We recently hosted a Facebook LIVE discussion covering lymphedema and the surgical treatment options available today. If you missed it, don’t worry! You can catch the replay here!
Lymphedema is a chronic condition where excess fluid collects in the body causing swelling. Most commonly, lymphedema occurs in the arms or legs. Patients are at a high risk for lymphedema if they have had lymph nodes removed from the under arm during breast cancer surgery. The risk is also increased following radiation treatment.
They lymphatic system is part of the vascular system and is located throughout the entire body.
Common symptoms of lymphedema in the upper extremity include swelling of the hand or arm, a constant dull ache and/or loss of feeling.
Symptoms of lymphedema can occur anytime, even years, after surgery or trauma to a given area.
If a patient is concerned they may have lymphedema, they have the option of being evaluated by a certified lymphedema specialist or a board-certified plastic surgeon specializing in lymphedema surgery.
There is not much a patient can do to prevent lymphedema but keeping active and maintaining a BMI below 30 can help reduce the risk of developing the disease.
At PRMA we offer two surgical treatment options—Vascularized Lymph Node Transfer (VLNT) and Lymphaticovenous Anastomosis (LVA).
LVA is performed as a stand-alone procedure in an outpatient setting.
VLNT can be performed as a stand-alone procedure or combined with DIEP flap breast reconstruction.
The rate of success after surgery is variable. Because both procedures are relatively new, there is little data on the long-term success. The LVA procedure does have a lower risk of complications, but early studies suggest that the VLNT procedure may provide a slightly increased benefit to patients compared to the LVA.
Unfortunately, insurance does not cover these procedures at this time. However, PRMA offers financing options through Care Credit.
Technically yes. However, these procedures are still very new. Early studies do not indicate that prophylactic surgery would benefit patients.
Non-surgical treatment options include lymphatic drainage performed by a certified lymphedema specialist, wearing compression garments and practicing proper skin care.
No. There is no evidence suggesting undergoing breast reconstruction will increase the risk of developing lymphedema.
There is a very slight risk of developing secondary lymphedema in the donor site after VLNT. Again, this procedure is very new so there is no exact data, but we have not encountered this in our experience at PRMA.
We recommend patients continue to follow up with a certified lymphedema specialist for proper evaluation and follow up care. This includes massage, wearing compression garments and practicing proper skin care.
Author: Dr. Ramon Garza III and Courtney Floyd
If a patient is concerned they may have lymphedema, they have the option of being evaluated by a certified lymphedema specialist or a board-certified plastic surgeon specializing in lymphedema surgery.
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