Compression after breast implant removal, yes or no?

Question

My surgeon told me to not use compression after breast implant removal,he even said that fluid build up was good and that it would help me feel like I still had implants. Now I am reading just the opposite on realself! I didn´t have drains or compression at all and I have a seroma that is bothering me one week post surgery (one breast is twice the size). Should I use ace wrap now? Or should I drain the seroma first?

Robert Cohen, MD · Answer

The importance of compression after explantation varies depending on whether you simply had your implants removed (low risk for seroma) or had a capsulectomy as well (higher risk for seroma).  I rarely use drains, but I do generally like a compressive bra.  Even with drains and compression, it is still possible to have a seroma. I don't think it is ideal for you to have a seroma, so I would recommend having this drained at your surgeon's office.  Luckily, this is a relatively easy and minimally painful procedure.  Seroma tend to recur, so it is possible that you may need it drained more than once.  Luckily, once seromas resolve, they usually don't come back.

Lewis Albert Andres, MD · Answer

Hello! Thank you for your question!   If significant capsule formation is seen intraoperatively, a full capsule removal may be warranted with a drain in order to completely remove all of the tissue and allow better adherence of your breast back to its normal anatomic position down on your chest wall.  I believe that the drain as well as compression minimizes fluid to accumulate in the potential space from where the implant was previously.  Typically, not allowing a capsule to form is desired and will likely give best results and minimze complications.   If minimal contracture is seen, it may be possible to leave the capsule, or place cuts within the capsule to allow better adherence. It truly is dependent on what is seen with your capsule and the issues that may be causing you to have such a procedure (e.g., contracture from rutptured implant vs pain vs simple pocket adjustment, etc).   I would discuss your questions/concerns with your plastic surgeon who will assist you in your postoperative care. Hope that this helps! Best wishes!

Gregory A. Buford, MD, FACS · Answer

I'm not sure why your surgeon recommended against compression.  Most Plastic Surgeons would encourage you to compress for at least 4-6 weeks after surgery to encourage closure of the pocket and discourage seroma formation.As the other PS suggested, you really need to follow up with your surgeon and have this drained.  I hope this helps!All the best,Greg

Charles W. Spenler, MD · Answer

Thank you for your question! After practicing plastic surgery for over 30 years, I generally do not have my patients wear compression garments after breast implant removal. However, I do always use drains with this procedure in order to prevent fluid collection and possible future operations to correct complications. It is difficult to make any recommendations without examining you myself; however, I would recommend draining the seroma before using any type of compression. After draining it, I would recommend compression with a surgical bra. When removing implants, we remove the capsule which creates a raw surgical surface which produces fluid. Since you did not have drains, this fluid collected leading to your seroma. After draining it, the compression will stabilize the surgical surfaces allowing them to heal together without fluid.

Camille Cash, MD · Answer

It is unusual to not use any form of compression or support after surgery.  Your surgeon would be the one to answer his rationale for this.  The seroma that you indicated needs to be addressed and follow up care established.  Contact your surgeon for an appointment.

Susan Kolb, MD - Account Suspended · Answer

Compression after explantation is very important in order to avoid complications. We recommend a breast binder compression for two weeks after drain removal. Seroma formation is associated with infection, capsule re-formation, and mold growth.

Robert E. Zaworski, MD (retired) · Answer

Yes, you should wear a compression garment after explant surgery.  See your surgeon immediately regarding the fluid, as this is a complication that needs to be resolved.

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