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Arnica Montana and Bellis Perennis for Seroma Reduction Following Mastectomy and Immediate Breast Reconstruction: Prospective, Randomized, Double-blinded, Placebo-controlled Trial

Maisel-Lotan, Adi MD; Lysy, Ido MD; Binenboym, Rami MD; Eizenman, Nirit MD; Gavriel Stuchiner, Barak MD; Goldstein, Oren MD; Oberbaum, Menahem MD; Gronovich, Yoav MD, MBA

Plastic and Reconstructive Surgery - Global Open: August 2019 - Volume 7 - Issue 8S-1 - p 24-25
doi: 10.1097/
Breast Abstracts

Shaare Zedek Medical Center, Jerusalem, Israel

This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.

PURPOSE: Seroma is a common surgical complication created by the inflammatory process that follows mastectomy and reconstruction.1,2 It is, therefore, common practice to insert surgical drains, which often remain in place for long periods and delay recovery.3,4 In light of the many advantages of homeopathic treatment, there has been a global trend of integrating this with conventional medicine.5 In this study, we examined the effect of Arnica montana and Bellis perennis on seroma prevention after mastectomy and breast reconstruction.

METHODS: This was a prospective, double-blind, randomized analysis of 55 patients (78 breasts) who underwent mastectomy and immediate breast reconstruction between January 2016 and August 2017. Patients were randomly assigned and treated with A. montana and B. perennis or placebo from surgery and up to the time of drain removal.

RESULTS:A. montana and B. perennis significantly reduced drain removal time (discharge <30 ml) by 18% (2.4 days; P< 0.05), 11.1 days (6.1 days) in the study groups compared with 13.5 days (6.4 days) in the placebo group. Age, body mass index, mastectomy type, and lymph node dissection were similar among groups. Patient opioid intake was lower (P < 0.057) in the study group. Quality of life, postoperative pain, hemoglobin and cortisol levels, and complications were not associated with any treatment.

CONCLUSION:A. montana and B. perennis have been shown to reduce seroma formation and opioid intake following mastectomy and reconstruction. Because this treatment lacks side effects and is inexpensive, it should serve as a valuable treatment adjunct in patients undergoing mastectomy and reconstruction.


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2. Pogson CJ, Adwani A, Ebbs SR. Seroma following breast cancer surgery. Eur J Surg Oncol. 2003;29:711–717.

3. Purushotham AD, McLatchie E, Young D, et al. Randomized clinical trial of no wound drains and early discharge in the treatment of women with breast cancer. Br J Surg. 2002;89:286–292.

4. Puttawibul P, Sangthong B, Maipang T, et al. Mastectomy without drain at pectoral area: a randomized controlled trial. J Med Assoc Thai. 2003;86:325–331.

5. Johnson PJ, Jou J, Rhee TG, et al. Complementary health approaches for health and wellness in midlife and older US adults. Maturitas. 2016;89:36–42.

Copyright © 2019 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of The American Society of Plastic Surgeons. All rights reserved.