Benefits of Additional Liposuction in Lymphatic Reconstructive Surgery

The goal of this study was to examine the benefits of immediate adjunctive liposuction in patients undergoing lymphatic reconstructive surgery with a focus on complications, limb volume, and patient-reported outcome measurements (PROMs).

We conducted a single-center prospective study on patients receiving reconstructive lymphatic surgery at the Department of Plastic Surgery and Hand Surgery of the University Hospital Zurich. Besides patients characteristics and operation details, volume measurements and PROMs were assessed pre- and postoperatively.

We included 73 patients with upper extremity lymphedema (UEL) or lower extremity lymphedema (LEL). A total of 41 patients received lymphatic reconstruction only, while in 32 patients, an additional liposuction in case of fat accumulation was performed. Mean percentage volume reduction for all limbs was -10.1% (±10.0%) in UEL and -9.3% (±6.9%) in LEL. Volume reduction in the additional liposuction group was not statistically different from reconstruction only. Although patients with liposuction had a significantly lower hemoglobin postoperatively (p = 0.03), there was no difference in length of rehabilitation. Regardless of the surgical technique, PROMs confirmed improvements in a broad range of different domains.

Combining reconstructive lymphatic surgery with immediate liposuction is effective for patients with a significant lymphedema-associated fat accumulation without increasing postoperative complications.