Can someone have arm Lipo if they have had axillary lymph node dissection?

Question

I had a lumpectomy and axillary node dissection. Im scheduled for a abdomniplasty revision with bbl and arm lipo in july 2017. Are these procedures, especially the arm lipo ok to have done?

Donovan Rosas, MD · Answer

The lymph system is intimately involved in fluid clearance with the axilla being the major reservoir for drainage of the upper extremity. Patients who have had some degree of node sampling in this area are at higher risk of swelling or lymphedema. However, it is important to understand the specifics of the operations performed. Lymph node sampling usually involves less extensive dissection i.e. less damage to the lymphatic drainage (vs. axillary dissection). With this in mind, more dissection equals higher risk of post op swelling (which may or may not be persistent).This decision to operate is generally operator dependent. I would avoid liposuction in the setting of an axillary dissection. For patients who have undergone sentinel lymph node sampling, I would have to mask the decision on a case by case basis. These patients should be aware that their risk profile is higher.As always, discuss your concerns with a board certified plastic surgeon.

Jason Emer, MD · Answer

If you had lymph nodes removed it's likely that you have lymphedema and not true fat in the area, so the treatment is not liposuction.  If you have true fat, swelling post can be way worse with your history.  Please see a vascular physician for an evaluation.  Best, Dr. Emer.

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question.   First, speak with your surgeon and ask his/her opinion.  If you only had a sentinel node dissection, then I have safely performed liposuction of the arm in patients before.  In my practice, I do not perform liposuction of the arm if a formal axillary node dissection has been performed.
Best wishes and good luck.
Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Charles Galanis, MD · Answer

Excellent question.  Ultimately this is at the discretion of your chosen surgeon.  If you had a sentinel lymph node biopsy (which is the removal typically of only 1-2 nodes), you might be ok to proceed so long as you understand there might be increased risks of prolonged postoperative swelling.  I would likely avoid performing arm liposuction in a patient who had a formal axillary dissection (removal of most or all axillary nodes) as these patients are already at some risk of lymphedema and may clear fluid associated with the procedure at a significantly impaired rate.

Erica Anderson, MD · Answer

I assume if you had axillary node dissection and lumpectomy, you have also had radiation to the breast. I think liposuction of the arm could lead to lymphedema as you have a predisposition at this point. Better to focus on the abdomen and butt and accept your arms than have a devastating complication. Be sure to talk to your surgeons about your concerns. Also ask your breast surgeon his/her opinion. Best wishes.

Steven Wallach, MD · Answer

I think that if you had a true axillary node dissection and not just a sentinel lymph node biopsy, it could make you prone to swelling issues in your arm post-op that could be permanent. Best to review with your surgeon.

Can someone have arm Lipo if they have had axillary lymph node dissection?

Answers (6)

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