Lymphedema Surgery Live Q&A with Dr. Ramon Garza III

By: Courtney Floyd

Blogs

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! 

What is lymphedema?

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.

Where is the lymphatic system located?

They lymphatic system is part of the vascular system and is located throughout the entire body.

What are the common symptoms of lymphedema?

Common symptoms of lymphedema in the upper extremity include swelling of the hand or arm, a constant dull ache and/or loss of feeling.

When can symptoms of lymphedema appear?

Symptoms of lymphedema can occur anytime, even years, after surgery or trauma to a given area.

Who should a patient consult with if they think they have lymphedema?

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.

What can patients do to prevent or improve the symptoms?

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.

What are the surgical options for treatment?

At PRMA we offer two surgical treatment options—Vascularized Lymph Node Transfer (VLNT) and Lymphaticovenous Anastomosis (LVA).

Can the surgical treatment options be performed as a stand-alone procedure?

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.

What are the success rates of the surgical treatment options/What is the benefit of one surgical treatment option over the other?

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.

Does insurance over the surgery?

Unfortunately, insurance does not cover these procedures at this time. However, PRMA offers financing options through Care Credit.

Can surgery be performed as a prophylactic procedure?

Technically yes. However, these procedures are still very new. Early studies do not indicate that prophylactic surgery would benefit patients.

What are some non-surgical treatment options?

Non-surgical treatment options include lymphatic drainage performed by a certified lymphedema specialist, wearing compression garments and practicing proper skin care.

Does breast reconstruction increase the risk of developing lymphedema?

No. There is no evidence suggesting undergoing breast reconstruction will increase the risk of developing lymphedema.

What is the risk of developing lymphedema in the donor site after VLNT?

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.

What type of follow up care is recommended after surgery?

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. 

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