title: Unraveling Factors Influencing Early Seroma Formation in Breast Augmentation Surgery.
abstract: 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.
  
  
  
  The aim of this study was to isolate and identify risk factors that may be associated with early seroma formation.
  
  
  
  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.
  
  
  
  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.
  
  
  
  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.
  
  
  
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authors.affiliation: Prof. Sforza is responsible for the Elective Internship in Plastic Surgery, Dolan Park Hospital, Bromsgrove, UK; and is an Examiner of the Royal College of Surgeons of Edinburgh.
authors.forename: Marcos
authors.initials: M
authors.lastname: Sforza
authors.affiliation: Mr. Husein is a Senior House Officer, Royal Salford Hospital, Manchester, UK.
authors.forename: Rodwan
authors.initials: R
authors.lastname: Husein
authors.affiliation: Mr. Atkinson is a medical student, Leeds Medical School, Leeds, UK.
authors.forename: Connor
authors.initials: C
authors.lastname: Atkinson
authors.affiliation: Dr Zaccheddu is a Plastic Surgeon, Dolan Park Hospital, Bromsgrove, UK.
authors.forename: Renato
authors.initials: R
authors.lastname: Zaccheddu
mesh_terms: D000293:Adolescent; D000328:Adult; D015992:Body Mass Index; D019928:Breast Implantation / Q000009:adverse effects* / Q000295:instrumentation*; D018427:Breast Implants; D005260:Female; D006801:Humans; D016015:Logistic Models; D008875:Middle Aged; D016017:Odds Ratio; D011474:Prosthesis Design; D012189:Retrospective Studies; D012307:Risk Factors; D049291:Seroma / Q000175:diagnosis / Q000209:etiology*; D020034:Silicone Gels; D012907:Smoking / Q000009:adverse effects*; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D020034:Silicone Gels