How long is post Mastectomy drainage normal?

I had a mastectomy 5 weeks ago, the last of 2 drains were removed due to it being nasty. However I was still outputting 100 or more ml a day. Now I have swelling above and under my arm which is excess fluid again. Should I be worried this is still happening? The surgeon is going to drain it with a syringe, but how long will this go on before it stops? I am beginning to think something is wrong. Thank you

Doctor Answers 2

Fluid post mastectomy

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The body's response to injury is to weep fluid. (remember how fat your ankle gets after a sprain?) The more tissue removed and the larger the flaps (skin of the chest wall/breast) the more fluid develops. It is not uncommon to have residual fluid after the drains have been removed - either because they were taken out too early or are a source of infection. The fluid can be removed in the office by a needle and syringe or if it is a lot of fluid or keeps reaccumulating, a tiny drain can be replaced in the office as well. Hang in there. It wil lnot last forever and although inconvenient is not a worrisome sign. Take care.

Fluid build up following mastectomy

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Seromas (fluid pockets after surgery) can happen as a result of the raw edges of tissue leaking fluid to clean, buffer, and heal the surfaces. The fluid is made of water, salts and dead cells. It is much like the fluid found in a blister you would get if you wore a too-tight shoe. They happen 100% of the time but are sometimes so small, the body resorbs them/dries them up before a pocket develops. The more "surface area" there is, the leakier the tissue will be, and it can take time for this process to slow and dry up. Having the fluid evacuated efficiently allows the tissue surfaces to stick and heal so that new fluid doesn't have a place to build up. Another, seperate issue can be a lymph leak if lymph nodes were taken from the underarm. This however, happens very rarely and the fluid is usually milky or cloudy in color. Is there an implant or expander in place?  Concern for low grade infection, presence of artificial material, or patients that sometimes push themselves too much early on in the recovery period can make seromas more problematic. It can be frustrating, for sure! Ask your surgeon if he/she thinks another drain needs to be placed to encourage the maximum amount of fluid evacuation for the longest time, to promote the tissue surfaces to adhere to each other. A drain that is a catheter like a small IV can be inserted very easily with ultrasound guidance in an office. There is no set time limit for this process and can certainly take weeks to resolve.

Heather Richardson, MD, FACS
Beverly Hills General Surgeon
5.0 out of 5 stars 2 reviews

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