Arnica montana and Bellis perennis for seroma reduction following mastectomy and immediate breast reconstruction: randomized, double-blind, placebo- controlled trial

  • Adi Maisel LotanEmail author
  • Yoav Gronovich
  • Ido Lysy
  • Rami Binenboym
  • Nirit Eizenman
  • Barak Stuchiner
  • Oren Goldstein
  • Polina Babai
  • Menahem Oberbaum
Original Paper



Seroma is a common surgical complication created by the inflammatory process that follows mastectomy and reconstruction [9, 10, 11, 12, 13, 14, 15]. It is, therefore, common practice to insert surgical drains, which often remain in place for long periods and delay recovery [26, 27]. In light of the many advantages of homeopathic treatment, there has been a global trend of integrating this with conventional medicine [29]. In this study, we examined the effect of Arnica montana and Bellis perennis on seroma prevention after mastectomy and breast reconstruction.


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


The mean patient age was 47.9 years. Comorbidities included obesity, diabetes mellitus, essential hypertension, fibromyalgia, and hypothyroidism (1, 4, 6, 2, and 4 patients respectively). Age, body mass index, mastectomy type, and lymph node dissection were similar among groups. Forty-two breasts underwent one-stage procedure, and the remaining were two-stage. Arnica montana and Bellis perennis significantly reduced drain removal time (discharge < 30 ml) by 18% (2.4 days, p < 0.05), 11.1 (6.1) days in the study groups compared with 13.5 (6.4) days in the placebo group. 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.


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

Level of evidence: Level I, therapeutic study.


Mastectomy Breast reconstruction Seroma Homeopathy Arnica montana Bellis perennis 



This study was funded by Mirski grant no. 18004640, Shaare Zedek Medical Center, Jerusalem, Israel.

Author contribution

All authors contributed to the study conception and design. All authors read and approved the final manuscript.


This study was funded by Mirski grant no. 18004640, Shaare Zedek Medical Center, Jerusalem, Israel.

Compliance with ethical standards

Conflict of interest

Adi Maisel Lotan declares that she has no conflict of interest. Yoav Gronovich declares that he has no conflict of interest. Ido Lysy declares that he has no conflict of interest. Rami Binenboym declares that he has no conflict of interest. Nirit Eizenman declares that he has no conflict of interest. Barak Stuchiner declares that he has no conflict of interest. Oren Goldstein declares that he has no conflict of interest. Polina Babai declares that he has no conflict of interest. Menahem Oberbaum declares that he has no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2020

Authors and Affiliations

  • Adi Maisel Lotan
    • 1
    Email author
  • Yoav Gronovich
    • 1
  • Ido Lysy
    • 1
  • Rami Binenboym
    • 1
  • Nirit Eizenman
    • 1
  • Barak Stuchiner
    • 1
  • Oren Goldstein
    • 1
  • Polina Babai
    • 2
  • Menahem Oberbaum
    • 3
  1. 1.Department of Plastic & Reconstructive Surgery, Shaare Zedek Medical CenterHebrew University of JerusalemJerusalemIsrael
  2. 2.Mashav Applied ResearchJerusalemIsrael
  3. 3.Center for Integrative Complementary Medicine, Shaare Zedek Medical CenterHebrew University of JerusalemJerusalemIsrael

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