Seroma After Bilateral Mastectomy?

Bilateral mast.on 4/5. Expanders were placed, implants removed from previous breast aug.There was enough skin for implant on left but not enough for the right,so PS placed expanders in both.Drains for 8 days,removed at 20cc. Now the left breast has seroma. I have an appoint in 3 days for my 1st expansion, and am concerned about the amount of fluid(a lot). PS says it will resolve and help in the expansion. Is this right since the expansion in under muscle, and there already is enough skin?Help!

Doctor Answers 6

Seroma after mastectomy

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Dear Sully,

Don't worry. Seroma after mastectomy is common.  It may be that while the seroma is present, that your surgeon will not perform expansion.  You are right that the seroma will only be helping to keep the skin expanded and as the seroma settles, you will still need to have your expander filled to stretch the submuscular space where your definitive implant will be placed (assuming that you are having a two-stage reconstruction).  My main worry in this situtation is infection, so make sure that you keep a close follow-up with your plastic surgeon.

Seroma with Tissue Expander

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It depends on how much fluid there is.  Your surgeon can help determine this (ask for an estimate in cc).  If it's a relatively small amount it will resolve on its own.  If its a large amount, aspiration may be beneficial.  It can be tricky to aspirate a seroma with an implant or TE in place.  Care must be taken to not damage the implant/TE.  This is a relatively straight forward problem that I'm sure your surgeon can manage if he does a fair amount of breast reconstruction in his/her practice.

Leif Rogers, MD, FACS
Beverly Hills Plastic Surgeon
4.7 out of 5 stars 26 reviews

Seroma after Mastectomy

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Seromas are collections of fluid that can occur after mastectomy surgery.  They usually resolve with compression dressings and time.  Occasionally they may require surgical drainage, or drainage with a needle.  

Sometimes it is reasonable to proceed with an expander which will occupy the potential space that the seroma would otherwise fill.  So you may begin expansion even if a seroma is present.  

However, there may be a higher risk of infection.  If you have a flap reconstruction with a TRAM flap or a DIEP flap, The healing of the flap to the mastectomy  pocket will help to resolve the seroma, and will provide you with a one stage  breast reconstruction.   has more information on breast reconstruction options

Fredrick A. Valauri, MD
New York Plastic Surgeon

Breast reconstruction

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Serums are one of the most common complications during breast reconstruction. Sometimes surgeons will proceed with the expansion depending on the size of the Seroma and the location.

David L. Abramson, MD
New York Plastic Surgeon

Seroma after mastectomy

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Seromas are very common after mastectomy, and usually resolves. The exapansion does help by squeezing the tissue the fluid is forced into the tissue. the only concern it getting an infection before it completely resolves. In our patients we would aspirate the seroma if sizable and expand immediatley

Fadi Nukta, MD
Ashburn Plastic Surgeon
5.0 out of 5 stars 11 reviews

Mastectomy and seroma

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Seromas can happen after masterctomy, and some surgeons do expand the expanders even in the presence of a seroma.  Speak with your surgeon.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.