Fluid Found Around Implant on Ultrasound?

The reason it has taken eight months is first I went to an ob-gyn, who sent me to a breast center for a mammogram and an US, Then back for an MRI. I made an appt with a PS who told me about the alcl. He has asked the breast center to do the fluid test but they don't understand the importance. I have saline, textured implants and the MRI showed ruptures. But my breast have not deflated. The left breast is swollen, hard and the right is still the same. The US showed fluid on the outside of the IP.

Doctor Answers 2

You don't need more "studies." You need surgery.

For all potential or actual breast enlargement patients reading your question, I would point out that if you have a problem (or think you might have a problem) with your breast implants, you should contact your plastic surgeon FIRST. The problem with other specialists can be exactly what you experienced, test after test, lots of concern, lots of (wasted) time, and expense that could have been utilized for what you really need--surgery to deal with the capsular contracture on the left side, and whatever is needed on the right, plus exchange of your textured saline implants for smooth round silicone cohesive gel implants, and just to be absolutely safe, histologic analysis of any fluid found around your implants.

I'm sorry you were made to worry about ALCL; the incidence of this is SO RARE (34 cases over the past 13 years in up to 10 million breast augmentation patients) that it would be like your internist speculating about Ebola virus if you went in for a sore throat!

Forget more studies; you need an expert ABPS-certified plastic surgeon experienced in revisionary surgery of the breast to deal with the real concerns you have. I have yet to operate on an ultrasound or MRI scan--I operate on real living patients who have identifiable problems. Don't get me wrong; I'm not test-averse. They just don't change what has to be done in your situation . . . so WHY get the test?

Click on the web reference link below and look at other articles I have written, especially the one on ALCL. Best wishes! Dr. Tholen

Minneapolis Plastic Surgeon
4.9 out of 5 stars 255 reviews

Fluid around breast implants

Sorry that this is taking a long time to figure out. There may be a misreading of the MRI as ruptured saline implants would cause your breasts to become smaller. While very, very rare, ALCL can happen and so your plastic surgeon is correct in asking for a fluid analysis. You may need to ask you plastic surgeon to make some calls for find another breast center that can do the required studies. 

Karol A. Gutowski, MD, FACS
Chicago Plastic Surgeon
4.9 out of 5 stars 68 reviews

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