Surgical Treatment

After evaluating your lymphedema, surgery may be recommended by your physician. They will decide on the most suitable treatment plan for you, sometimes employing a combination of treatments.

Surgical Options

Preventative Lymphatic Bypass

Preventative lymphatic bypass or immediate lymphatic reconstruction, is a new way of treatment in breast cancer related lymphedema. During the removal of breast cancer and axillary clearance, this surgery can be performed to reduce the risk of developing lymphedema. This can be performed either as Lymphatic Microsurgical Preventative Healing Approach (LYMPHA) in the axilla, or Distally-based Lymphatic Microsurgical Preventative Healing Approach (dLYMPHA) in the upper limb. In a chronic disease such as lymphedema, prevention is often better than cure.

Lymphovenous Bypass (LVB)

LVB is recommended to treat early stage lymphedema where swelling is predominantly caused by fluid accumulation. LVB is a minimally invasive procedure done under microscopic magnification. Lymphatic vessels in the body are connected to small veins nearby, allowing excess lymphatic fluid to drain directly into the vein and return to the body’s natural circulation. In most cases, immediate results are observed following surgery. It can be performed under local anaesthesia during which you can watch the procedure on a TV screen. It may also be used in combination with other treatments.

1-LVBP-high-res

Vascularised Lymph Node Transfer

Lymph node transfer is useful in patients whose native lymph nodes have been removed due to cancer treatment or whose conditions do not improve significantly after lymphovenous bypass. This procedure involves harvesting lymph nodes from the neck or groin region and transplanting them to the affected area with their blood supply intact. With time, new lymphatic channels grow from the transplanted lymph nodes, to effect lymphatic drainage. It may take up to 2 years for the function of transplanted lymph nodes to take effect.

Liposuction

Liposuction is indicated in patients who show extensive fat accumulation in the affected limb. When lymphatic fluid spills over to surrounding tissue, it can cause inflammation and stimulate the growth of fat cells which present as fat accumulation in the limb. You may have non-pitting edema where it is difficult to press the tissue to create a dent. Magnetic resonance imaging can be used to study the fat content and distribution in the affected limb. Liposuction helps to remove this excess fat to achieve a more complete reduction in limb volume. If you are obese, we recommend weight reduction through exercise and dieting as part of the overall lymphedema treatment.

Charles’ Procedure

Charles’ procedure consists of a radical excision of lymphedematous tissue followed by skin grafting. This procedure is reserved for late stage lymphedema where conservative measures no longer work. In late stage lymphedema, the soft tissue has undergone extensive fibrotic changes. Surgery will be able to significantly reduce the limb volume and remove warty skin overgrowths prone to infection and skin breakdown.

Messages from Members and Clinical Professionals

Twenty percent of patients who undergo axillary lymph node clearance develop lymphedema, which is a chronic and ....


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Dr. Jolie Hwee
Dr. Jolie Hwee Consultant Plastic Surgeon
Lymphedema is an often misunderstood disease that causes much untold suffering and morbidity to our patients.


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Dr. Chong Tze Tec
Dr. Chong Tze TecVascular Surgeon
Lymphedema is a debilitating condition that requires multi-disciplinary care. This society would bring together healthcare and allied health professionals interested in this area to provide the best possible care for lymphedema patients.
Dr. Ong Yee Siang
Dr. Ong Yee SiangPlastic Surgeon
Vascularized Lymph Node Transfer is one of the most advanced techniques we have in the treatment...


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Dr. Adrian Ooi
Dr. Adrian OoiPlastic Surgeon
Lymphedema is now the next frontier for microsurgery. Using supermicrosurgery techniques, previously unsolvable problems like lymphedema can now be treated with elegant solutions like lymphatic bypass and lymph node transfers.
Dr. Allen Wong
Dr. Allen WongPlastic Surgeon
Detect breast cancer early to avoid the risk of breast cancer related arm lymphedema.




Dr. Lim Geok Hoon
Dr. Lim Geok HoonBreast Surgeon
There is still so much unknown about lymphedema. Some shy away from the unknown. But this is an exciting area for basic science and clinical research.



Dr. Pearlie Tan
Dr. Pearlie TanPlastic Surgeon
Through a multi-disciplinary team approach we can effectively identify, control and treat lymphedema . Early intervention ensures that maximum limb function is preserved.

Dr. Jeremy Sun
Dr. Jeremy SunPlastic Surgeon
Lymphedema is a chronic and debilitating disease that may cause functional disability...


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Dr. Matthew Yeo
Dr. Matthew YeoPlastic Surgeon
Lymphedema, albeit not a fatal condition can be very debilitating and exacts a huge toll on our patients. Advances in lymphedema surgery enables us to gives these patients an improvement in their quality of life.
Dr. Terence Goh
Dr. Terence GohPlastic Surgeon
Through patient education and close collaboration between plastic surgeons, breast surgeons and physiotherapists, swelling of the arms which may arise from breast cancer treatment can be effectively treated to improve patients' quality of life.
Dr. Pek Wan Sze
Dr. Pek Wan SzePlastic Surgeon
In the past, lymphedema was often considered untreatable. Disease progression led to long-term physical and psychosocial consequences for the patient. .

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Dr Jonah Kua
Dr Jonah KuaPlastic Surgeon
All stages of lymphedema can be managed safely and effectively to improve the patients' quality of life.
Dr. Feng Jia Jun
Dr. Feng Jia JunPlastic Surgeon