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

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.

Without capsulectomy, the pocket will persist to a certain extent allowing for collection of fluid. This does not occur in all cases. In my experience it is more rare. Most surgeons will close down the capsule to a certain extent (partial capsulectomy and quilting sutures) and encourage compression in the early phases of healing.With regards to timing, late seromas are even more rare and most will occur over the first 4-6 weeks during which primary healing is occurring.As always, discuss your concerns with a board certified plastic surgeon (ABPS).

    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

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. 

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!