Internal fluid build up after arm lift, is that normal?

Thank you for reaching out with concerns about fluid accumulation post-brachioplasty. Following an arm lift, it's not uncommon to experience some fluid build-up. There are primarily three types of fluid accumulations:
Edema: This is general swelling and is expected after surgery. Unlike the other two types, you cannot aspirate edema with a needle.
Seroma: This is a build-up of the clear serous fluid that our body naturally produces after surgery. Sometimes, the body can produce an excess of this fluid leading to a seroma. These can be aspirated with a needle, and sometimes might require repeated aspirations.
Hematoma: This is a collection of blood, which can be in a liquid state initially but can then solidify. Over time, the body will break this down and revert it back to a liquid state.
Given that you've mentioned needing office visits to have the fluid removed, it sounds more likely to be either a seroma or hematoma rather than edema. Seromas are typically treated with needle aspirations, which can occur multiple times a week. In persistent cases, a surgical drain might be placed or surgical intervention might be considered. Hematomas may also need similar interventions.
Maintaining close communication with your plastic surgeon is crucial to ensure the best course of action and optimal healing. Wishing you a speedy recovery.
Sincerely,
Dr. Katzen

Fluid collections can occasionally happen after this operation. Your surgeon may need to drain them a few times. Typically, they will go away with time and treatment. Be patient, continue to use your compressor dressing and be in close contact with your doctor. It is imperative
that you seek the advice of a plastic surgeon who is certified by the American
Board of Plastic Surgery and has extensive experience in brachioplasty / arm
lift.

I wish you the best.

Dr. Gabbay.

Thank you for your question. Given that you have had fluid removed twice now in the post-operative period, you likely have a little bit of a seroma or fluid collection that is contributing to your swelling. This may have been avoided initially if a drain was placed; or, it may have happened anyway. Regardless, some Plastic Surgeons continue to serially drain the fluid, and keep the arms in a compressive dressing. This should all eventually get better over the next couple of weeks. In some cases, it can last a couple of months. Sometimes something can be injected into the tissue to help the tissue stick down and close off the seroma capsule. Or, in worst case scenarios, you may need a slight revision surgery to fully remove the seroma. During this time it's important to ensure you are in constant communication with your plastic surgeon, and to report any changes in your condition - things like fever, chills, etc. Internal bumps are normal and should get better over the next 3-6 months. Best of luck! 

Seromas which is actually a build up of tissue fluid can happen after any soft tissue dissection even if a drain is used.  Normally it will require 3 or more aspirations before it disappears.  The bumps along the suture line are likely suture reactions to the deep sutures.  They will probably disappear in 2-3 months as healing progresses and the deep sutures dissolve.  Good Luck.