AboutAlan M. Engler, MD, FACS Expertise Dr. Engler has answered over 2700 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.
Question Dear Sir
I had breast implants placed above the muscle in february 2004 and had no problems whatsoever up until 5 weeks ago when my right breast swelled up dramatically overnight .
I was at first on penicillin antibiotics as the Dr initial diagnosis was infection . After a week i was referred to a breast consultant at my local hospital after the swelling did not reduce and had a mri scan to try to determine the cause . The results of the mri showed the breast was filled with fluid , the consultant drew a small amount of fluid for culture analysis and referred me to a NHS plastic surgeon as he felt he was more able to help me .
The result of the culture analysis were negative and there is no infection present .
The NHS plastic surgeon was quite abrupt with me and said all he was prepared to do was remove the implants and has put me on his waiting list and said it will be late July early august when he removes them , he has stated he will not consider replacing them on the NHS as they are cosmetic .
Since this i have been looking into my complaint on the internet and wonder if i could have a seroma . . . i have received no official diagnosis .
My questions that i hope you can answer are if i do have a seroma would it be possible to try to drain it ?
I do understand that if it is drained and doesn't respond my only option is implant removal but feel i should at least be given the chance to try to keep the implant if at all possible .
Also if it turns out i do have to have the implants removed will i be able to have replacements and how long after ??
Thankyou for taking the time to read my problem
Frances
Answer from Dr. Alan Engler
www.bodysculpture.com
Hi Frances,
It sounds like you have something called a Late Hematoma or Seroma after Breast Implants. This has been described occurring anywhere from several months to many years after the surgery. The mechanism is unclear; sometimes there was known trauma, often there was not.
As long as the breast and breast implant in questions do not become infected, it is possible to undergo and exploration, irrigation of the pocket and, if everything else looks okay, the implant can be reinserted. Many implants have been saved in this manner although there is, of course, no guarantee. But from both medical and surgical standpoints, that would be my advice: undergo and exploration, remove this implant, irrigate the pocket with an antibiotic solution, address any active bleeding and, if appropriate, reinsert the implant (probably over a drain).
Getting someone to agree to do this, and with what financing, is a completely separate issue that I cannot, unfortunately, help with. I agree that it should be done as soon as possible as, at least in theory, the longer you wait the more you risk infection.
On the other hand, I believe there are also cases in which the fluid absorbs on its own, and the patient eventually did fine. Again, not every example of this has been reported in the literature.
If they have to be removed altogether, most people that I know of wait at least 3 months to reinsert them but I would try to get that done at one procedure.
