OVERVIEW

Many women (and some men), who have had breast cancer surgery, are at a higher risk of developing post-mastectomy lymphedema at any age after breast removal. When the lymph nodes are removed or damaged during breast cancer surgery, it can cause this painful condition where there is excessive fluid buildup. If the lymph nodes are not properly functioning or are absent, the lymph fluid will not properly drain, causing swelling, redness, and pain. There are only a handful of plastic surgeons in the nation that will perform surgical treatment of post-mastectomy lymphedema. At Elite Plastic Surgery in Phoenix and Scottsdale, AZ, our plastic and reconstructive surgeon, Torabi, provide this superfine microsurgical reconstruction needed to control this condition.

If conservative, noninvasive treatments, such as compression garments, manual lymphatic drainage massage, and pneumatic pump therapy are all unsuccessful, and our patient continues to get skin infections, has discomfort, and chronic swelling, we will suggest a lymphaticovenous bypass (LVB), or a vascularized lymph node transfer (VLNT). If it is determined that the patient is not a suitable candidate for LVB or VLNT, liposuction can be implemented on the affected extremity, which provides significant improvement in certain patients.

SURGICAL TECHNIQUES

Our plastic surgeons will first want to perform pre-operative imaging to see if the damaged lymphatics are in the axilla (underarm), or more further along in the arm. Depending on where the obstruction is, the plastic surgeon may do a lymphaticovenous bypass (LVB), or vascularized lymph node transfer, or a combination of both. The average procedure time is 4 – 8 hours in the operating room.

LVB

A lymphaticovenous bypass (LVB) is a special microsurgery, which involves creating a new channel for lymphatic fluid to drain through the veins.

VLNT

The vascularized lymph node transfer (VLNT) involves moving lymph nodes from one area of the body to the affected lymphedema area so that it can help process and drain lymphatic fluids.

Delayed Breast Reconstruction

If the patient has already had the mastectomy without breast reconstruction (which called a delayed breast reconstruction), and the patient has lymphedema in missing breast, our plastic surgeons will recommend transferring the lymph nodes together with an autologous tissue flap reconstruction.

Liposuction

If all of the lymph nodes are damaged or are not appropriate for transfer, our plastic surgeon will recommend treating the area with liposuction.

IN RECOVERY

In the recovery room, our post-operation nurses will monitor your progress, help manage your pain, and care for your incisions. Our plastic and reconstructive surgeons will send you home with after-care instructions. The estimated recovery time is 1 – 3 weeks.

FOLLOW-UP & CONSIDERATION

We will want to see you in our office in 1 week after the surgery. If at any time you feel like you have an infection, complication in your incision area, high fever, excessive fluid build-up, or you cannot manage your level of pain, please call our office to be seen by our medical staff.

RELIEVE THE SYMPTOMS

When compression garments, manual lymphatic drainage massage, and pneumatic pump therapy give no alleviation to your chronic, post-mastectomy lymphedema, it may be time to see a plastic surgeon, who has the special skills in microsurgery to assess your need for an invasive intervention. If you would like more information, please call and schedule a consultation with our front office staff today.