Lipo after breast cancer/axillary node clearance surgery?

Hello savs_ldn,

First and foremost, congratulations on your successful battle against breast cancer. Addressing your question about tumescent liposuction post axillary node clearance: The primary concern with lymph node removal is always the risk of lymphedema. While you're contemplating liposuction in areas distant from your affected arm, caution remains paramount.

Now, about undergoing tumescent liposuction while awake, especially for extensive areas like the upper/lower abdomen, back, and flanks: I must emphasize that I generally advise against this approach. The reason is twofold. First, for comfort and safety during the procedure, especially on large areas, general anesthesia is typically preferred. Second, there's a limit to how much local anesthetic, particularly lidocaine, can be used safely. When this limit is exceeded, there's a risk of toxicity. Given the extensive areas you're looking to address, it's highly likely that this procedure would have to be segmented into multiple sessions if local anesthesia were to be used, to ensure patient safety.

Moreover, even if liposuction is performed away from your arm, the body's intricate fluid dynamics means that any significant surgical intervention might have unforeseen consequences on the arm at risk of lymphedema.

Your intention to lose weight before surgery is commendable and can certainly reduce risks associated with the procedure. But it's absolutely vital to consult closely with a board-certified plastic surgeon, especially one versed in post-cancer surgical scenarios, to make well-informed decisions.

Thank you for trusting us with your concerns. Wishing you all the best as you navigate this next chapter of your health journey.

Sincerely,
Dr. Katzen

Having had axillary lymph node clearance for breast cancer does put you at a higher risk for developing lymphedema. Lymphedema can occur due to impaired lymphatic drainage resulting from the removal of lymph nodes.

When considering tumescent liposuction, it's crucial to discuss your medical history and the potential risks with your plastic surgeon. They will be able to evaluate your lymphedema risk and determine if the procedure is appropriate for you. They may also recommend specific precautions to minimize the risk of lymphedema exacerbation, such as avoiding liposuction in the at-risk area or using gentle techniques that minimize trauma to the lymphatic system.

It's important to note that weight loss achieved through liposuction is generally not significant and the primary goal of the procedure is body contouring rather than major weight reduction. Therefore, it's advisable to focus on achieving your weight loss goals through healthy lifestyle changes before considering liposuction.

I hope this helps,
best of luck !

You should be fine if no liposuction or done on your involved arm and axillary area. Liposuction elsewhere does not involve the lymphatics of your breast and arm.

Having Liposuction of your torso by itself, should not be an issue for somebody who has had a history of breast cancer, including those who have had axillary no dissections.
You may or may not be a good candidate for Liposuction. You did not include any pictures, so we can’t make any type of assessment. You also did not include what type of breast cancer surgery you had, including if you’ve had reconstruction or not. One thing to consider before having any abdominal cosmetic surgical procedure is to make sure there are no reconstructive options that may be desirable or needed in the future in regards to breast cancer treatments.
Women who’ve had mastectomies sometimes need autologous, tissue reconstruction, and the lower abdomen is often the best tissue for breast reconstructive purposes.
You should make absolutely certain that it is unlikely you’ll need the tissue for breast reconstructive purposes in the future.
For example, a woman who’s had implant reconstruction, may develop capsular contractions in the future, making implant reconstruction a long-term failure. When this happens, converting the Rc Construction to autologous tissue reconstruction is sometimes necessary in order to have a good outcome.
Liposuction skills very substantially among different plastic surgeons. Do not assume that because somebody is board-certified, has years of experience or an overall good reputation that they have mastered Liposuction. Doing the procedure well on a consistent basis is more difficult than most people realize.
Likewise, a significant number of people seeking Liposuction are in fact, not particularly good candidates for the procedure and this needs to be made clear so you can have realistic expectations. In the end, patient’s candidacy and provider selection of the two most important variables. To begin the process, I recommend patients have multiple in person, consultations with local, board-certified plastic surgeons, who seem to have a good reputation for Liposuction.
During each consultation, ask each provider to open up their portfolio and show you their entire collection of before, and after pictures of previous patients, who had similar body characteristics to your own. An experienced provider should have no difficulty showing you with the before and after pictures of at least 50 previous patients. Poorly done Liposuction can leave disfigurement that is difficult or impossible to improve upon. I cannot emphasize enough the importance of provider selection when it comes to Liposuction or any other permanent body contouring procedure.
Being board-certified, and plastic surgery does not mean that somebody has mastered any one single procedure.
Best,
Mats Hagstrom, MD