WHAT IS Lymphedema

Lymphedema can either be congenital (primary) or a result of treatment or injury (secondary). Secondary course is the most common reason and may occur after cancer treatment of mainly breast cancer, gynecological cancer, prostate cancer, malignant melanoma or tumors in the head/throat. Lymphedema is a chronic and complex condition that has major physical, psychological and social implications for the quality of life of patients suffering from it.

Lymphedema affects millions of people worldwide. Secondary lymphedema is by far the most common reason and statistics show that one in five women who survive breast cancer will develop arm lymphedema.

Even though lymphedema is a chronic condition, it can often be managed with conservative interventions, mainly bandaging or compression garments.

For some reasons and for some patients the compression treatment is just not enough. The adipose tissue increases due to chronic inflammation and it can not be removed with compression.

But, this excess fatty tissue can be removed by liposuction.

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HARD FACTS

Lymphedema is a progressive and still incurable condition of variably painful swelling that can affect any part of the body. The swelling results from an insufficient lymphatic system and disarranged lymphatic transport and will subsequently lead to swelling of the tissues and eventually thickening of the skin and soft tissue. At a cellular level this inadequate drainage of lymph will lead to accumulation of interstitial fluid, which causes cellular proliferation and inflammation. As a result, chronic inflammation leads to dilatation and fibrosis of lymph vessels, which become incompetent with concomitant deposition of subcutaneous fat, and later fibrosis. The excess adipose tissue deposition begins either when the lymphedema becomes clinically significant or can occur within 1- 2 years.

Can Lymphedema be cured?

You might have heard or read about other surgical options and even been told that lymphedema is curable. It is not possible to cure lymphedema with any techniques known today and an easy explanation is simply that the lymphatic vessels lose their function and no surgical intervention, big or small have proven to give a long-term result.

In addition, these other surgical procedures are very expensive, and the reduced volume of the extremity comes from liposuction, that is mostly done as a supplement.

The scientific answer to the same question.

”Another treatment option in early stages of lymphedema is microsurgical reconstruction of the damaged lymphatic system, for example, lymphatico-venous or lymphaticovenous-lymphatic shunts, lymphatic node transfer and lymph vessel transplantation. However, there are few studies presenting long-term follow-up after microsurgical procedures using a standardized postoperative treatment protocol, with or without the use of compression garments. In addition, lymph stasis leads to dilatation of the lymphatics with concomitant insufficient valves and irreversible fibrosis of the smooth musculature in the vessel walls, which become rigid and lose their intrinsic contractility (lymphaticosclerosis), thus making the application of microsurgical techniques difficult.

Neither CDT (complex decongestive therapy) nor microsurgical reconstruction can be used in later stages of lymphedema as none of the techniques can remove the hypertrophied adipose tissue that occurs in response to lymph stasis and inflammation. In later stages of nonpitting lymphedema, not responding to conservative treatment, liposuction, combined with postoperative CCT, gives a complete reduction of the excess volume”

Hoffner M, Ohlin K, Svensson B, Manjer J, Hansson E, Troëng T, Brorson H. Liposuction gives complete reduction of arm lymphedema following breast cancer: A 5-years’ follow-up. Plast Reconstr Surg Glob Open 2018;6:e1912. [Epub 2018 Aug 16]

If you want to read the thesis behind our offer please follow this link:

https://lu.app.box.com/s/xlnuha286ts7bk0jfltwicq3r8j9op9k/file/21786077599

Associate Professor Håkan Brorson presents his results

Complete Reduction of Non-Pitting Lymphedema with Liposuction
– Dr. Hakan Brorson, MD, PhD.

This presentation is part of the inaugural Lymphedema Symposium at Beth Israel Deaconess Medical Center (BIDMC), a Harvard Medical School teaching hospital. This event was a two-day symposium held November 3-4 2017.

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PUBLICATIONS

Thesis: Liposuction and Controlled Compression Therapy in the Treatment of Amr Lymphedema following Breast Cancer
Author: Håkan Brorson
Publication year: 1998

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Thesis: Liposuction of lymphedema: Treatment strategy,
pathophysiology and long-term outcome

Author: Mattias Hoffner
Publication year: 2018 

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Liposuction in Lymphedema Treatment
Author: Håkan Brorson
Publication year: 2016 

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Detailed information about the procedure
Author: Håkan Brorson et al.

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