Bilateral mast.on 4/5. Expanders were placed, implants removed from previous breast aug.There was enough skin for implant on left but not enough for the right,so PS placed expanders in both.Drains for 8 days,removed at 20cc. Now the left breast has seroma. I have an appoint in 3 days for my 1st expansion, and am concerned about the amount of fluid(a lot). PS says it will resolve and help in the expansion. Is this right since the expansion in under muscle, and there already is enough skin?Help!
Seroma After Bilateral Mastectomy?
Doctor Answers (6)
Seroma after mastectomy
Don't worry. Seroma after mastectomy is common. It may be that while the seroma is present, that your surgeon will not perform expansion. You are right that the seroma will only be helping to keep the skin expanded and as the seroma settles, you will still need to have your expander filled to stretch the submuscular space where your definitive implant will be placed (assuming that you are having a two-stage reconstruction). My main worry in this situtation is infection, so make sure that you keep a close follow-up with your plastic surgeon.
Seroma with Tissue Expander
It depends on how much fluid there is. Your surgeon can help determine this (ask for an estimate in cc). If it's a relatively small amount it will resolve on its own. If its a large amount, aspiration may be beneficial. It can be tricky to aspirate a seroma with an implant or TE in place. Care must be taken to not damage the implant/TE. This is a relatively straight forward problem that I'm sure your surgeon can manage if he does a fair amount of breast reconstruction in his/her practice.
Seroma after Mastectomy
Seromas are collections of fluid that can occur after mastectomy surgery. They usually resolve with compression dressings and time. Occasionally they may require surgical drainage, or drainage with a needle.
Sometimes it is reasonable to proceed with an expander which will occupy the potential space that the seroma would otherwise fill. So you may begin expansion even if a seroma is present.
However, there may be a higher risk of infection. If you have a flap reconstruction with a TRAM flap or a DIEP flap, The healing of the flap to the mastectomy pocket will help to resolve the seroma, and will provide you with a one stage breast reconstruction.
nybreastreconstruction.com has more information on breast reconstruction options
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Seroma after mastectomy
Seromas are very common after mastectomy, and usually resolves. The exapansion does help by squeezing the tissue the fluid is forced into the tissue. the only concern it getting an infection before it completely resolves. In our patients we would aspirate the seroma if sizable and expand immediatley