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Your Lymphedema Surgery Questions Answered

October 31, 2014

Lymphedema is a condition that affects more than 4 million people in the United States.

Characterized by abnormal swelling and pain in the arms and legs, lymphedema occurs when the blood vessels in the lymphatic system are unable to adequately drain fluid. Lymphedema can happen after an injury, infection or the removal of lymph nodes during breast cancer surgery.

Our plastic and reconstructive surgeons are the only surgeons in Florida—and among only a few in the country—who perform a procedure called vascularized lymph node transfer. This reconstructive procedure, which involves harvesting and transferring healthy lymph nodes to the site of the lymphedema, can partially or completely eliminate this condition. Our video gives a high-level overview of the procedure:

In recent weeks, we have received a number of questions regarding vascularized lymph node transfer, and I’ve shared my answers below to help you better understand lymphedema surgery.

Q: How long has vascularized lymph node transfer been around?

A: The procedure was initially described about 20 years ago, but it has gained traction in the past four years as more data has become available. We've been performing the procedure since March of 2013, and have operated on 61 patients.

Q: How long does the procedure take?

A: Vascularized lymph node transfer typically takes 2-3 hours. During the procedure, our surgeons harvest tissue from the abdomen that contains the lymph nodes, fat cells, arteries and veins and reattach this tissue to the site of your lymphedema. We transfer five to eight healthy lymph nodes to the affected body part. Once blood flow resumes to the area, the tissue and healthy lymph nodes should again allow lymphatic fluid to drain properly.

Q: What is the success rate?

A: We have analyzed our initial findings and have seen an improvement of 60 percent in swelling at one year in our upper extremity patients and a 20 percent improvement in swelling at one year in our lower extremity patients.

Q: Depending on the number of lymph nodes taken from the donor site, wouldn't that part of the body develop lymphedema?

A: No. We are careful to select donor sites that have node redundancy so as to avoid donor site lymphedema. Although theoretically possible, there are no reported cases in the literature so far.  We have not experienced donor site lymphedema in our series so far.

Q: I have a five year old who was born with idiopathic congenital lymphedema of bilateral feet up to mid shin. Is this surgery a possibility in pediatric primary lymphedema?

A: Vascularized lymph node transfer has indeed been performed for congenital lymphedema and can be done at an early age to help prevent the condition from worsening over time.

Vascularized lymph node transfer has had promising long-term results for our patients, including reduced swelling, enhanced range of motion and a significant reduction or complete elimination of the lymphedema. Our goal with this treatment is to improve your quality of life and ensure you are as pain-free as possible.

If you have questions about lymphedema surgery, please feel free to reach out to us on our Facebook and Twitter pages. We’re here to give you accurate medical information, so you can make the most informed decision about your treatment.

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