title: Is late seroma a phenomenon related to textured implants? A report of rare complications and a literature review.
abstract: BACKGROUND
  Late seroma is an infrequent complication that manifests as fluid collection in the periprosthetic space at least 1 year after breast enlargement surgery. Interest in late seroma has grown with the potential connection between breast implants and anaplastic large cell lymphoma (ALCL), which presents with clinical symptoms similar to those of late seroma. This report presents a case of late seroma experienced by a patient with a history of multiple implant ruptures and a review of the relevant literature.
  
  
  METHODS
  Details are reported for a patient who presented with sudden swelling of an augmented breast that was initially suspected to be symptomatic of ALCL. A literature search of PubMed regarding this phenomenon also was conducted.
  
  
  RESULTS
  The literature review identified 14 articles on late seroma involving 60 patients, including the reported case. Analyses included epidemiology, etiology, and management strategy. Although a detailed statistical analysis was not performed, 55 cases (92 %) of late seroma occurred that involved patients with textured implants. No evidence-based guideline for the management of late seroma has been established, although the patients were managed successfully in all cases using various strategies.
  
  
  CONCLUSIONS
  The reported case and data from the literature provide evidence of a relationship between textured implant use and late seroma. Based on their review, the authors offer "sequential treatment steps," from conservative treatment to surgical management, which will be helpful for successful management of future late seroma cases. However, further study is needed to clarify the relationship, if any, between a particular type of textured implant and the development of late seroma.
  
  
  METHODS
  This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
authors.affiliation: Department of Plastic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Irwon-dong 50, Gangnam-gu, Seoul, Korea.
authors.forename: Bo Young
authors.initials: BY
authors.lastname: Park
authors.affiliation: Department of Plastic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Irwon-dong 50, Gangnam-gu, Seoul, Korea.
authors.forename: Dong-Han
authors.initials: DH
authors.lastname: Lee
authors.affiliation: Department of Plastic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Irwon-dong 50, Gangnam-gu, Seoul, Korea.
authors.forename: So Young
authors.initials: SY
authors.lastname: Lim
authors.affiliation: Department of Plastic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Irwon-dong 50, Gangnam-gu, Seoul, Korea.
authors.forename: Jai-Kyong
authors.initials: JK
authors.lastname: Pyon
authors.affiliation: Department of Plastic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Irwon-dong 50, Gangnam-gu, Seoul, Korea.
authors.forename: Goo-Hyun
authors.initials: GH
authors.lastname: Mun
authors.affiliation: Department of Plastic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Irwon-dong 50, Gangnam-gu, Seoul, Korea.
authors.forename: Kap-Sung
authors.initials: KS
authors.lastname: Oh
authors.affiliation: Department of Plastic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Irwon-dong 50, Gangnam-gu, Seoul, Korea. si55.bang@samsung.com.
authors.forename: Sa-Ik
authors.initials: SI
authors.lastname: Bang
mesh_terms: D018427:Breast Implants / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008875:Middle Aged; D011474:Prosthesis Design; D049291:Seroma / Q000209:etiology*; D013997:Time Factors