How should seroma or lymphedema treated?

Question

7/30/15 bilateral mastectomy for DCIS. No reconstruction or implants; no adjuvant therapy needed. Tender puffiness in middle of chest, closer to unaffected side. Was wearing compression binder post-op but too uncomfortable. Surgeon's nurse says not lymphedema & try male compression vest. Is seroma symptomatic of LE? 1 SLND & 8 ALND, all negative removed from right side only. How to treat seroma/LE? Exercises/massage helpful? Male compression vest? Needle aspiration? How can they tell if it's not LE?

Jaime S. Schwartz, MD, FACS · Answer

I appreciate your question.The best way to assess and give true advice would be an in-person exam.Please see a board-certified plastic surgeon that specializes in aesthetic and restorative breast surgery.best of luck!Dr Schwartz

M. Zakir Sabry, MD · Answer

In simple terms,a seroma is a collection of fluid in a cavity, often surgically created. Lymphedema on the other hand, is swelling of an affected area/ extremity secondary to blockage of the lymph draining mechanism. This often results from removal of lymph nodes.A collection of lymph in a cavity is termed, a lymphocoele. Seromas can be treated by repeat aspirations, if need be,  followed by compressions. Recalcitrant Seromas may require surgical intervention. Most common treatment of lymphedema includes compression garment. Lymph draining massages have been proven effective in selected cadres. Discuss your concerns with your surgeon and he/ she will be able to guide you in the proper direction.Best

Paul Gill, MD · Answer

It does not appear to be seroma, most likely lymphedema or normal postoperative swelling.  I recommend close followup with your surgeon and a consultation with a physical therapist specializing in lymphedema who can teach at home exericses to fix this problem.   All the best.Dr. GIll

How should seroma or lymphedema treated?

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