Late Seroma in Breast Implants: A Coronavirus Disease 2019 Phenomenon?

Abstract

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.

A Rare Case of BIA-ALCL Mass Associated with Mastectomy Skin Flap Erythema After Immunization with COVID-19

“…Núñez et al reported two cases of breast implant late seromas that occurred during SARS-CoV-2 symptomatic disease [ 6 ] and Chan et al presented a case of late seroma and surrounding skin erythema over a tissue expander in a mastectomy reconstruction undergoing adjuvant chemotherapy during an asymptomatic COVID-19 infection [ 9 ]. SARS-CoV-2 infection might, in those cases, be responsible for the seromas, since late seromas that are not BIA-ALCL related nor mechanical friction related are thought to be generated by some immune-mediated reaction (i.e., allergic, subclinical infection, etc.…”

“…SARS-CoV-2 infection might, in those cases, be responsible for the seromas, since late seromas that are not BIA-ALCL related nor mechanical friction related are thought to be generated by some immune-mediated reaction (i.e., allergic, subclinical infection, etc. ), involving cytokines, histamine, serotonin, and prostaglandins modifying with inflammatory cells the interstitial fluid and the osmotic gradient in the pocket, eventually ending in major serum production [ 6 , 9 ].…”