Can Surgery Cure Lymphedema? Debunking Myths and Setting Realistic Expectations

Everyone has a lymphatic system. This system — a complex network of vessels, nodes, and organs — helps maintain fluid balance by collecting and draining excess fluid from the tissues. It also plays a crucial role in the immune system by transporting lymph, which contains infection-fighting white blood cells.

“When the lymphatic system becomes impaired, such as from lymph node removal or from radiation during cancer treatment, fluid can build up in the tissues leading to lymphedema. This can be worse in patients who are obese and may eventually lead to cellulitis,” explains Eric Chang, M.D., FACS, a surgeon at The Institute for Lymphatic Surgery and Innovation.

According to Dr. Chang, build-up can lead to lymphedema, a chronic condition often marked by symptoms such as persistent swelling in the arms and legs, discomfort, and a feeling of heaviness.

For this reason, many individuals are drawn to lymphedema surgery when conservative options fail to provide relief. However, there is no cure-all solution for lymphedema, and not everyone with lymphedema is a good candidate for surgery. Therefore, it’s important to understand the realistic role of lymphedema surgery, separating the myths from the facts, in managing this condition.

Common Myths About Lymphedema Surgery

Myth #1: Surgery Offers a Complete Cure for Lymphedema

“This myth is misleading because lymphedema is a chronic condition with no definitive cure,” shares Dr. Chang. 

While surgical options, such as free lymph node transfer, liposuction, or lymphedema mass excision, can reduce symptoms and improve quality of life, they do not restore the lymphatic system to its pre-disease state. Management of lymphedema often still requires ongoing therapies, like compression garments and physical therapy, to maintain results.

Myth #2: Surgery is a Quick-Fix with Minimal Recovery Time

“Surgery for lymphedema is a complex procedure that requires careful planning and significant recovery time,” explains Dr. Chang. “Some patients may need weeks to months of rehabilitation, including physical therapy.” 

Additionally, a person’s outcomes depend on individual factors like the stage of lymphedema, the patient’s overall health, and adherence to postoperative care, making it far from an instant solution.

Myth #3: Surgery Eliminates the Need for Ongoing Management

While surgery can significantly reduce symptoms and improve quality of life, most patients still require ongoing management to maintain results and prevent complications. “The idea that surgery is a standalone solution, requiring no further management on the patient’s part, leads to unrealistic expectations,” shares Dr. Chang. Therefore, debunking this myth only further underscores the importance of patient education about the role of surgery in comprehensive lymphedema care.

What Surgery Can and Can’t Do for Lymphedema

The Institute for Advanced Reconstruction offers several advanced surgical options, each tailored to the patient’s needs and condition stage and designed to alleviate symptoms, improve limb function, and enhance overall quality of life. 

Free Lymph Node Transfer 

This procedure involves transplanting healthy lymph nodes from one part of the body to the affected area to help restore lymphatic drainage. Over time, the transferred nodes can integrate with the existing lymphatic system and reduce swelling. Results from this option are gradual, however, often taking months to become noticeable, and success depends on the severity of lymphedema and adherence to postoperative care. Some ongoing management may still be necessary.

Lymphaticovenous Anastomosis (LVA)

LVA is a microsurgical procedure that connects lymphatic vessels directly to nearby veins, allowing lymph fluid to bypass damaged areas and drain into the bloodstream. This allows for symptom relief in earlier stages of lymphedema, particularly in reducing swelling and heaviness. While it works for earlier stages of lymphedema, it is less effective in advanced cases, and patients may still need adjunct therapies like compression garments.

Lymphedema Mass Excision

A lymphedema mass excision can help remove large fibrotic tissue accumulated due to chronic swelling for patients with advanced lymphedema. This ultimately improves mobility, reduces excessive tissue's physical and emotional burden, and enhances limb functionality. While it significantly relieves bulkiness, it is essential to understand that it does not fully restore lymphatic function, and further interventions may be needed for comprehensive management.

Liposuction for Lymphedema

Liposuction for lymphedema works by targeting the fatty deposits that can accumulate due to chronic lymphedema, particularly in cases where swelling has led to permanent tissue changes. This procedure helps reduce limb volume and improve appearance and comfort, but it does not treat the underlying root cause of lymphatic dysfunction. 

Who is a Candidate for Lymphedema Surgery?

Several factors determine whether a person is a good candidate for lymphedema surgery. These factors include the condition's stage, its cause, and the patient’s overall health and goals. Additionally, those with early-stage lymphedema may benefit from procedures like LVA, while advanced cases or those who haven’t achieved relief from non-surgical treatments might require liposuction, mass excision, or another form of surgery.

“A patient’s ability to tolerate surgery and their commitment to postoperative care are also crucial determinants of surgery,” shares Dr. Chang. 

Call 855-980-6981 to schedule an appointment with Dr. Chang.

Visit here to learn more about The Institute for Lymphatic Surgery and Innovation, a division of The Institute for Advanced Reconstruction.