In short
- Normal and no need to call: pressure and tightness in the chest, pectoral soreness if the implant is under the muscle, swelling that increases over the first few days, bruising, tightness when moving the arms, high, firm breasts, noises or bubbling when you move and electric-type twinges.
- 🚨 Call without waiting if you develop: a temperature of 38 °C or above, pain that increases instead of easing or that stops responding to the prescribed pain relief, one breast that grows within hours, increasing redness or heat, discharge from the wound, the wound opening, or pain in a calf or sudden breathlessness.
- 🔑 And who to call, here, is not complicated: all our patients have their surgeon’s direct number, with no intermediary and at any hour.
- ⚠️ A point about fever that almost nobody publishes: in the first 3 days a post-operative temperature is common and does not necessarily mean infection. You still call — but knowing it saves a night of anxiety.
- 🔑 The sign of a haematoma is asymmetric and fast: one breast that swells, hardens and hurts more than the other within hours, almost always in the first 24 to 48.
- ⚠️ Infection is the one it is most urgent not to let slide. The FDA warns that, if it does not respond to antibiotics, the implant may need to be removed.
- Most infections appear between a few days and a week after surgery, although they are possible at any time.
- Breasts sitting high is what is expected, not a placement error: they drop over the following weeks.
- ⚠️ And there is one late sign worth knowing even years later: a breast that swells persistently long after surgery requires an assessment.
In the first two weeks after a breast augmentation almost everything that frightens you is normal: the breasts sit high, firm and swollen, they make odd noises and they do not feel like yours.
This page separates that from what does need attention without waiting. And it does so in that order deliberately: if it started with the emergencies, anyone with a bruise would be alarmed.
⚠️ This page does not replace your surgeon. If something worries you, the short answer is always the same: call them. What follows is so that you know when that cannot wait.
What frightens you and is normal
We start here because it accounts for most of the calls.
Pressure and tightness. The dominant sensation is usually not pain but pressure: the tissue has stretched to accommodate a volume that was not there before. It is described as a weight or a tight band.
Pectoral soreness. If the implant has been placed under the muscle, the pectoral has been released and lifted. The consequence is muscular discomfort that increases when you move your arms, cough or laugh. It is one of the reasons the subpectoral plane has a slightly slower recovery.
High, firm breasts. 🔑 It is the most common thing and the one that worries people most. At first the implant sits above its final position, the upper pole looks full and the whole feels firm. It is the swelling and the tissue not yet adapted. It settles and softens over the following weeks.
Swelling that increases over the first few days. It usually peaks between the second and third day. That it increases over that period is not in itself a bad sign — what matters is that it is symmetrical and gradual, not sudden and one-sided.
Bruising and changes in colour. These can track downwards with gravity towards the side or the abdomen. They change colour as they are reabsorbed.
Noises, bubbling or sloshing. Common in the first few days, from air or fluid in the pocket where the implant sits. They disappear.
Twinges, electric sensations or numb patches. The sensory nerves have been stretched and are recovering. It is reinnervation, not a problem.
One breast more swollen than the other. In the first few weeks this is common: the two sides settle at different rates. ⚠️ What is not normal is for that difference to grow within hours with pain.
The feeling that they are not yours. Described by almost everyone in the first month. It is not a medical sign.
🚨 What does need attention without waiting
Call the same day if you notice:
- 🚨 A temperature of 38 °C or above. It is the threshold we use and the sign most often cited, with reason: in surgery involving a prosthesis, a fever is not left to develop. ⚠️ With one point worth knowing so that you do not spend the night awake: in the early post-operative period — the first 3 days — a temperature is common and does not have to mean infection. It is the body’s response to the surgery itself. What does not change is that you call; what changes is that, in those first days, the answer is most likely to be reassuring. Beyond that window, a fever carries more weight.
- 🚨 Pain that increases instead of easing, or that stops responding to the three painkillers you have been prescribed. That is the practical definition of “uncontrolled pain”: not that it hurts, but that the full regimen no longer holds it.
- 🚨 One breast that grows, hardens and hurts more than the other within hours. That is the sign of a haematoma, and it is the most important one in the first 48 hours.
- 🚨 Spreading redness, increasing local heat or shiny, tight skin over the implant.
- 🚨 Discharge from the wound, particularly if it is cloudy or smells bad.
- 🚨 A wound that opens, or any area where the implant appears to be showing beneath the skin.
- 🚨 Pain in a calf, swelling of one leg, chest pain on breathing or sudden breathlessness. This has nothing to do with the implants: it is the standard vigilance after any surgery under general anaesthetic, and it is the only item on this list that goes straight to A&E.
Get seen without urgency if you notice a change in shape that is not settling, a stable asymmetry that is not improving, an area of skin without sensation after several weeks, or new discomfort that was not there before. These are reasons to be seen; they are not reasons for a night-time call.
Why infection cannot wait
It deserves a section of its own because it is the one that changes what you do.
Where there is an implant, an infection is not just a wound infection. The FDA says so plainly: if an infection does not respond to antibiotics, the implant may need to be removed.
That makes the first hours of an infection useful clinical time. Caught early, in many cases it resolves with treatment; ignored, the chance of losing the implant grows.
When they appear. Most infections after surgery show up between a few days and a week afterwards, but infection is possible at any time after surgery.
