Late Shape Distortion after SPAIR Mammaplasty Secondary to Seroma Induced Scar Contracture
Mitchell G. Eichhorn, MD1, Gerogeanna Huang, MD2, Matthew Fahrenkopf, MD1, Yu Kit Li, MD2, Dennis Hammond, MD1.
1Grand Rapids Medical Education Partners, Grand Rapids, MI, USA, 2Partners in Plastic Surgery, Grand Rapids, MI, USA.
PURPOSE: Previous reports have documented the safety and efficacy of the short scar periareolar inferior pedicle reduction (SPAIR) mammaplasty. This technique utilizes an inferior pedicle, circumvertical skin resection pattern, and purse-string peri-areolar closure to achieve a stable and aesthetic breast shape. Late breast distortion from seroma formation is rare complication than may occur after an initially satisfactory result. Contraction of the seroma cavity may cause the surrounding breast tissues to deform. The purpose of this case series is to describe the treatment of this unique complication after SPAIR mammaplasty.
METHODS: The senior author’s database was retrospectively reviewed to identify all cases with late breast shape distortion after SPAIR mammoplasty. Patients treated operatively and non-operatively were statistically compared. Furthermore, a literature search was conducted to identify any further studies reporting this similar complication.
Over an 18 year period, 747 SPAIR mammaplasty procedures were performed. Late breast distortion from seroma contracture was identified in 16 patients (2.1%). In seven of these patients (12 breasts), the distortion resolved with non-operative management. In nine patients (17 breasts), persistent shape distortion prompted operative exploration and excision of the seroma cavity. In the operative group, eight patients experienced complete resolution of symptoms, while one patient experienced a mild recurrence and declined further treatment.
CONCLUSION: Late breast distortion due to a contracted seroma cavity after SPAIR mammoplasty is a previously unrecognized complication. Persistent shape alterations may require excision of the seroma cavity. Proper management of this complication allows restoration of an aesthetic breast shape.
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