Drainage After Failed Breast Reconstruction

I experienced a partial failure of a DIEP reconstruction. After chemo, I underwent a fat graft to fill out the breast. However, my surgeon found and removed a large seroma during that process. I had another round of fat grafts about 5 weeks later. The seroma had returned, but this time my surgeon left it. About a month after the second round of fat grafts, two spots opened on my incision. Four weeks later, one is still draining heavily. How long should I expect the drainage to continue?

Doctor Answers (6)

Drainage after DIEP

+1

You either have a draining seroma or draining liquefied fat necrosis.  This can go on for some time, meaning weeks.  It will stop on it's own eventually in the vast majority of the cases.  I personally would not attempt any fat grafting until the drainage has completely stopped and the skin was well healed.  An ultrasound prior to the next round of fat grafting will help determine if there is any fluid collection that needs to be addressed before surgery.


Beverly Hills Plastic Surgeon
4.5 out of 5 stars 15 reviews

Breast reconstruction

+1

There really is no way to determine how long the drainage will persist. This is a complicated problem and and may require additional surgery to correct

David L. Abramson, MD
New York Plastic Surgeon
3.0 out of 5 stars 4 reviews

Drainage after failed breast reconstruction

+1

it is a tough situation.  fat necrosis after any type of tram can continue for up to a year, with consequent changes in shape and size of the reconstruction.  i have had better luck with being conservative and not opening up and debriding.  i would definitely not do any fat grafting till the wounds have stabilized  hang in there

Jonathan Saunders, MD
Newark Plastic Surgeon
5.0 out of 5 stars 27 reviews

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You need to have exploration and removal of the necrotic flap tissue

+1

You have partial or full loss of the DIEP flap and fat injection should not performed till you are fully healed. You need exploration,debridment and packing till wound healed, Seroma are due to the necrotic tissue.No more fat grafting till you breast healed well. Fat will not survive in the necrotic tissue.

Kamran Khoobehi, MD
New Orleans Plastic Surgeon
5.0 out of 5 stars 51 reviews

Drainage of breast

+1

With  a DIEP flap and then a fat inejction procedure, it sounds like you may have fat necrosis from the flap or more likely the fat injections.  Follow closely with your surgeon. Hard to say when it will stop draining.

Steven Wallach, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 15 reviews

Drainage After Failed Breast Reconstruction

+1

From my experience you may be having "fat necrosis" in the transplanted fat grafts. I treat this via open incision & drainage. Discuss with your surgeon the options. From MIAMI 

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.5 out of 5 stars 61 reviews

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