How to recognise it. Spreading redness, heat, increasing pain, one-sided swelling, discharge and fever. They rarely all appear at once: two or three are enough to call.
The haematoma and its window
It is the complication of the first few hours.
A haematoma is a collection of blood near the surgical site. It causes swelling, bruising and pain, and when it is large it requires surgical drainage; small ones are reabsorbed by the body.
🔑 Its signature is rapid asymmetry. Not “my chest hurts” but “this breast has grown, it is firmer and it hurts a lot more than the other, and three hours ago it was not like this”.
The FDA adds a point worth bearing in mind over the long term: haematomas usually occur shortly after surgery, but can appear at any time when there is trauma to the breast.
The signs that appear much later
Not everything that matters happens in the first two weeks. These three justify a consultation even years later:
A breast that gradually hardens and changes shape. It may be capsular contracture, the most characteristic complication of this surgery. It is not an emergency: it is a reason to be seen. It is explained in the risks page.
A change in the size or shape of the breast, hard lumps, pain or altered sensation. These are the signs with which an implant rupture occasionally shows itself — although most silicone ruptures are silent and are only detected by imaging.
Persistent swelling, a lump or pain in the area of the implant, years after surgery. 🚨 It is the typical presentation of BIA-ALCL lymphoma, and it is why this sign is worth knowing even when the incision healed a decade ago. It is not an emergency and it is an assessment not to be postponed. It is set out on its own page.
Who to call
If you had your surgery with us, there is no system to decipher. 🔑 All our patients leave with their surgeon’s direct contact number: no intermediary, no nursing bleep and available at any hour.
It is worth explaining why that matters, because it is not the norm: the person who picks up the phone is the person who operated on you. They know which implant you have, which plane it is in and how your surgery went, and so they can tell you in two minutes whether what you are describing is expected or not. It is the difference between an answer and “go to A&E”.
⚠️ If you had surgery elsewhere, the person who needs to see you is the person who operated — they have your surgical report, they know which implant you have and in which plane, and that changes the management. Outside their hours, the route is hospital A&E. Our practice is available for anything that is not urgent.
🔑 And if you are having surgery anywhere, ask that question all the same, because it is the one most often forgotten: what number do I call, who answers and at what hours. Whether the answer is a direct line or a switchboard is not a matter of convenience: at three in the morning on a Sunday it is the difference between resolving it and not resolving it.
Book an appointment
You can book your own appointment. Pick the day and time from the free slots in the diary, in a panel that opens right here, without leaving this page.
Frequently asked questions
My breasts are very high and firm — is the implant in the wrong place?
It is what is expected in the first few weeks. The implant starts above its final position and the whole feels firm because of the swelling and because the tissue has not yet adapted. It settles and softens over time.
How much swelling is normal?
The kind that increases over the first few days — usually peaking between the second and third — and then goes down gradually, affecting both sides similarly. What is not normal is one breast growing within hours with increasing pain.
My breasts make noises when I move.
It is common in the first few days and is due to air or fluid in the pocket where the implant has been placed. It resolves on its own.
When do I need to call about a fever?
From 38 °C. In surgery involving a prosthesis you do not wait to see whether it comes down. And an important point: in the first 3 days a post-operative temperature is common and does not necessarily mean infection — you still call, but the explanation is likely to be the surgery itself rather than a complication. The later it appears, the more weight it carries.
What exactly is “uncontrolled pain”?
That the full regimen of three oral painkillers no longer holds it, or that the pain is rising rather than easing. It is not having discomfort: the first 48 hours are uncomfortable. What signals a problem is the trend and the failure of the pain relief.
What happens if I have an infection?
It is treated, and the sooner the better. The FDA warns that if an infection does not respond to antibiotics the implant may need to be removed, which is why time matters more here than in other surgery.
One breast is more swollen than the other. Is it a haematoma?
It depends how it develops. A stable difference in the first few weeks is common, because the two sides settle at different rates. A difference that grows within hours, with hardening and more pain on that side, is the sign of a haematoma and you should call.
I had surgery years ago and one breast has swollen. Is it serious?
We do not know without seeing you, and that is exactly why you need to be seen. Persistent swelling appearing late is the typical presentation of BIA-ALCL lymphoma, an uncommon condition with a good prognosis when diagnosed in time. It can also have more mundane causes. It is not an emergency; it is an assessment not to be postponed.
Sources
- Risks and Complications of Breast Implants. U.S. Food and Drug Administration, updated 14 December 2023. fda.gov. — Haematoma: a collection of blood near the surgical site that can cause swelling, bruising and pain, usually appearing shortly after surgery but possible at any time when there is trauma to the breast, with large ones potentially requiring surgical drainage. Infection: most appear between a few days and a week after surgery, are possible at any time, and if they do not respond to antibiotics the implant may need to be removed. Seroma, extrusion and delayed healing among the complications described. The largely silent nature of silicone gel implant rupture and the signs with which it occasionally shows itself.
- Questions and Answers about Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL). U.S. Food and Drug Administration. fda.gov. — Main symptoms of persistent swelling, a mass or pain in the area of the implant, which can appear well after the incision has healed and often years after placement; frequent presence of a peri-implant seroma on assessment.
Book your consultation
If you are going to have surgery, there is one question worth asking before you leave the clinic that almost nobody asks: what number do I call, at what hours and what counts as a reason to call. At our practice in Valencia that information is given before surgery, not afterwards.
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