How Long Do I Have to Worry About Possible Seroma After Explant of Breast Implants?

I am having my saline breast implants removed without replacement. This will be a simple removal, no lift or capsulectomy/capsulotomy. I inquired about having a capsulectomy, but my extremely qualified surgeon believes in my case it would do more harm than good, as I have very little breast tissue and none of the common reasons for capsulectomy (silicone implants or calcification of the capsule). How long will I have to be on the lookout for seroma? If it did, what time frame will it develop?

Doctor Answers 9

Breast Implant removal and seromas

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When removing breast implants and not placing new ones seroma is always a possibility. Your surgeon may perform a complete removal of the capsule which could decrease the cahnces of this. Without that, your surgeon may place "quilting" sutures to close off the capsule (this also helps hold the breast higher to prevent sag) or a drain. A seroma generally would be apparent within three weeks after surgery but I have fouond they are quite rare in my practice.

Most seromas form within 6 weeks of surgery.

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Although swelling following breast implant removal is common, the development of seromas is rare.Seromas are even less likely when implants are removed and capsules are left in place.

The vast majority of seromas form in the first four to six weeks following surgery.For this reason, we have patients wear compression garments for at least six weeks following surgery.

If you have questions regarding postoperative seroma formation, it’s important that you discuss this issue with your plastic surgeon.Your surgeon should be able to answer all your questions.

Seroma after Implant Removal

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    Your surgeon is absolutely correct in leaving the capsules due to all of the reasons you mentioned.  The anterior and posterior capsule walls can be sutured together to prevent seroma formation as well.  After 4 to 6 weeks, the risk for seroma is much less.  Kenneth Hughes, MD Los Angeles, CA

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Seroma after breast implant removal?

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A seroma can potentially occur with any surgery, but it is not a common problem after removing implants.  I would agree with your surgeon's recommendation to leave the capsule in place.   Limiting postoperative activity and wearing compression over the area may help reduce the fluid that can accumulate in this area.   Typically, seromas will occur within the first month or so after surgery, and very rarely much later. 

How Long Do I Have to Worry About Possible Seroma After Explant of Breast Implants?

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Seroma is a known complication after explantation, though it does not occur frequently. Based on what you have noted in your posting, I concur with your surgeon's recommendation. 

When they occur, most will be apparent by 10 days or so. You can help minimize the chances by avoiding strenuous activities during the early post-op period, and by wearing a compression bra. Best wishes. Thanks for your question.

Jourdan Gottlieb, MD
Seattle Plastic Surgeon

Seroma after explantation of breast implants

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Seromas are one of the most common complications following explantation of any prosthetic or any procedure where large undermining of tissue has been done.  Without examining you, it is difficult to tell you what I would recommend in your specific case.

I typically perform a capsulectomy along with explantation of the prosthetic implant in order to allow adherence of the tissue and decrease the potential space, which was created by the implant.  Inevitably, there is some degree of encapsulation of any prosthetic device that has been implanted.  I like to remove the capsule for this reason.  Often times, I utilize drains to assist in removing the fluid which will form, until the overlying tissue readheres back to the chest wall or muscle.  

Seroma capsules usually form within the first couple of months when there is still a potential space, and it has filled with fluid.  Although unlikely to develop a clinically significant seroma capsule after breast surgery, it is possible.  I would raise your questions with your surgeon so as to alleviate any concerns that you may have prior to your procedure being performed.  Good luck!

Lewis Albert Andres, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 28 reviews

Seroma after explant

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is nearly unheard of.  But you should be asking this of your surgeon as he sounds quite reputable.  I have not appreciated a seroma after removal of implants and leaving the capsule behind during my 21 years of practice.

Curtis Wong, MD
Redding Plastic Surgeon
4.8 out of 5 stars 33 reviews

Removal of Breast Implants and Seroma?

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Thank you for the question.

Although rarely,  seromas  may present in a “delayed” fashion, I think that the majority of seromas  will be clinically evident within 2 weeks after removal of breast implants.

 Your plastic surgeon will likely have advice regarding limitation of activity with your upper extremities during this timeframe.

 Best wishes; hopefully you will be very pleased with the outcome of the planned procedure.

Seroma after implant removal

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I will sometimes drain breasts that  I have removed implants from.  Especially if I remove the capsule.  I think in most cases the usual seroma window is withint the first few weeks.

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.