Swelling After Breast Implants Abroad: What It Could Mean

In the first few weeks of establishing my practice back home in Singapore, after years of training and work abroad, I have already met several patients returning from overseas cosmetic surgery. Many of them are unsure of how to manage their recovery.

One patient had undergone breast augmentation abroad. Unfortunately, she developed a haematoma (postoperative bleeding) after her surgery and required further surgery before she could return home.

After returning to Singapore, she contacted her overseas clinic about one month post-op. She wanted to check on her scars and was concerned about a possible seroma. The clinic advised her to see a local plastic surgeon to ensure everything was healing properly. This was the right course of action, and that’s when she reached out to me.

I asked her to obtain a copy of her operation report, but the clinic declined her request. Without that information, it wasn’t immediately clear what had been done or what materials were used. Only later did she mention that fat grafting had also been performed alongside the implants. This tiny but important detail changes how we interpret the swelling.

This case highlighted how postoperative bleeding can increase the risk of capsular contracture. It also underscores the importance of clear preoperative counselling about such risks for patients undergoing breast augmentation, regardless of where it is performed.

Understanding Postoperative Complications

After breast surgery, fluid can accumulate under the skin, resulting in a seroma. This can occur due to several reasons:

• Leftover blood from earlier bleeding

• Inflammation from fat grafting (e.g., fat necrosis, oil cysts)

• Normal healing fluid around the implant

  
  

Most of the time, this fluid settles on its own. However, if swelling persists, it is worth checking early. Occasionally, imaging, usually a bedside ultrasound scan, is needed to confirm that it’s simple healing fluid. In rare cases, aspiration may be necessary to rule out other causes, such as infection or breast implant-associated anaplastic large cell lymphoma (BIA-ALCL), a lymphoma linked to certain implants, especially textured ones.

The Importance of Aftercare

Operative notes are crucial. They belong to the patient and are part of their medical record. These notes provide essential information about what was done, what materials were used, and guide safe follow-up care, regardless of where that care takes place.

Without these notes, even seemingly straightforward recovery can become uncertain, especially when complications arise.

The Role of Communication in Recovery

Effective communication is vital in the recovery process. Patients should feel empowered to ask questions and seek clarification about their procedures. This includes understanding the potential risks and complications associated with their surgeries.

When patients are well-informed, they can participate actively in their recovery. This not only helps in managing expectations but also fosters a sense of trust between the patient and the surgeon.

Takeaway

If you have had breast augmentation or fat grafting and notice new swelling a few weeks later, don’t panic, but don’t ignore it either. A careful review by a qualified plastic surgeon can help clarify what’s happening and ensure your recovery stays on track.

Good cosmetic surgery doesn’t end when you leave the operating room. It continues with communication, aftercare, and follow-up.

Conclusion

In conclusion, the journey of recovery from cosmetic surgery is multifaceted. It requires attention to detail, effective communication, and a thorough understanding of postoperative care. By prioritising these elements, we can enhance patient outcomes and ensure a smoother recovery process.

Written by **Dr Ng Zhi Yang**, Singapore Plastic Surgeon, and Founder & Medical Director of **Doctor Stitch, a specialist-led cosmetic surgery aftercare service.