My body rejected tissue expanders. Will it do the same with silicone? (photos)

I had a double mastectomy with tissue expanders in april. I went for 3 small fills of 50ml each to make me a small B cup. But over the course of the next 3 months my boobs got to an E cup. They were HUGE. Last week I had the exchange to small smooth silicone. But I am terrified my body will reject the silicone like the expanders: pumping fluid into the breast. (The surgeon drained over 350ml in the exchange surgery) He said he's never seen a patient react like this and that I'm very rare. Am I?

Doctor Answers 1

Seromas are a nuisance, but there are good options for treatment

Hello!Congratulations on completing your reconstruction and cancer treatment journey!  It sounds as though you had "seromas," or fluid that collected inside the breast and around the implants, rather than "rejection" of the implants.  The short answer to your question is "yes", there's always a risk that seromas come back because the lymph tissue is cut after mastectomy and lymph node removal.  The risk of getting seromas again depends on whether some or all of your lymph nodes were removed, how early drains are removed (I recommend removal when output is less than 24 cc / 24 hours), what type of reconstruction you have (implants are more commonly associated with seromas), and uncontrollable factors such as how how your body heals itself.  Although sometimes difficult to prevent, seromas are not dangerous to your health and they're treatable, so rest assured that with the appropriate treatment it can't harm you.  If you still have drainage tubes in place, then I would be cautious in removing the drains too early, and in patients who have had seroma problems, my criteria for removing drains is even stricter. External compression can be helpful and Spanx garments or Spandex sportswear are cost effective, but it's a "soft" measure in risk reduction. If a patient has a chronic seroma (i.e. present for months), then the only definitive fix is tissue reconstruction with either a DIEP flap or a "Love Handle" flap, operations in which I rebuild the breasts with your abdominal skin and fat, or your love handle skin and fat, respectively. By replacing the implants with your own tissue, this can seal off any leaky lymph channels that cause the seromas.  Most importantly, you should be cared for by a skilled breast reconstructive surgeon, preferably one who does microsurgery, to guide you. 
All my best!- Dr. Rad


Washington DC Plastic Surgeon
5.0 out of 5 stars 48 reviews

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