Novosti
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This journal is indexed in Scopus |
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Year 2019 Vol. 27 No 4
GENERAL & SPECIAL SURGERY
S.A. PLAKSIN
LATE SEROMAS AFTER IMPLANT-BASED BREAST ENLARGEMENT SURGERY
Perm State Medical University named after Academician E.A. Wagner, Perm,
The Russian Federation
Objective. To evaluate risk factors, clinical history and surgical treatment of late seromas after implant-based breast enlargement surgery.
Methods. Late seromas were diagnosed in 19 cases (1.4%) of 1387 implant-based breast enlargement surgeries in total at the long-term follow-up, 6 months – 16 years after the first surgery. Six of these cases underwent the initial surgeries at other hospitals. The incidence of late seromas was 0.9%. Seromas were diagnosed via ultrasound and computed tomography.
Results. The origins of late seromas were related to capsular contracture (n=6), rupture of the implant (n=3), mastitis (n=4), general infection (n=1), lactation (n=1), three were discovered during surgeries, and one had no apparent risk factors for its origin. The accumulation of milk around the breast prosthesis in the early postpartum period was called “milkoma.» Late seromas were divided into three groups: small with their volume up to 50 ml (29.3±7.5 ml), discovered in 8 (42.1%) patients, medium ranged in volume between 50 to 150 ml (97.7±37.8 ml), discovered in 4 (21.1%) patients, and large – more than 150 ml (271.4±111.3 ml) in volume, discovered in 7 (36.8%) patients. Three patients with small seromas were treated with antibacterial, anti-inflammatory and physiotherapy; one case of milkoma was treated via repeated transcutaneous needle aspiration and lactation suppression, and one case of seroma was treated by drainage. 14 (73.7%) patients required repeat surgeries: 6 patients with small seromas underwent capsulectomy with the replacement of breast implants and drainage; 5 patients with large seromas or signs of mastitis, and/or infected fluid in the presence of medium seromas underwent capsulectomy with implant removal and drainage, and 3 patients required implant removal with drainage. Implants were not replaced until 6 months later.
Conclusions. Risk factors for formation of late seromas include capsular contracture, rupture of implants. Anti-inflammatory therapy or capsulectomy with the replacement of breast implants is effective in cases of small seromas. Implant removal, complete capsulectomy and drainage are required for cases of large seromas or signs of mastitis and/or infected fluid.
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614990, The Russian Federation,
Perm, Petropavlovskaya Str., 26,
Perm State Medical University
Named after Academician E.A. Wagner,
Surgery Department of the Faculty of
Advanced ProfessionalEducation.
Tel. +7 342 239-29-72,
e-mail: splaksin@mail.ru,
Sergei A. Plaksin
Plaksin Sergei A., MD, Professor of the Surgery Department of the Faculty of Advanced Professional Education, Perm State Medical University named after Academician E.A. Wagner, Perm, Russian Federation.
http://orcid.org/0000-0001-8108-1655
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