Unraveling factors influencing early seroma formation in breast augmentation surgery

Abstract

Background: It is often assumed that seroma formation trails closely behind with incidence rates reported at 1 to 2%. Seroma is highly problematic for both the surgeon and patient and results in both patient anxiety and discomfort, succeeded by frequent outpatient visits, follow-up treatment, increased costs, and potentially hampered aesthetic outcomes. Consequently, it is now more important than ever to study seroma and to assess its pathophysiology and mechanisms of prevention. Objectives: The aim of this study was to isolate and identify risk factors that may be associated with early seroma formation. Methods: The authors reviewed 539 female patients who had undergone bilateral breast augmentation with silicone cohesive gel implants in a period of 12 months. Five possible risk factors were isolated for analysis: patient's age, body mass index (BMI), smoking habit, implant pocket position, and implant size. A total of 15 patients developed early seromas within the one-year postoperative period. Results: Using exact logistic regression with the independent variables treated as binary variables, we found that smoking, BMI, and pocket are associated with increased risk of seroma while we cannot reject the hypothesis that pocket size and age do not affect the development of seroma at 5% significance level. Conclusions: A high BMI, large implant size, submammary pocket, and smoking are factors significantly associated with seroma development whilst age is not. Smoking however was found to be the most detrimental factor as it significantly amplified the effects of other variables.