This month and every month, our practice aims to provide support and hope for those living with lymphedema. At The Institute for Advanced Reconstruction, we have developed a Center for Lymphedema Surgery, dedicated to providing surgical treatment options for patients with lymphedema. We are proud to be nationally recognized as a Lymphatic Disease Surgery Center of Excellence by the Lymphatic Education and Research Network (LE&RN).
Director of The Center for Lymphedema Surgery, Dr. Russell Ashinoff, along with Dr. Eric Chang answer some common questions about lymphedema surgery below.
Q: What is lymphedema? What are some common causes of lymphedema?
A: Lymphedema is a chronic condition that often manifests as an abnormal buildup of fluid, causing swelling, most commonly in the arms or legs. There are two types of lymphedema, known as primary lymphedema and secondary lymphedema. Primary lymphedema has no known direct cause, but may result from inherited problems with the lymph vessels. Secondary lymphedema results from damage to the lymph nodes or lymph vessels caused by another condition or treatment. Secondary lymphedema typically results from surgery related to cancer treatment and/or radiation therapy.
Q: What are some conservative treatment methods for lymphedema?
A: Conservative treatment methods for lymphedema include lymphedema therapy, which may involve wrapping the affected limb, wearing compression garments regularly, getting lymphatic massages or complete decongestive therapy (CDT). CDT combines multiple therapies with lifestyle changes.
Q: What surgical treatment options does The Center for Lymphedema surgery offer?
A: Our Center offers four different types of surgical treatment methods for lymphedema. The simplest is lymphedema liposuction to reduce the weight and circumference of the affected limb. Liposuction can also be done in conjunction with the other procedures to further augment the results.
Lymphaticovenous Anastomosis (LVA) is a procedure done in order to improve the fluid drainage. In this procedure, the distal lymphatics are anastomosed or connected to small superficial veins, creating a “bypass” for the lymphatic fluid into the venous system.
Another procedure is free lymph node transfer, also known as Vascularized Lymph Node Transfer. In this procedure, lymph nodes from the groin or chest wall are isolated with their blood supply and surgically transferred to the arm or groin, where the lymph nodes are not functioning properly.
Lymphedema mass excision is a procedure done to surgically remove a large mass hanging from the inside or outside of a patient’s thigh which is related to lymphedema. Following this surgery, it becomes easier for patients to walk and move their leg.
We offer all of these procedures as needed. Sometimes, LVA and lymph node transfer can be done together. These two procedures can also be combined with breast reconstruction surgery. Every patient is unique, so each person is individually assessed. We take each patient through a detailed evaluation to determine which procedure is best for them.
Q: How successful are these surgical procedures?
A: These surgical procedures have been found to be extremely successful in decreasing the symptoms and side affects associated with lymphedema.
Q: What is recovery like?
A: Recovery can vary based on the type of procedure a patient has underwent. With LVA, the patient will have a number of small incisions, depending on how many bypasses are performed. LVA typically requires the patient to stay overnight in the hospital, returning home the next day, and the recovery time is minimal. With a lymph-node transfer procedure, because the surgery is more involved, these patients typically stay in the hospital a little bit longer following the procedure. The recovery time for this procedure is usually about 4 weeks. If a patient undergoes a lymphedema surgery during the time of breast reconstruction, the recovery time will be dependent on the type of breast reconstruction performed. Following surgery, we have all patients work with a lymphedema therapist regularly to help maximize improvement.
Q: What sets your center apart from other lymphedema treatment centers?
A: Our center differs from other lymphedema treatment centers because we provide comprehensive treatment planning for patients, offering numerous surgical procedures and working hand in hand with lymphedema therapists. We also received the designation of a Center of Excellence by the Lymphatic Education and Research Network. We are proud to be the only private practice who received this honorable designation and are dedicated to proving hope to patients with lymphedema around the world.
Q: What do you hope for the future of lymphedema?
A: Our ultimate goal for the future of lymphedema is to increase awareness about the disease and the treatment options available. We also hope to reach more physicians worldwide because the surgical treatment options are novel; we aim to help them become more well-known and highlight the benefits that these procedures have on patients. We want these surgical treatments to be accessible to anyone who is a candidate for them.
If you are interested in learning more about lymphedema and the surgical treatment options that are available, visit The Center for Lymphedema Surgery at The Institute for Advanced Reconstruction