Lymphedema Surgery

Justin Sacks

Treatment Team

Justin Sacks, MD, Professor of Surgery, Sydney M. and Robert H. Shoenberg Chair, Chief, Division of Plastic and Reconstructive Surgery

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Anolik Rachel

Treatment Team

Rachel Anolik, MD, Assistant Professor of Surgery, Division of Plastic and Reconstructive Surgery

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What is lymphedema?

Lymphedema is a condition that can occur as a result of cancer treatment.

When lymph nodes are removed or damaged, abnormal swelling can occur due to the buildup of lymph fluid in the body’s soft tissues. Lymphedema usually in the arms or legs, but may occur in other parts of the body. Symptoms include:

  • Extremity swelling
  • Decreased flexibility
  • Changes in skin elasticity or thickness
  • Discomfort while wearing clothing or jewelry
  • Pain, redness, itching, or increased skin temperature in a particular area

Treatment options

While damage caused to the lymph system is irreparable, there are treatments that can ease discomfort and minimize long-term effects. These treatment options include:

  • Compression devices
  • Pressure garments
  • Exercise
  • Massage therapy
  • Laser therapy
  • Weight loss

When nonsurgical therapy is not successful in controlling the symptoms of lymphedema, surgery may be considered.

Different surgical options for lymphedema

There are a variety of surgical options available for treating lymphedema. The invasiveness of these options varies based on the stage of the lymphedema.

Lymphaticovenular anastomosis

Lymphovenous BypassLymphaticovenular anastomosis (LVA) is the most minimally invasive of the surgical options for lymphedema. It is a bypass procedure that aims to remedy the obstruction of lymph flow by redirecting lymphatic fluid into the veins in the arm or leg. Small incisions are made on the affected limb and a high-precision microscope is used to identify lymphatic vessels near the area of obstruction. These tiny vessels are connected to the veins, and as many connections as possible are created to enable shunting of lymphatic fluid. This procedure is typically performed on an outpatient basis.

Vascularized lymph node transfer

Lymph Node TransferVascularized lymph node transfer (VLNT) is a minimally invasive outpatient procedure involving the transfer of functional lymph nodes with an intact blood supply to the extremity in which the native lymph nodes have been damaged or removed. Once transplanted, the functional lymph nodes stimulate the growth of new lymph nodes. This procedure takes approximately 4 hours.

Ablative procedures

Liposuction ProcessAblation can be used to remove excess skin and soft tissue to reduce mass and improve hygiene. These procedures are typically reserved for cases of advanced-stage lymphedema with extensive fibrosis. Multiple procedures may be required to remove excess skin. Liposuction has also been used successfully to treat patients with advanced lymphedema who have excess fat and who are not candidates for other surgical treatment options, such as the Charles Procedure. For those who undergo liposuction for lymphedema treatment, lifelong compression garments must be worn to maintain the effects of the procedure.

Charles Procedure

Who is a good candidate for lymphedema surgery?

You may be a good candidate for lymphedema surgery if you meet the following criteria:

  • You have exhausted all nonsurgical treatment options
  • You do not have additional medical conditions that may hinder the healing process
  • You have a positive approach to treatment and realistic goals for restoring your body image

Request an Appointment

Do you have lymphedema? Call us or fill out our web form to request an appointment with one of our lymphedema specialists.