Liposuction for Advanced Lymphedema in a Multidisciplinary Team Setting in Australia: 5-Year Follow-Up

Area of Science:

• Plastic Surgery
• Lymphedema Management
• Adipose Tissue Research

Background:

• Liposuction is an established surgical treatment for International Society of Lymphology late stage 2 or 3 limb lymphedema.
• It targets excessive adipose tissue deposition and has been utilized in Australia since 2012.

Purpose of the Study:

• To evaluate the 5-year outcomes of suction-assisted lipectomy for advanced limb lymphedema.
• To assess the long-term efficacy of this surgical intervention in managing lymphedema volume.

Main Methods:

• A prospective study involving 59 patients with unilateral primary or secondary arm or leg lymphedema.
• Patients underwent suction-assisted lipectomy following the Brorson protocol, with a 5-year follow-up period.

Main Results:

• Arm lymphedema showed significant and sustained volume reduction: 1061 mL pre-op to 22 mL at 5 years.
• Leg lymphedema volume reduced from 3447 mL to 263 mL at 1 year, but increased to 669 mL by 5 years.
• The majority of participants (92%) were women, with 51% having leg and 49% arm lymphedema.

Conclusions:

• Suction-assisted lipectomy is a viable long-term management option for select patients with stage 2 or 3 limb lymphedema.
• It is particularly effective for arm lymphedema, offering sustained volume reduction.
• For leg lymphedema, while initial results are positive, long-term volume may increase, requiring careful patient selection.