AboutAlan M. Engler, MD, FACS Expertise Dr. Engler has answered over 2800 plastic surgery questions for Allexperts. His expertise is in cosmetic plastic surgery including breast surgery (breast enlargement with implants, breast reduction, breast lifts), liposuction, eyelid surgery, tummy tucks, facelifts etc.
Dr. Engler has been listed as one New York`s Top Doctors, and as "One of the World's Most Famous Aesthetic Surgeons" (Aesthetic Surgery, TASCHEN Books, Angelika Taschen, Editor). He is the author of 4 books, including "BodySculpture" (a best-selling plastic surgery book on breast surgery, liposuction and tummy tucks), "EyeScapes" (Plastic Surgery of the Eyelids), "Restylane," and "The Slim Book of Liposuction."
Dr. Engler has two US Patents for surgical instruments that he's designed, and has appeared on numerous television shows, including The Tyra Banks Show, The Ricki Lake Show (four times), and the Dr. Keith Ablow Show. Videos of his appearances are available on YouTube (SEARCH FOR "DR. ENGLER"). His website is www.bodysculpture.com.
Experience Dr. Alan Engler is a board-certified plastic surgeon in New York and the author of BodySculpture - Plastic Surgery of the Body for Men and Women (ISBN 0966382749) one of the top-selling plastic surgery books on amazon.com, barnesandnoble.com, etc.
Education/Credentials Dr. Engler graduated from Yale University (undergraduate) and the College of Physicians and Surgeons of Columbia University (medical school). He did his residency training in General Surgery and, after that, Plastic Surgery, at the Montefiore Medical Center in New York. He is on the faculty of the Albert Einstein College of Medicine in New York.
I had old 280cc saline breast implants removed and 600cc saline implants replaced with a lift. After 8 weeks, I had returned to riding and caring for my horses. At that time, something happened and I went back into surgery from internal bleeding in the left breast. After surgery, the PS told me I had torn the area around my implant and had to have a drain put in to drain the hemotoma. After 6 weeks, the drain was still in and draining the same amount of blood daily-55CC. After a Dr. appt., I believe the nurse accidently pulled the drain out while priming the line. Once the drain was completely removed, my breast became very, very swollen and more painful. I was instructed to wrap it tightly and it eventually decreased in size, but it still was very hard, swollen and painful in the clevage area. Next, I had several openings in the surture area which drained a yellowish fluid off and on for several weeks. I was put on antibiotics and was started on 4 LED light treatments. It has been 11 weeks since the emergency surgery and I'm still swollen and hurting in that same area. Sometimes, I can actually feel that area filling up. My hemotoma and brusing was at the bottom of the boob, but the swollen area that hurts is at the top. Do you think this area will eventually heal and go down? The nurses say that the swollen area is trapping the implant from dropping and as soon as it goes down it will drop. It is oddly shaped and doesn't look anything like the right one.
Answer Hi Amy,
I'm sorry for the problems you've been having.
It's hard to know for sure what will happen but the persistent presence of fluid, including blood and serous fluid (the yellow fluid) is believed to increase the likelihood that a hard capsule will form around the implant.
The first thing, though, is to get through the acute and subacute phases; ie, where there isn't a fluid draining out or accumulating, there are no fevers, chills, sweats, the wounds are healing etc. It sounds like you might be there although I'm concerned about your feeling that the left breast is still swelling at times; it depends on whether you feel it is or it really is, and I can't tell that.
Once things have settled down, you'll have to see how the breast heals. That may take a few more months If, however, it heals with scar tissue, hardness, pain, distortion, etc., then you may have to consider a second procedure in which the implant is removed, the scar tissue is removed and the implant is then replaced. I would advise using a drain for that procedure.
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