Sentinel lymph node dissection (SLND) and radical lymph node dissection (RLND) represent standard surgical procedures in skin cancer patients. Complications may arise, with seroma formation being the most prevalent. Although both conservative and surgical approaches have been undertaken in effort to reduce the occurrence of postoperative seroma, none have been able to show a beneficial effect. Therefore, the aim of our study was to examine the rate of complications in RLNDs and SLNDs in respect to the influence of different preventative techniques on potential seroma formation. We performed an evaluation of all SLNDs and RLNDs within a 2-year period at our hospital. The primary focus was seroma formation, with secondary points being infection, wound healing problems (WHP), and lymphedema, as well as the total length of hospital stay and revision surgery. Three hundred eighty-nine patients were recorded, of which 268 patients (69 %) underwent an SLND while 121 patients (31 %) underwent an RLND. Seroma in RLNDs occurred significantly more frequently with 46.3 % compared to SLNDs with only 11.6 %. Pressure and vacuum dressings were associated with a considerably higher chance of seroma formation, namely 3.5 and 2.1 times more than with a normal dressing. Other methods such as ligation, clipping, fibrin glue, or a sartorius flap showed no effects. RLNDs are associated with a higher rate of seroma regardless of surgical or postoperative approach, whereas SLNDs only induce a few side effects. Further infections, wound healing problems, and lymphedema were significantly associated with seroma formation. Level of Evidence: Level IV, risk / prognostic study