Seroma is the accumulation of fluid or lymph after plastic surgery to correct the breast. The accumulation of fluid is mainly formed after breast augmentation and when using large implants. Such an accumulation of substance entails stretching of the skin and leads to sagging. The accumulation of serous matter after mammoplasty has a straw yellow color. Depending on the composition of the cluster, it can change its color and go from yellow to red.
The causes of this complication may be:
- The reaction of the body to the endoprosthesis. A prosthesis for a woman’s body is a foreign body that can be rejected. Implants are made of biological material, so the probability of rejection is very small and passes quickly. But there is always a percentage of women who show sensitivity to biological material, which may increase the risk of fluid accumulation after surgery. But modern surgery still cannot figure out the reaction of the body to the implant before surgery;
- Damage to the lymphatic vessels. Such a cause is the accumulation of fluid in the chest when the blood vessels are damaged during the operation. The vessels are restored within the first days after the operation, but sometimes this process slows down, which leads to the allocation of lymph;
- Bleeding tissue. Small capillaries during surgical intervention tend to seep into the soft tissues of the chest and form a serous substance at the site of implant placement;
- The presence of a hematoma. When resorption of the hematoma begins, clusters of blood substances and the formation of seroma are formed. Therefore, it is necessary to observe the patient for several days after the operation;
- Lack of proper drainage. Any operation, like mammoplasty, is accompanied by the release of lymph and if it is not removed on time, this provokes the appearance of complications;
- The reaction of the body to suture material. In modern surgery, there are many high-quality surgical materials, but not one of them is not ideal. Also, with large use of absorbable threads, they lead to the accumulation of matter.
The accumulation of serous material after mammoplasty appears within 5-7 days after surgery.
One of the significant signs that affect the accumulation of fluid in the chest is a mastectomy (removal of the mammary gland), which increases the appearance of lymph nodes.
Another factor contributing to the appearance of serum may be inflammatory processes in places of skin injury.
There may also be factors such as:
- excess weight. Large thickness of subcutaneous fat, increases the risk of fluid;
- high blood pressure;
Symptoms of seroma after mammoplasty
Do not forget that seroma appears in many women after breast correction, so you should consult a specialist and monitor the healing process and, of course, pay attention to the symptoms of the manifestation of fluid for its timely prevention and treatment.
The main symptoms of fluid accumulation may be:
- breast shape change. The breast increases in volume, a lump may appear in the place where the fluid is collected, the contour changes and the nipple shifts.
- soft tissue swelling. Since the liquid does not remain outside the borders of the capsule, it has the ability to penetrate the soft tissues and, when palpated, some skin elasticity and tension can be felt;
- pain in the area of fluid accumulation. Usually the pain is normal and moderate, but when pressed, the pain intensifies. Pain can also be felt during physical exertion and walking;
- redness of the skin in the seroma. This symptom is explained by the fact that the liquid exerts pressure and destroys small vessels, and therefore the color in the accumulation area can change;
- the release of serous matter through the edges of the wound. Such a symptom happens extremely rarely, but if such a complication exists for a long time, then an outlet may form – a “fistula” through which the substance wakes up. Such a complication is characteristic of patients with thin skin.
The patient, after breast enlargement, notices that the breast is enlarged, swelling appears, which increases every day, redness appears in the area of accumulation of the substance, pain increases.
Methods of diagnosis
Diagnosis methods for complications include:
- X-ray mammography
- Magnetic resonance imaging.
Using ultrasound, you can determine the internal changes occurring in the chest area after mammoplasty, determine the degree of development of seroma and diagnose it in the early stages of education.
X-ray mammography is shown to all women who have ever undergone surgery for breast plastic surgery, as well as women after 40 years.
This method of research helps to assess the nature of the state of the mammary glands and helps to determine the nature of the formation of nodes, seals and the formation of fluids in the chest area.
Unlike x-ray radiation, magnetic resonance imaging implies the absence of radiation exposure and diagnosis is carried out separately for each case.
Magnetic resonance imaging can control the condition of implants after mammoplasty, and also helps prevent the development of complications such as seroma and contracture.
Methods of treatment
You can treat such a formation in the chest as gray with two methods, such as surgical and medical. With large formations, you can treat simultaneously in two ways.
