I had a mastectomy/expander over 9 months ago. Detected skin breakdown, before radiation. After radiation, seroma developed & has been aspirated over 15 times by Dr. Had to have expander removed, & now seroma is draining through 2nd incision mark for past 4 months. Have to wear maxi pads 24 hrs a day as fluid never stops draining. Dr. has given me option to undergo surgery to remove scar tissue & hope that my body will begin to absorb or tram-flap reconstruction. Has any Dr dealt with this?
4 Month Old Seroma, Post Mastectomy-still Draining Through Incision, Have any Doctors Dealt WIth This Before?
Doctor Answers (4)
After the skin has radiation, healing is frustrating because the skin is just not as strong as it was before. Discuss this with your surgeon and explore your other options. Perhaps surgery to remove scar tissue is your best option.
Web reference: http://www.elitemdspa.info/
Chronic seroma after radiation.
Chronic seromas following radiation in the setting of an expander do occur. Unfortunately, due to the radiation, they usually do not resolve on their own. Attempts at scar revision and suction drainage can be successful, but the more reliable option is to bring in non-radiated vascularized issue from either a TRAM flap or a latissimus flap. If the skin is thin (and usually is), the vascularized tissue can help salvage this skin and improve the overall cosmetic result of the reconstruction.
Web reference: http://www.drbogue.com
Post mastectomy chronic seroma cavity needs to be surgically removed.
Unfortunately this will not go away on its own. It sounds like the lining of the seroma cavity needs to be removed with an operation, and then one or two suction drains inserted and left in for about two weeks. The suction from the drain collapses the cavity, and usually gets it to seal shut.
Once that is all done, you probably should have a flap reconstruction using your own abdominal fat.
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Seroma formation is common, especially after radiation therapy. If you have chronic drainage the the capsule should be removed, as your surgeon has proposed, drain the wound and keep the drain till drainage is down to 15-20 cc per day.
Of course the removal of the capsule in the radiated area carries the risk of skin not healing well because of the radiation. There is also higher risk of infection.
Discuss all this with your plastic surgeon and then you can make an informed decision.
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.
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