The coronavirus disease 2019 (COVID-19) pandemic has been challenging in all aspects of the medical field with new clinical presentations constantly arising. Plastic surgeons are not immune to this and need to be aware of their implications. There has been a recent report of late periprosthetic seroma (breast implant) as a clinical manifestation of COVID-19 infection. To our knowledge, this phenomenon has not been further reported. We present a 53-year-old immunocompromised lady who developed late seroma after COVID-19 infection. She eventually required explantation of the implant and is awaiting autologous reconstruction. It is likely that we will increasingly continue to see this phenomenon of implant complications as a result of COVID-19 infection and should be watchful, especially regarding potential immunocompromised patients.
We present a patient whom we believe developed a late abdominal mesh collection in response to COVID-19 mRNA vaccination booster and COVID-19 infection. A polypropylene mesh was placed during her right breast reconstruction operation 2 years ago where she underwent a right transverse abdominis rectus muscle (TRAM) free flap. She recovered uneventfully from this operation. This lady, though vaccinated, developed respiratory symptoms and tested positive for COVID-19 infection 3 days after her booster injection. She then noticed right-sided abdominal swelling 3 days after the onset of respiratory symptoms. She only presented 1 month later due to a 7-day history of pain at the site of abdominal swelling. A computed tomography scan confirmed the presence of a seroma, and she underwent ultrasound-guided percutaneous drainage. A COVID Antigen Rapid Test of the fluid returned positive, though the PCR swab returned negative. There have been no published reports of periprosthetic mesh seroma after COVID-19 vaccination or infection to date. We wanted to share our experience so that other surgeons may be aware of this potential presentation given the current ongoing pandemic. Level of evidence: Level V, risk/prognostic.
Background Autologous fat transplantation is a promising technique for soft tissue augmentation. However, the longterm maintenance of fat grafts remains unpredictable. Based on Peer's cell theory, techniques that cause less cellular damage will optimize graft integration. Water jet-assisted liposuction (WAL) was introduced as a gentle and efficient technique for harvesting a large volume of fat in a short period of time. In this study, we evaluated the viability and function of adipocytes and preadipocytes harvested using WAL and compared this with the Coleman technique. Methods Eleven patients were enrolled in this study. Fat grafts were harvested using WAL from one limb and the Coleman technique from the other limb. The lipoaspirates were compared based on the following analyses: trypan blue vital staining for viable adipocyte and preadipocyte counts, glycerol-3-phophatase dehydrogenase assay for adipocyte function, histological examination, and speed of fat harvest.
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