LYMPHEDEMA – LIPEDEMA

Lymphedema

Lymphedema is an abnormal accumulation of fluid in tissues, typically at the upper or the lower limb.

This may be the result of surgery (especially in the context of cancer treatments), radiation therapy, trauma, etc.

Up to 50% of patients treated for breast cancer develop lymphedema of the upper limb (after radiotherapy, sentinel node sampling or axillary dissection). Problems often arise some time (sometimes years) after primary treatment for breast cancer. Functional disability and the high risk of infection (lymphangitis) are the main effects of lymphedema, and so sometimes a serious consequence of breast cancer treatment.

There are three possible treatments for lymphedema: transplantation of lymph nodes, the lympho-venous anastomosis and liposuction.

During the transfer of the lymph nodes of the same patient healthy nodes (groin) are transplanted microsurgically to the affected area (e.g., armpit). This procedure is performed under general anesthesia and can be performed in combination with a breast reconstruction.

In lympho-venous anastomosis creating a short circuit between the lymphatic and venous system via small incisions in the skin.

Liposuction is a treatment for the advanced stages of lymphedema and is reserved only for edema unresponsive to other treatments.

After these procedures, patients must follow a rehabilitation program, where the physiotherapist plays a major role.

It is important to intervene during the first year, before the fibrosis stage sets. Acting early to edema stages guarantees the best results.

This procedure is performed under general anesthesia and lasts three hours.

During your consultation, you will discuss with your surgeon surgical treatment options. The necessary preoperative investigations are talked about at that time. The discomfort and possible complications are discussed with you during this consultation.

Lipedema

Lipoedema is a hyperplasia of fat cells under the skin that gives a ‘fat legs’ appearance with a visible disproportion between the lower limbs and the rest of the body. This problem is seen in almost 10% of the female population and is often misunderstood thinking the patient has a problem of obesity or lymphedema.   Initially often aesthetic complaints that quickly become functional problems with severe pain in the affected limbs , blue bruising at the slightest trauma and if not treated lymphedema may appear on the long run.   Lipoedema typically does not respond to diets and sports. The cause is not known but a hormonal role is suspected in view of the aggravation of the problems following puberty, pregnancies, and menopause.   The basic treatment consists of manual drainage and the wearing of compression stockings, but often a surgical treatment which constitutes a liposuction / lymphologic liposculpture of the affected limb is necessary (special technique for the pathology).