Still have seroma after 5 months of saline implant removal.

Question

I had saline implants removed without capsulectomy five months ago but the seroma on my right breast still not completely go away. The left side is normal. I have fluid aspiration 6 times already. The amount of fluid is from 100cc, 60, 40, 30, 20, 10. I still feel the lump/hardness when the fluid is down to 10 cc. I need your professional advises. Please help.

Lewis Albert Andres, MD · Answer

gHello! Thank you for your question! It is a matter of surgeon preference as well as what is seen during your procedure that will determine whether or not a complete capsulectomy is performed. If significant capsule formation is seen intraoperatively, a full capsule removal may be warranted with a drain in order to completely remove all of the tissue and allow better adherence of your breast back to its normal anatomic position down on your chest wall. If minimal contracture is seen, it may be possible to leave the capsule, or place cuts within the capsule to allow better adherence.  It is still not completely understood what forms the capsule, but the popular theory would lead most to removing it entirely. It truly is dependent on what is seen with your capsule and the issues that may be causing you to have such a procedure (e.g., contracture from rutptured implant vs pain vs simple pocket adjustment, etc).  But, I completely believe in removal of the entire capsule, en bloc, for several reasons. Without knowing your issues and without an examination, it is difficult to tell you what may be the best thing for you. I favor performing capsulectomies (in an en bloc fashion) in order to create a fresh pocket, reshape the pocket, allow better shape and adherence of the overlying breast. I would discuss your issues with yourplastic surgeon who will assist you in determining the right modality for you. Given the capsule formed from the foreign object and was not there to begin with, as well as some theories of what exactly is a capsule and what causes it to form...I favor complete capsule removal.  Hope that this helps!  Best wishes!

Camille Cash, MD · Answer

I'm sorry to hear of the issues you are having with a seroma.  They can be frustrating, as they may require multiple aspirations, as in your case.  From what you are reporting the amount aspirated is less each time, which is good.  The body will take care of it when the fluid amount is small.  Continue to follow the advice of your plastic surgeon.

Susan Buenaventura, MD, FACS · Answer

A persistent seroma can be resolved by going back to surgery and removing the capsule.  This will allow the pocket to close down.  Sometimes the lining (capsule) contributes to the fluid build up.. I would consider going back to surgery to remove the capsule on the seroma side.

Ahmed Ali-Khan, FRCS (Plast) · Answer

Hi thank you for your question. It sounds as though things are improving given the volumes being drained are decreasing. Most often the body can absorb seroma once the volumes are this low. If not occasionally other intervention is needed.
The best thing to do is follow the advice of your surgeon and keep them informed of your progress. If more needs to be done they can advise you on this.
Best wishes.

Still have seroma after 5 months of saline implant removal.

Answers (4)

Answer: Persistent seroma

Answer: Persistent seroma

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Still have seroma after 5 months of saline implant removal.

Answers (4)

Answer: Persistent seroma

Answer: Persistent seroma

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Recommended reading

Everything you need to know about Breast Implant Removal

Our mission is to create a world where every investment in modern beauty is Worth It.