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Ultrasonographic Evaluation of Breast Cancer-related Lymphedema
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Does Liposuction for Lymphedema Worsen Lymphatic Injury?

W F Chen1, S K Pandey1, J N Lensing2

  • 1Center for Lymphedema Research and Reconstruction, Department of Plastic Surgery, Cleveland Clinic, Cleveland, OH, USA.

Lymphology
|November 29, 2023
PubMed
Summary

Liposuction for lymphedema treatment effectively reduces limb volume and improves quality of life. Objective lymphatic function assessments show no worsening, with paradoxical progressive improvement in lymph drainage post-procedure.

Keywords:
ICGindocyanine greenliposuctionlymphatic dysfunctionlymphatic injurylymphedemalymphedema debulkinglymphography

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Area of Science:

  • Plastic Surgery
  • Vascular Surgery
  • Lymphedema Management

Background:

  • Liposuction is an established treatment for lymphedema.
  • Concerns exist regarding potential lymphatic damage from liposuction.

Purpose of the Study:

  • To objectively evaluate lymphatic function before and after liposuction in lymphedema patients.
  • To assess the impact of liposuction on lymph drainage and patient outcomes.

Main Methods:

  • Prospective study of 41 patients with solid-predominant lymphedema (57 limbs).
  • Assessment included patient-reported outcomes, LYMQOL, limb measurements, and indocyanine green lymphography (ICGL).
  • Follow-up averaged 10.7 months post-liposuction and redundant skin excision.

Main Results:

  • Significant limb volume reduction (mean 32.2%) and improved LYMQOL scores.
  • No patient showed worsened lymphatic drainage on ICGL; all demonstrated improved drainage.
  • Lymphatic drainage improvement was progressive throughout the follow-up period.

Conclusions:

  • Liposuction for extremity lymphedema does not impair lymphatic function.
  • The procedure paradoxically induces progressive improvement in lymph drainage.
  • Liposuction is a safe and effective treatment option for select lymphedema patients.