American Society of Plastic Surgeons
For Medical Professionals
 

Lymphedema Treatment

Surgical Options

Lymphedema is a condition characterized by painful swelling in the extremities, which can be addressed with surgical treatment options.

What is lymphedema?

Lymphedema is a condition characterized by painful swelling in the extremities (arms and/or legs). The swelling occurs when lymph nodes are no longer facilitating the proper drainage of lymph fluid from an area of the body. Primary lymphedema is a congenital condition; however, in the developed world, secondary lymphedema is the most common type of lymphedema. This condition may be caused by infection, trauma or, most commonly, treatment of cancer.

What causes lymphedema?

Lymphedema in cancer patients

Lymphedema affects some cancer survivors who have been treated for breast cancer, gynecologic cancers, melanomas and other types of skin and urologic cancers. Lymphedema may impact cancer survivors on a daily basis and is a constant reminder of the disease that they have fought. The onset of symptoms may be delayed by months or even years after the initial injury.

Lymphedema symptoms

There are a number of symptoms that affect patients with lymphedema that typically worsen over time:

  • Extremity swelling caused by lymphatic fluid
  • Change in skin quality such as skin fibrosis
  • Extremity tenderness or pain
  • Intermittent redness of the extremity, known as cellulitis
  • Excess fat in the extremity

Lymphedema treatment

Surgical treatment options for lymphedema include Lymphatic Bypass Procedures, where lymphatic vessels are connected and drained into the body's venous system and Vascularized Lymph Node Transfer, where lymph nodes are harvested from one part of the body and surgically implanted in the affected area to rebuild a failed system.

Once the diagnosis of lymphedema is established, nonsurgical treatment is initiated as soon as possible including extremity elevation, skincare, elastic stockings, physical therapy and pneumatic compression devices. These treatments, although beneficial, can be burdensome to patients and require lifelong commitment. Surgery for lymphedema may be appropriate when nonsurgical therapy is inadequate to control the symptoms.



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