Late seroma formation after breast surgery with textured silicone implants: a problem worth bearing in mind.

The use of mammary implants may lead to a variety of complications. The most common early complications are seroma and haematoma formation and acute infection. The most common delayed complication is capsular contracture and implant failure (e.g. leaking, rupture). Late haematoma and seroma accumulation within the capsule have seldom been reported in the literature; indeed, no data on the incidence of these complications are available, nor are there any theories on their etiology or on how to avoid them. Cases of late haematoma and seroma unrelated to trauma have been strictly associated with textured or polyurethane implants. We present a series of eight late seromas in patients who underwent breast augmentation or breast reconstruction using textured implants. All the patients presented a painless, progressive enlargement of one breast. Four patients referred a history of trauma some days before the appearance of the symptoms. We performed an ultrasound-guided percutaneous needle aspiration of the fluid in all eight patients. Symptoms recurred in all the patients within days of seroma evacuation, following which a decision was taken to reoperate to drain the serous fluid and change the prosthesis. During the 1-year follow-up, no recurrence of the seroma occurred in any of the patients, nor were any local or general complications observed. If patients complain of unexpected breast enlargement following mammary implantation surgery, the physician should first rule out infection, then investigate the possibility of friction irritation from either a fold in the device or rubbing of a textured implant.