Late Massive Breast Implant Seroma in Postpartum

Late seroma is a rare complication that may occur after a prosthetic breast augmentation. "Seroma" is a generic term used to indicate a serous clear fluid collection, which can develop in surgically dissected areas. A seroma can be defined as "late" if this complication occurs at least 4 months after surgery. Several possible etiologies have been proposed. A 39-year-old old woman with breast implants presented with a huge enlargement of her right breast. Clinical and instrumental evaluation ruled out infection. The swelling was attributed to the presence of fluid adjacent to her implant and aspirated. Nonremission of the fluid collection after aspiration led the authors to surgical removal of the prosthesis, fluid drainage, and capsulectomy. The serous fluid and a portion of the removed capsule was subjected to chemical, cytologic, microbiologic, and anatomopathologic analysis. At the chemical evaluation, the sample of the seroma appeared to be an exudate. Cytologic examination of the fluid showed a large number of neutrophil cells but no malignant cells. Microbiologic evaluation and pathologic findings of the serum sample showed neither the presence of infection nor that of neoplastic infiltration. The postoperative period was uneventful, and the woman experienced no recurrence within 21 months after surgery. This report describes a case of late-onset implant seroma associated with a postpartum breast pump. The authors believe this case could be useful in diagnosing this rare complication and understanding its management. It also may serve to make physicians and nurse practitioners aware of the need for prompt evaluation and treatment.