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What can be done for a recurring seroma six weeks after breast augmentation?

Q:

I had breast augmentation and developed a seroma in the right breast after six weeks post op.  I have massive fluid leakage through my incision.  The doctor re-operated to flush out the pocket and reinsert the implant.  I have no real improvement and the incision continues to rupture to release fluid at least once a week.  What can be done - I am absolutely desperate at this point.

A:

Your postoperative course is not customary or usual following a breast augmentation.  May I suggest you expeditiously seek evaluation and care from another surgeon.  Please consider one of the many members of the ASAPS for a consult. 

Also, understand that there will be additional expenses you will be held responsible for in this process.  Your predicament is why all our aesthetic patients are provided with Cosmetic Protect or Cosmetic Assure.  I receive no financial compensation from either company.

Best,

 

Gary R. Culbertson, MD, FACS 

A:

Recurrent seroma in breast augmentation is not normal course.  The seroma fluid needs to be cultured and if there is any sign of bacteria, the implant must be removed.

See your plastic surgeon ASAP.  If your surgeon is not a BOARD CERTIFIED PLASTIC SURGEON, THEN YOU NEED TO SEE A BOARD CERTIFIED PLASTIC SURGEON (AMERICAN BOARD OF PLASTIC SURGERY).

A:

Continued drainage 6 weeks after revision for a seroma most likely indicates that your breast implant is exposed.  If the breast implant is not visible then you'll likely have an impending extrusion or exposure of the implant.  This is a plastic surgical emergency and most likely your breast implant needs to be removed and you need a period of healing before a breast implant can be replaced.  If your surgeon is not addressing this then consult another board certified plastic surgeon.

A:

This is a very unusual situation.  A second opinion may be useful in this case.  The fluid needs to be cultured.  If it is sterile, then i would consider placing a drain to decompress the pocket.  If this doses not work i would remove it.  Good Luck.

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