Is breast explant the best choice moving forward? Persistent seroma (Photo)

Question

I had severe bilateral capsular contracture so needed to remove my previous implants and undertake change of implants. 1 month post-op, I have developed persistent leaking seroma on my right breast and the incision site wouldn’t heal because of it. I have been on antibiotics and steroids but nothing helped. The PS does not recommend a drain or aspiration as he said it will make it worse. Is breast explant the best choice moving forward? Thanks.

Alan Gonzalez, MD, FACS · Answer

Hello @queenoflean, thank you for your question. Yes, it is the ideal approach to remove the prostheses and capsules that surround it. Also it would be necessary to carry out a preventive biopsy on each capsule. I link a video about a capsular contraction that will shed some more light. The most appropriate course of action is to consult one or several board certified plastic surgeons. This will allow you to get more information and options tailored specifically to your needs. Best wishes! Alan Gonzalez, MD FACS.

Wess Cohen, MD · Answer

Thank you for your question. The treatment for a seroma is drainage. If you continue to have fluid around me implant with unhealed wounds, it can prevent the wounds from healing and potentially lead to an infected implant. Without knowing your exact situation, my recommendation is usually repeat aspiration As the seroma tends to resolve after 2 to 3 sessions. Good luck

Daniel Barrett, MD · Answer

Dear queenoflean,
I understand your concern. However, without a proper assessment, it would be difficult to determine what went wrong. It is best that you visit your plastic surgeon for further assessment or ask for a second opinion. Only after a thorough examination, you can get proper recommendations and advice.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Camille Cash, MD · Answer

I'm sorry to hear of the issue of your seroma.  It is definitely an option to completely remove the implant and allow the breast to heal.  You can consider augmentation again in a few months.  I encourage you to speak with your surgeon about your options.

Connie Hiers, MD, FACS · Answer

So very sorry about your trouble with seroma. Yes, removing the implant might be the best choice. Continued leaking is a risk for infection and that will lead to another capsule. Continued seroma is a risk of developing a thick cavity around the seroma which will need to removed surgically. If the implant is removed, your tissue can settle back down to normal. Later, you can replant.

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