Dr Matthew Yeo, Plastic Surgeon
Lymphedema is a chronic and debilitating disease that may cause functional disability due to extremity swelling as well as potential complications including dry and cracked skin, non-healing wounds and infection. Management of advanced lymphedema cases is challenging. Conservative measures such as lymphatic massage and bandaging have limited effect and most patients require surgery. Surgical procedures may be divided into physiological procedures in which lymphatic drainage is recreated or bypassed, and resection procedures that remove the affected tissues, or a combination of both.
The modified Charles procedure is particularly useful for the treatment of advanced lower extremity lymphedema and provides definitive and long-term reduction of the excess tissue. This procedure removes all the involved subcutaneous fat and dysfunctional lymphatic tissue while preserving the underlying muscle. Because the muscles are preserved and the excess tissue weight is removed, the majority of patients experience significant functional improvement following surgery. Patients immediately experience relief of the additional weight following surgery. Patients are also free of skin infections that occur frequently in cases of chronic lymphedema. Many are happy to be able to wear normal clothing and restore their social lives that have been previously hampered by the extremity swelling. With the modified Charles procedure, there is no long-term recurrence of the lymphedema and this gives patients long-term assurance of their recovery.
