University Place Doctors

why did it take so long to diagnose a seroma and 3 mos. to fix it?

The tummy tuck went beautifully and "seemed" to be healig well.  However,  there was a very large collection of fluid (a seroma) located "above" where the bandages were.  The huge mass was pressing very hard on my diaphram and making breathing VERY difficult.  When the surgeion "looked" at it at the first follow-up, he said that everything looked fine.  I should have insisted that he actually "touch" it to tell just how hard and how large this mass was.  Instead, I went on to suffer for several weeks before he even realized there was a problem.  I have not been able to breathe normally or straighten up normally since the surgery in November. I went to the ER twice with shortness of breath and was admitted overnight once because of an abnormal ekg.  I have the feeling of a large rhino sitting on my diaphram and making breathing "VERY" difficult.  All of this was feeling like a HUGE strain on my heart, not allowing space enough forf my heart to even pump at all....Also, I have sharp pains, like knitting needles going through me....I suffered for months feeling like I was being crushed and suffocated from the inside out.........I recently had a sudden surge of movenment where the seroma seemed to shift a little lower making breathing a "little bit" easier.  It's still difficult to breath, and I still have sharp, stabbing pains as well as the feeling that internal stitches are being pulled.  There is defiantely a large mass which does not belong.  The surgeon intends to be able to get it out soon, waiting for 3 mos. from original incisioin date.  So, in 2 weeks, G-d willing, this whole nightmare can FINALLY be over.........  He is planning on making a small incision, under local anesthesia and pull it out..........

Your situation sounds highly unusual. Seromas can occur following a tummy tuck, but they are easily diagnosed and usually easily treated by simple aspiration through a needle inserted through the skin. If surgery is required then you may actually have had a hematoma (collection of blood) which has now had time to organize and is not treatable just by aspiration. Or perhaps you just have a seroma but your surgeon plans to remove the lining of the seroma cavity (bursa). Doing this under local only will be a challenge unless it is fairly small. You might want to consider getting a second opinion. Best of Luck.

Braden Stridde, MD

Federal Way Plastic Surgeon

My Breast Implants Are 7 Years Old. On the Left Side the Bag is Protruding, Should I Switch to Silicone?

This started happening about 2-3 years ago and has progressively gotten worse. The right side feels like a normal breast, however on the left side there is a spot on each side (by my side, and in between) where it looks like the bag shifted and the edges are now poking out. I had them put under te muscle, but everyone that looks at them says that the left side looks like its over while the right looks like its under. What could be causing this? Would it be best to switch to silicone gel?

What you are describing sounds like you have thinned tissues on the outer (lateral) side of your breast. You may also have some implant malposition, meaning that the implant is displaced too far to the outside. Simply replacing the implant with a silicone implant will not fix the problem because it does not address the issue of thinned tissues.

When an implant is placed under the muscle, it is not completely covered by muscle. The lower and outer parts of the implant pocket  are covered by fascia. If the tissues have thinned over time, or if you have a large implant, which will thin your tissues, then you need more than just a silicone implant to correct the problem. Likely you need to have the thinned tissues reinforced with some implantable material such as Strattice. 

These types of revisionary implant problems can be very complicated and you should see someone who has lots of experience in managing implant problems.

Braden Stridde, MD

Federal Way Plastic Surgeon

Is Raising my Low IMF the Same As a Breast Lift? (photo)

Hi. It's been suggested my IMF is very low, and that raising the fold could improve my shape. Is this the same thing as a lift? I would love to have a fuller, rounder shape, more circular. I feel like my breasts are long and I have no cleavage. The right almost looks like a v shape. I have very small high profile saline implants and I wonder if they should be filled more to improve the shape and fullness as well? Thanks so much for your suggestions! This will help me when I go back to see my PS

Raising a low IMF is definitely not the same thing as a breast lift. Your before photos indicate that your implants had bottomed out and the fold was pushed down too low. Raising and reinforcing the IMF was the appropriate correction, however your after photo was taken from a different angle so it is hard to tell how well the problem has been corrected. You are still quite early after surgery and things will still settle in with additional changes to your breast shape. Adding more fill to your implants is unlikely to give you greater cleavage. Creating more cleavage is not something that can always be fully achieved with an implant. 

Braden Stridde, MD

Federal Way Plastic Surgeon