Why fluid/seroma keeps coming back after implant removal? 8 weeks post op.

Question

My saline implants are removed 8 weeks ago without capsulectomy and drainage. The fluid keeps coming back on my right breast. The doctor aspirated the fluid 3 times already since surgery but I still feel the right side breast has some soreness/mild pain when touch. Will the fluid do any harm to my breast if I leave it there? Will there be a complication? What can I do about it? Thank you for your advise.

Camille Cash, MD · Answer

I'm sorry to hear of the seroma formation since your implant removal.  They can be frustrating and can take multiple aspirations to treat, as you've already experienced.  If it continues your surgeon may need to place a drain to help it heal.  I encourage you to closely follow your surgeon's instructions.  Compression of the area is helpful.

Parham Ganchi, PhD, MD · Answer

Hi beautifulrose1,Don't worry. First, the fluid is not going to harm you. It sounds like the fluid has been drained 3 times and now you have some soreness.  This is expected since you had the drainage.  After draining the fluid several times, it should stop.  If a little remains inside, this is not dangerous and is not a problem as long as it doesn't make your right side look a lot bigger than your left.  If after a few month, both breasts look relatively even, then it wouldn't make sense to do more surgery.  At this point, I would be patient, let your surgeon drain the fluid as needed and give everything time.  Jumping back into surgery would only make sense if the amount of fluid was large.  Even then, a drain could be placed without surgery.  Be patient.  Take care.Dr. Parham Ganchi - Wayne, NJ Plastic SurgeonPrinceton ~ Harvard ~ Duke

Benjamin J. Cousins, MD · Answer

Thank you for your comments and very sorry to hear of your troubles. Several things are possible. The fluid/seroma could stay there, increase in size, shrink in size, slowly go away or other possibilities...The thick capsule or layer of scar tissue around the breast implant should be removed to help prevent a seroma from forming. A closed suction drain may help to seal down the tissues at this point, and also a sclerotic agent (doxy,tetra, talc) to help the sides of the scar/capsule seal together so as not to create a space for fluid to build up with. Another operation to remove the capsule can be done as well. It is best to be sure to see a Board Certified Plastic Surgeon for an in person exam and discussion. I hope this helps.
Dr. Benjamin J. Cousins MD
  
Board Certified Plastic Surgeon- Miami/Miami Beach, FL

Christopher L. Hess, MD · Answer

Unfortunately, this is why I never can understand why plastic surgeons don't remove the capsules.  The capsules are a very smooth scar tissue that is resistant to tissue drainage.  After implant removal without capsullectomy the top and bottom of the capsules will hold that fluid in a pocket.  This is why I always removal the capsules and place drains.  What your surgeon needs to do is either place percutaneous drains or after aspirating the seroma inject Doxycycline into the pocket.  This results in irritation of the capsule which can get them to stick together and prevent an area for the seroma to form.  The other option is to just keep aspirating it and hope it eventually stops.

Why fluid/seroma keeps coming back after implant removal? 8 weeks post op.

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Why fluid/seroma keeps coming back after implant removal? 8 weeks post op.

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