The swelling that occurs with lymphedema can be inhibiting. Proper care is necessary to support optimal quality of life. The question that many patients have about their swelling is what to expect in terms of treatment. Specifically, when might surgery be the next best step to reduce swelling?
Generally, doctors take a nonsurgical approach to lymphedema as much as possible. The first corrective step that is typically taken is for the patient to wear compression garment or wraps. If compression does not achieve the desired improvement, other conservative therapies are considered before surgery.
The lymphatic system is part of the body’s immune system. It circulates lymph fluid through the body as a way of collecting waste products, viruses, and bacteria. These products are carried by lymph fluid to the lymph nodes, which filter wastes. Lymphedema is an accumulation of lymph fluid in the tissue, usually in the arm or the leg. Swelling develops when the lymph vessels lose their capacity to effectively drain lymph fluid. This usually occurs as a side effect of trauma, infection, or cancer treatment.
The purpose of wrapping and compression therapy is to encourage the flow of lymph fluid. When compression isn’t sufficient, complete decongestive therapy may be recommended. This may include compression in addition to massage, skincare, and exercise to reduce swelling. A compression device may also be used to “pump” lymph through vessels.
Surgery may be considered when complete decongestive therapy does not achieve the intended improvement in swelling. Various surgical techniques are currently available for lymphedema that is in the fluid stage. These include lymphaticolymphatic bypass, lymphaticovenous anastomosis, and vascularized lymph node transfer. The technique that is selected may vary depending on each individual situation. Treatment may be somewhat time-sensitive. If lymph fluid stagnates for an extended period, solids may accumulate in tissue, making the condition more difficult to treat.
Dr. Patel is a board-certified plastic surgeon with advanced training in the use of microvascular surgical techniques. His experience with reconstructive breast surgery and lymphedema surgery makes him a sought-after resource for patients from across the country. To learn more about the diagnosis and treatment of lymphedema, contact us to arrange a consultation.