Seroma after arm liposuction with multiple needle aspiration. What do you think about the sclerosing injection to solve seroma?

Question

I hadarm tumescent liposuction 3 weeks ago,was diagnosed with seroma post op. Underwent needle aspiration until fluid decreases. I had total of 6 needle aspiration since my lipo.PS said nothing to worry as he will drain the fluid until he notice a decrease in volume.started 10 cc on R arm and 8 cc on L arm. Today 6 on R arm and 6 on L arm. PS might inject a Sclerosing agent for spider veins to adhere skin to the underlying tissue. What do you think about the sclerosing injection to solve seroma?

Gary Lawton, MD, FACS · Answer

I have never used sclerosing agents for this application.  You are too early after this surgery to be worried about sclerosing the area.  These volumes you had aspirated are super small.  Serums can be hundreds to thousands of cc.  This should resolve without sclerosis.

Christopher J. Davidson, MD, FACS · Answer

Having a seroma after lipo is relatively unusual.  It is much more common after an arm lift where lymphatics are cut.  I generally would recommend aspirating the seroma multiple times prior to sclerosis.  That being said, if you have had a bunch of aspirations the choices would include excision of the capsule versus injecting a sclerosant.  Best of luck.

Jeffrey M. Darrow, MD · Answer

Seromas can happen and nearly always respond to time and simple aspiration.  Your drainage amount is decreasing so stick with that and don't complicate things by adding the sclerosing agent.   Simple is best.

Francisco Canales, MD · Answer

The amounts you mention are small and getting smaller. If you are getting better then why add a sclerosing agent?If the seromas clear without additional treatment ( other than aspiration) then that is the simpler option.

Mats Hagstrom, MD (license on probation) · Answer

From what you describe, it seems like your seroma is almost gone.In my experience, we continue draining until no fluid comes back.I have not sclerosed a cavity for a seroma.Make sure your surgeon has done a few of these before.It seems like you're almost done as it is.Best of luck,Mats Hagstrom, M.D.

Thomas M. DeWire Sr., MD (retired) · Answer

Lyzzamae,As long as the seroma seems to be decreasing, I would not recommend sclerosing agents in a situation like this. Seroma in upper extremity liposuction is usually due to lymphatic duct disruption, but it may not be leaking exactly where the fluid is building up, and thus it may be hard to actually target the source.  The natural course for lymphatic drainage that is accumulating as a seroma is for it to subside unless there is an underlying lymphatic system disease process, and that is not the case here. The situation is different in a chronic seroma after a procedure like tummy tuck, where the space can be very large, and may actually form an internal scar that prevents resolution.  Sclerosis is used in that situation sometimes, but there are also no large nerves or nearby vessels that can be subjected to the sclerosing agent.  If you move forward with it, ask precise questions about how often your surgeon has done that, and how often it worked.  I hope that this helps.     Best wishes,      Tom DeWire, MD, FACSRichmond, VA

George Commons, MD (retired) · Answer

Your seromas will subside and disappear without the sclerosing agent.  I would not use a sclerosing agent.    You will respond to simple drainage in my opinion.   Why add a sclerosing chemical.   My Best,  Dr C

Seroma after arm liposuction with multiple needle aspiration. What do you think about the sclerosing injection to solve seroma?

Answers (7)

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