When Does Fluid Build-up After Liposuction Begin to Subside?

Question

I have had some fluid build up in my arms after Liposuction on my upper arms 3 weeks ago. I had to have several drainages, and was wondering, how long does it take for the fluid to subside? Is fluid build-up normal for some people?

J. Timothy Katzen, MD, FACS · Answer

Thank you for your question regarding fluid build-up after liposuction, specifically concerning your experience with your upper arms.

Fluid accumulation post-liposuction, known as a seroma, is relatively common and can occur as part of the body's natural response to the trauma of surgery. While it is more typical in areas where large amounts of fat have been removed, it can certainly occur in the arms as well.

The duration for which fluid build-up subsides can vary depending on several factors, including the extent of the liposuction, the area treated, your body's healing response, and how effectively the fluid is being managed post-operatively. Typically, most patients see a significant reduction in fluid accumulation within the first few weeks after surgery, but it can sometimes take longer.

Since you are already three weeks post-operation and have required several drainages, it sounds like your body is still actively managing the healing process. It is not uncommon for some patients to need more time to resolve these issues, especially if a significant amount of fat was removed.

Here are a few suggestions to help manage and reduce fluid build-up:

Continue wearing compression garments: These help reduce swelling and encourage the body to absorb fluids more efficiently.
Follow up regularly with your surgeon: They might need to perform additional drainages if the fluid persists.
Maintain a healthy diet and stay hydrated: Good nutrition and hydration are crucial for optimal healing.
Gentle exercise: As approved by your surgeon, light activities can help improve circulation and fluid dynamics.
It’s important to keep in close communication with your plastic surgeon, as they can provide the most appropriate care and interventions if the fluid build-up continues or if there are any concerns about the healing process.

Fluid build-up is a normal response for some people after liposuction, and with proper management, it typically resolves over time. If you have ongoing concerns or if the situation doesn't improve, be sure to discuss them with your plastic surgeon.

Sincerely,

J. Timothy Katzen, MD, FASMBS, FICS
Plastic and Aesthetic Surgeon

York Jay Yates, MD · Answer

I have seen only one seroma after liposuction and it was in a very large gentleman with 4 Liter fat removal from the abdomen. The amount of "dead space" left after the removal of the fat contributed to the development of the seroma I am sure. This resolved with conservative therapy (time, pressure garment, decreased activity). This was very small and didn't even require drainage. It sounds as if yours is large enough to have required drainage. This may need to be drained a few more times and possibly would even benefit from a sclerosant injected into the cavity after aspiration. Seromas are frustrating but they tend to improve once the balance of fluid removal by lymphatics is as quick as fluid creation by your healing tissues.

Otto Joseph Placik, MD · Answer

It seems as if certain modalities have a higher propensity to develop seromas or fluid buildup. For example, it is more common after ultrasonic liposuction. Did you have this?
It also is more common after aggressive liposuction where an extensive cavity with raw surfaces are left.
Typically, they resolve over time. It is difficult to predict how much time but commonly you will see a drop off in the amount that is drawn off. However it may take a few weeks or even a few months.
There is not consistent method to treat other than ongoing aspirations. Other methods have been used with mixed success such as opening and closing the cavity, drain placement, instillation of a sclerosing agent quitling sutures, etc.
As you have been advised, avoid tight garments that gather and create a tourniquet effect.

Armando Soto, MD, FACS · Answer

Hi there,
I agree with the other surgeons that this is a problem very rarely seen. I have never had this happen in a very large number of arm cases. The important points are to maintain a constant and firm compression of the area, in conjunction with your surgeon's drainage procedures. I have also had success with use of percutaneously placed indwelling drains (drain tubes your doctor can put in in the office).  The problem should take care of itself over time and your outcome should still be favorable.

Pat Pazmino, MD, FACS · Answer

Liposuction is a safe, popular, and effective way to contour the body. Patients undergoing this procedure should understand that there is a recovery process. In our practice, we inform our patients that they should expect to have a small amount of pink fluid drained from their liposuction incisions for several days after the surgery. This is completely normal. We also encourage our patients to use the special compression garment that we provide for them that has been specifically designed to apply circumferential pressure to the area that has been treated. This will help decrease and manage the swelling that always happens after liposuction and will provide support which will increase their comfort.

Stephen A. Goldstein, MD · Answer

Fluid collection following liposuction surgery is a recognized potential complication.  The fact that your treating surgeon has aspirated the fluid that has accumulated and localized in your arms suggests that this is a seroma.  The seroma may require additional aspirations but, more than likely, this will subside with time.  If you are wrapping your arms or you are wearing a pressure garment, make sure that there is no tight constriction band forming in the arm pit.  This will impede the lymphatics which drain and pull the fluid collection away.
Your treating plastic surgeon knows you the best&hellip;knows your anatomy&hellip;and, knows the operation he performed on you.  I would strongly advise you continue to see your surgeon and discuss your issues with him/her.  I am sure that with time your results will continue to improve.  
Stephen A. Goldstein, MD

Peter E. Johnson, MD · Answer

Liposuction in the upper arms takes great care because the skin is thinner, the skin elasticty is often poor, and the fat is not specifically concentrated in any one area such as in the saddle bag of the thigh. We suction the upper arm using a very thin cnnula to aspirate the fat, and work as uniformly as possible and feather around the whole surface of the upper arm.Because of the thinness of the skin we avoid ultrasound or other suction systems which can produce heat or burn the skin. All fluid is removed at the time and we close the site so that it remains clean and dry, and follow with a vest with a long sleeve to compress the area. Swelling should be down by two weeks.It is very uncommon with liposuction to have fluid buildup, which is called a seroma. When it does occur we would recommend continuation of wraps, rest and elevation. The fluid always resolves though the time it takes can be frustrating for you and your surgeon. Four to six weeks is probably a fair estimate of the time. Seroma does increase the risk of infection, so keep the area very clean and watch for reddness or warmth. Keep in close contact with your surgeon until the fluid subsides.Best of luck to you.

Kenneth R. Francis, MD, FACS · Answer

Tampa,
Fluid build up (seroma) following liposuction is one of the risks of liposuction surgery.  It occurs relatively infrequently and more commonly with ultrasonic liposuction. The reaccumulation of fluid following drainage varies from zero to several times, that may require repeated drainage procedures. After 2 or 3 drainages consideration is usually given to placing a drain into the site and leaving it in for a few days. On very rare occasion an open surgical procedure or injection of a sclerosing agent is required to permanently stop the drainage. Good luck!

Scott E. Kasden, MD, FACS · Answer

It is not usual for Liposuction to result in fluids to build up and require aspiration. Compression garments are very helpful to correct or prevent this problem.

Steven Wallach, MD · Answer

If you mean swelling, then yes it is common. The majjority of the swelling should improve over 4-6 weeks, but you may notice variations of swelling with acitivity that may last months. If you are accumulating fluid like a seroma and need the fluid aspirated then that is unusual for most forms of liposuction. Usually this "burns out" after a few aspirations and the use of a good compression garment.

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