you have been the victim of negligent breast augmentation surgery, we can help you get the compensation that you deserve. At Cosmetic Surgery Solicitors we have extensive experience supporting women who have experienced problems following breast implant surgery. We understand how daunting it can feel to seek help, but we are here to provide guidance and ensure your voice is heard.