Seroma After Breast Reconstruction With Tissue Expanders: Outcomes and Management.

Area of Science:

• Plastic Surgery
• Reconstructive Surgery
• Oncology

Background:

• Seroma is a frequent complication following breast reconstruction using tissue expanders.
• The primary risk associated with seroma is the development of periprosthetic infection, potentially leading to implant loss.

Purpose of the Study:

• To identify risk factors associated with seroma formation after tissue expander breast reconstruction.
• To outline a protocol for managing fluid accumulation in these patients.

Main Methods:

• A retrospective review of a breast reconstruction database was conducted.
• Patient characteristics, surgical details, outcomes, and treatments for 219 tissue expander reconstructions in 138 patients were analyzed.

Main Results:

• Seroma occurred in 12.8% of reconstructions; prolonged drains were noted in 34.2%.
• Risk factors for seroma included lymph node surgery, delayed reconstruction, prepectoral placement, higher BMI, and larger breast size.
• While seroma alone did not increase infection/explantation rates, any fluid concern (seroma and/or prolonged drains) was linked to higher infection and explantation rates.

Conclusions:

• Prolonged drain placement beyond three weeks should be avoided.
• Post-drain removal screening for fluid accumulation is recommended.
• Serial aspiration through the expander port, combined with continued expansion, offers a safe and effective strategy for managing seromas, mitigating infection risk and preventing expander loss.