Late onset seroma 6 years after breast augmentation (Photo)

Question

I’ve developed Seroma in my left breast 6 years post breast augmentation. Initially I was referred to the breast cancer clinic. I got the all clear and they told me to live with the Seroma for 4 weeks to see if it goes on it’s own and if it doesn’t they will drain it. The ultrasound only showed a slither of fluid but my breast is rock hard and larger. It’s also asymmetrical and uncomfortable. I’m really worried about capsular contracture too. Any advice would be appreciated

Daniel Barrett, MD · Answer

Dear Betty boobjob,
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

Donald R. Revis Jr, MD · Answer

Good morning,
Sounds like you have yourself one angry CC- and it is common to have fluid as a component, but that fluid can still be analyzed during the removal to rule out BIA-ALCL. I would suggest a complete capsulectomy, implant exchange, and a drain postop, as well as Vitamin E and singulair.

Nelson Castillo, MD · Answer

Thank you for sharing your question and photographs.  A late onset seroma needs to be fully investigated and worked up so I would be seen by your surgeon repeatedly and thoroughly for the best treatment.  They should be able to also help with any other symptoms you are experiencing

Camille Cash, MD · Answer

The symptoms you describe warrant a visit to your surgeon's office for an evaluation.  Capsular contracture is a possibility based on your photos and description.  Your surgeon will help determine if that is the case.

Connie Hiers, MD, FACS · Answer

You need to be seen by a plastic surgeon and have the seroma removed. Otherwise, it may organize and stay or you may develop a hard capsule. Please don't delay.

Samir Shureih, MD · Answer

All seromas after breast augmentation or breast reconstruction should have an extensive workup.
Seromas after one year of implants should have:
Ultrasound and MRI. if fluid confirmed then an aspiration of the fluid is required and tested for 
cytology
Flow cytometry for T cell clone
CD 30
additional markers; CD 3, CD 4, CD5, CD 7, CD8, CD45 and 
ALK
If the above is positive need full involvement of many specialties in a cancer center, Hematology, Oncology, and Plastic Surgery for treatment.
and Culture, Culture positive, treat depending on Bacteria.
If negative treat as a seroma.
Consult your plastic surgeon or a plastic surgeon in your area familiar with Breast Implant Illness and available imaging and laboratory to do all the testing available.
You have very good plastic surgeons in England and other specialties needed. How ever the work up is mandatory as soon as possible.
Samir Shureih MD. USA, Baltimore.

Paul Jason Skoll, MBChB, FRCS, FCS(SA)Plast · Answer

Hi. Late seromas are never normal and need to be investigated fully. If logistically possible, fluid should be tapped off under ultrasound guidance and sent for full analysis. Do you know what "make" of implants you have in place and whether or not they have a textured surface? If there is no resolution within a couple of weeks, I suggest you have a plastic surgeon review your case.

Douglas J. Raskin, MD (retired) · Answer

Greetings,
Sorry to hear about your late seroma. Looks like you need to return to your plastic surgeon for further evaluation and care.
You may have a combination of issues and drainage by a trained radiologist with appropriate studies could be a good starting point. Have your plastic surgeon discuss your options and a logical treatment plan.
This problem should not be ignored if you are seeing no improvement and are still in pain.
Best Regards,

Late onset seroma 6 years after breast augmentation (Photo)

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