“What are Mondor’s bands?
Mondor’s bands are bands of tight superficial veins that can often pop up a few weeks after breast surgery in the armpit area or under the breast, often below the breast fold (inframammary fold). We see them commonly in thin women after breast augmentation, breast lift or breast reconstruction procedures.
First described in detail by Henri Mondor in 1939, this condition is a rare entity characterized by “sclerosing thrombophlebitis” (superficial irritation) of the subcutaneous veins of the anterior chest wall. They are likely what some physcical therapists call “cording” in the axilla after mastectomy and breast reconstruction. Some think they are superficial lymphatics, but they are more likely small tense veins that become tented under the skin.
Why do Mondor’s bands occur?
The pathophysiology (cause) of Mondor’s bands has been explained as pressure on the vein with stagnation of blood or as direct trauma to the surrounding area. And in reality, ANY Plastic Surgery procedure is in fact an injury to the body.
After Plastic Surgery, regardless of the location of the incisions or where post-surgical swelling occurs, the body adjusts to bring increased blood supply to the area for healing and to drain waste products after surgery. Just like lymph nodes often swell and become palpable after surgery in the armpit region after breast surgery or in the groin after body surgery, surrounding blood vessels often undergo temporary changes during healing. If there is only a thin layer of fat over top, the bands can be visible, particularly when the arms are raised overhead.
Mondor’s bands characteristically appear suddenly as a subcutaneous cord, which is initially red and tender and can become a painless, tough, fibrous band that is accompanied by tension and skin retraction. These bands are benign and self-limited, and require only symptomatic therapy.
The incidence of Mondor’s bands after aesthetic or breast cancer surgery has been estimated at 1%. There is no racial or ethnic predilection. Mondor’s bands are 3 times more common in women than in men, and most patients are aged 30-60 years.
How are Mondor’s bands treated?
These bands are “self-limiting”, meaning they will go away on their own. They are also completely benign, without any long term consequences. Treatment is usually symptomatic – warm compresses and anti-inflammatories such as Ibuprofen can help with aching, if present. Usually they are completely asymptomatic, and simply reassurance and follow up are appropriate. Physical therapy or massage will not change their natural history. They usually go away on their own in 6-12 weeks from the time they were noticed.
We hope this information helps to alleviate concerns about “cording” in the armpit region after breast reconstruction or under the breast after cosmetic breast surgery! If you have concerns, be sure to visit a Board Certified Plastic Surgeon for an in-person evaluation.