The surgical method is accompanied by the presence of adequate drainage.
Drainage is established to remove serous fluid and can be from two to three days. The specialist can judge by the amount of the separated volume of the substance whether it is worth removing the drainage or not.
Drainage is a fairly popular treatment method, in which the process of removing the separated substance from the accumulation sites occurs.
Special devices can be removed from the wound, but in general, specialists remove fluid through special punctures located around the wounds.
The skin that is next to the installation site of the drainage system must be wiped with a solution of brilliant green.
Before starting the drainage procedure, all devices must be sterile and treated with sodium chloride in a proportion of 0,9%.
The medical worker must monitor the operation of the drainage system, if the tube falls out, it must be replaced with a new one. Only a professional can remove the drainage system.
Another method for treating seroma is vacuum aspiration. When carrying out this method, the serous substance is aspirated from the place of accumulation of the serous substance or postoperative wounds.
This method of treatment is most often used in the early postoperative period and provides fast healing of postoperative wounds.
A medication method of treatment involves taking anti-inflammatory drugs and broad-spectrum antibiotics.
If the formation of fluid is small, then it is worth doing only taking medications.
A very big mistake is the statement that the seroma itself will resolve without additional treatment and prevention.
In most cases, this may be true, but there is always a risk of an increase in the volume of fluid, which alone cannot disappear and cannot resolve.
This leads to subsequent complications such as:
- The formation of serous fistula. In this case, the serous substance independently seeps through the soft tissues. Most often these are the edges of the wound. This expiration can last up to several weeks, which contributes to the infection of the endoprosthesis, which entails a second operation;
- The development of capsular contracture. The accumulation of fluid accompanies inflamed processes, which ultimately leads to an increase in excess tissue. In turn, such tissue promotes the development and formation of capsules;
- Suppuration of the place where the implant is located. Serous matter is an ideal place for the accumulation and development of bacteria, which can lead to suppuration of the implantation pocket.
The best solution to the problem of fluid accumulation is a timely visit to a doctor and prevention.
Conventionally, prevention of fluid prevention can be divided into at a level of:
Preoperative prophylaxis is:
- passing tests;
- consultation and selection of a plastic surgeon;
- Ultrasound of the mammary glands;
- gynecologist consultation.
Interoperative prevention is directly related to the actions of a plastic surgeon and methods of plastic surgery, which include:
- the correct choice of area for the location of the implant;
- adequate notching;
- timely drainage of the wound;
- high-quality stitching.
Postoperative prevention is directly related to the patient’s behavior during the rehabilitation period.
In the postoperative period, the patient must comply with the following rules:
- wearing compression underwear;
- attending all consultations and following all recommendations of the attending physician;
- restriction of physical activity and movement.
Compliance with all preventive measures and respect for your health will give you a good aesthetic result after surgery and reduce the risk of complications after mammoplasty.
The following actions also apply to the prevention of the appearance of serous matter:
- suturing the wound without leaving pockets;
- a pressure dressing on the wound area for several hours;
- continuous use of antiseptics and antibiotics at all stages of treatment.
Experts advise taking complications such as lymphorrhea very seriously and approaching the choice of a plastic surgeon with all responsibility.
Large fluid accumulations require vacuum suction, and in complicated cases, the installation of a drainage system.
Infections can get into the gray, and therefore you need to take anti-inflammatory drugs and in some cases surgery is required. Therefore, it is better to prevent the formation of liquid matter at an early stage of its development.
- antibacterial agents;
- laser therapy;
- the wound after surgery must be carefully treated and prevent infection;
- during treatment, ointments such as Veshnevsky ointment or Levomikol can be used. You can use such ointments up to three times a day, gently pressing on the inflamed areas of the skin.
Only on the recommendation of a specialist can you use the thermal treatment technique in places where serous matter accumulates.
You can do this with a bag in which you need to place heated salt or sand, but do not heat the mixture strongly, since you can burn the skin.
If the above methods do not help, doctors perform an operative measure. The seam is slightly dissolved and a liquid substance is removed with a metal probe.
After that, the wound is washed, a drainage is installed in it for a short time and after a few days the wound heals.