Pain 11 months post op - and a buildup of fluid around implants

Question

Hello… i had a breast lift and augmentation in june 2022 (as well as a bracioplasty in jan 2023.) i am still experiencing pain in my breasts 11 months since having my breasts done.. i recently had an ultrasound and they told me theres a lot of fluid around my implants (more on the most painful breast.) as well as this, i have fluid in my hands i think as one is bigger than the other. I’m really worried mostly about my breasts because i’ve read about BIA alcl - please can i have some advice?

Gerald Minniti, MD, FACS · Answer

Mutational changes necessary to create this rare lymphoma require many years (minimum about 6 years) to manifest into disease. Further, you don't have Biocell textured implants from Natrelle, which caused about 93% of all cases. Instead, you clearly have some low level inflammatory process and the fluid needs to be analyzed for bacteria as well as white cells. You will need an ultrasound guided needle aspiration of fluid to remove the fluid for analysis. Surgeons who specialize in breast and breast implant surgery would have a high resolution ultrasound in their office to perform this minor procedure. Based on the results, a treatment plan would be formed.

Randal Haworth, MD, FACS · Answer

Experiencing pain and fluid accumulation around breast implants could potentially be a cause for concern and should be evaluated by your surgeon or a healthcare professional specializing in breast augmentation. While it's natural to have some fluid accumulation in the early stages of the healing process, persistent fluid accumulation, especially if it causes discomfort, should be addressed by a medical professional.

Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL) is a rare form of lymphoma that has been associated with breast implants. It's important to note that BIA-ALCL is extremely rare, and the risk is considered low. However, any persistent pain, swelling, or changes in breast appearance after breast augmentation should be discussed with your surgeon. They can evaluate your symptoms, order any necessary tests, and provide appropriate guidance based on your individual situation.

In addition to consulting your surgeon, you might consider seeking a second opinion from another qualified healthcare professional to ensure that you receive a comprehensive evaluation and appropriate advice.

I hope this helps,
best of luck !

Daniel Barrett, MD · Answer

Dear neeshasudra,
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, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Connie Hiers, MD, FACS · Answer

I have seen some fluid remain around textured implants since there is more inflammation and tissue reaction to that covering. I no longer use any textured implants because of this risk and others. It is rare to see fluid this late around smooth implants. If there is a lot of fluid, it does need to be drained. If you have textured implants, you might consider exchanging them for smooth. Please discuss this with your surgeon.

Camille Cash, MD · Answer

You should not have fluid around your implants nor persistent pain at 11 months post op from breast augmentation.  I encourage you to visit with your surgeon for an evaluation and next steps to address this concern.  The swelling in your hands could be related to the recent brachioplasty that you had performed.

Peter Andolina, DO · Answer

So lets start by addressing the breast implant issue.  You should not have fluid around your implant, especially 1 year post-op.  I think that you need to get that fluid aspirated and checked to rule out any issues or abnormalities.  In regards to your swelling in your hands after brachioplasty, that can last 6-12 months post-op especially if you are doing alot of upper extremity activities.  Good luck with everything and try to get that fluid tested ASAP

Brian Widenhouse, MD · Answer

Thanks for your question. I suggest you schedule an appointment with your plastic surgeon for a follow up appointment. If your surgeon feels the need to refer you for further evaluation, she/he will do that.
Try not to panic. It may be something as simple as a seroma that just needs to be drained.

Best of luck!

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