What are the chances a seroma will return if I replace my implants?

I had breast augmentation 20 years ago. A couple of months ago my right breast started swelling. My plastic surgeon drained it this week. It had 190 cc's of liquid in it. It is still swollen but much better. I have an appointment in 5 weeks to have the implants replaced. We are going with a smooth implant. What are the chances the seroma will reoccur? I would rather remove the implants entirely than to spend the money or go through additional procedures.

Doctor Answers 8

Late seromas after augmentation

are concerning and I assume your fluid drained was sent for proper analysis... and if not, it must be done before considering more surgery.  If your surgeon is planning on removing you old capsule, seroma formation is minimal.  You really need to find out why you had a late seroma.


Redding Plastic Surgeon
4.8 out of 5 stars 33 reviews

Will my seroma recur?

Great question!

Seromas are not common in patients with implants in as long as yours and so I would make sure that your surgeon sent the fluid for ALCL, a very rare but potential cause of seromas in breast implant patients.  

As for needing another surgery, there is no way to guarantee that this or any other implant-related complication will not occur.  And so if you are that concerned, you may want to just remove your implants entirely.

I hope that helps.  Please let me know if I can be of further assistance!

Warmest regards,

Gregory A. Buford MD FACS 

Gregory A. Buford, MD, FACS
Denver Plastic Surgeon
4.9 out of 5 stars 42 reviews

What are the chances a seroma will return if I replace my implants?

Seromas can occur with 20-year-old implants especially of the textured variety but ALCL must be ruled out.  The fluid should be sent to a pathology lab prepared to evaluate it for ALCL and as well a culture should be obtained.  I would under the circumstances you describe consider removing your implants and leaving them out to allow for healing before considering replacing them.  This also gives you the option of leaving them out permanently if you wish.  Good luck and best wishes.

Jon A Perlman M.D., FACS
Diplomate, American Board of Plastic Surgery
Member, American Society for Aesthetic Plastic Surgery (ASAPS)
ABC-TV Extreme Makeover Surgeon
Beverly Hills, California

Jon A. Perlman, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 31 reviews

Seroma

BIA-ALCL is usually treated by removing the textured implant with its capsule and has only been seen to occur in people with textured implants. A smooth implant should not give you the same symptoms although I might recommend removing them and waiting a few months before placing new implants. 

Allen M. Doezie, MD
Orange County Plastic Surgeon
5.0 out of 5 stars 50 reviews

Late seroma

A late seroma can potentially be related to a rare but important disease process called Anaplastic Large  Cell Lymphoma or ALCL. If the seroma has recurred aspirating the fluid and sending it for a CD30 test could help you with decision making. This may need to be done at a hospital after first checking that they can do this test. If it is positive the implants and entire capsule should be removed, and not replacing them may be in your best interest. Please discuss this with your plastic surgeon so that you are making the best decision possible.

Best of luck,

Stacey Folk, MD
Denver Plastic Surgeon
4.8 out of 5 stars 24 reviews

What are the chances a seroma will return if I replace my implants?

Let me apologize ahead of time for this answer because I am afraid it will alarm you. Anytime we see a delayed seroma, a malignancy known as BIA-ALCL, a type of lymphoma, must be ruled out and this is done by sending a sample of the seroma fluid to a patholgist FAMILIAR with making this diagnosis. Has your surgeon done this? If not you need to be proactive yourself in having this test done. The tumor is almost always cured by removing the capsule around the implant. It is quite rare and you probably do not have it but no good surgeon should overlook the possibility. Please feel free to call me should you have questions.

Ronald V. DeMars, MD
Portland Plastic Surgeon
5.0 out of 5 stars 27 reviews

Late seroma after breast augmentation

It is very unusual to develop a seroma late after breast augmentation. This needs to be evaluated to make sure there is nothing going on. The aspirated fluid can be sent to pathology. At surgery the fluid and capsule can be sent.Did you have textured implants? There is a rare disease called ALCL (Anaplastic Large Cell Lymphoma) that can present as a late seroma and needs to be ruled out. Seek a plastic surgeon who is certified by the American Board of Plastic Surgery who specializes in cosmetic plastic surgery, as evidenced by membership in The American Society for Aesthetic Plastic Surgery. 

John Squires, MD
Denver Plastic Surgeon
4.9 out of 5 stars 79 reviews

Seroma

Thank you for your question. It would be helpful to provide photos. It is very unusual to develop a seroma that far out from surgery. Did your PS discuss the etiology of the seroma? Do you have a scar tissue capsule around your implant? If you don't mind having smaller breasts removing your implants all together is a good option. I believe the chance of a recurrent seroma would be less than 1%. Best of luck

Christopher J. Morea, MD
Raleigh-Durham Plastic Surgeon
4.9 out of 5 stars 191 reviews

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.