Why 3+months after explant do the pockets keep filling with fluid?

Question

Over 3 months ago i had my small over the muscle silicone implants removed.. was fine a couple weeks then they blew up larger than when i had implants and were hard and painful.. i now have to go every week or 2 and get drained. I wear a tight compression bra or bandage almost constantly to keep it from re-swelling.. my dr has never dealt with this and i don't want to be damaging anything if this is something i will need surgery again for.. help!? Any advice or just more time and detoxing?! Thanks

Ankur Mehta, MD · Answer

Hello and thank you for your question. Its unfortunate you are having this issue but it is something that can occur whenever there is a space in the body. It sounds like you are having an issue with recurrent seromas in the pocket where your implants were. As many of my colleagues have discussed below, there are really 3 main options. The first is already being done which is the serial aspirations. If after 3 months the seromas are still forming then another step may need to be taken. Drains can be placed as a next step and kept in until the drainage starts to decrease to a satisfactory amount. Lastly, this may need a surgical solution which would involve removing the capsule (a wall the body produces around the implant). I hope you are able to get this resolved and wish you the best of luck!Ankur Mehta MD

Camille Cash, MD · Answer

A seroma is a pocket of fluid that accumulates and can occur after implant removal.  You are doing the right things by following up with your surgeon and wearing compression.  Activity level may be contributing as well.  If aspirations don't resolve your seroma your surgeon may opt to place a drain.  If nothing else resolves it your surgeon may discuss surgical intervention.

Lily Lee, MD · Answer

unfortunately, the capsule formed around your implant is acting like a cyst sac as it is fully mature. The ideal would be to go back to surgery and have at least a partial capsulectomy. If you are adamant against going back to surgery, you can have a drain placed in each pocket and left there for several weeks. Neither option is great, I know, but because the capsule has matured, it will continue to fill with fluid until something is done to "roughen up" the slick surfaces and get them to stick down to each other.

Kamran Khoobehi, MD · Answer

The options are drain placement to remove the fluid and surgical exploration to remove all of the capsule and closure of the pocket with Quail suture.

Benjamin J. Cousins, MD · Answer

Thank you for your question. A thickened capsule that is left behind after breast
implants are removed can cause fluid to build up or a seroma that will continue
to expand, leak and drain. Surgery to remove the capsule and leave a drain can
help treat this excessive fluid/seroma build up.Best wishes,Benjamin J. Cousins MD Board Certified Plastic Surgeon

Why 3+months after explant do the pockets keep filling with fluid?

Answers (8)