I’ve talk a bit about what a plastic surgeon actually does in a previous Sorta Random Sunday post. Included in that recap, I mentioned doing surgery to treat lymphedema.
Since moving to Buffalo after my training in NYC, treating lymphedema with surgery has actually become a pretty big part of my practice.
And honestly, most people are not even aware of lymphedema. Or if they are aware, they really don’t quite understand what it is or what happens when someone has lymphedema.
Well, March is Lymphedema Awareness Month so I thought I’d talk a little bit about it!
What is lymphedema?
Everyone has lymph channels in their body. Their job is to remove extra fluid from places like the arms and legs and bring lymph nodes. Eventually, this extra fluid makes it back to the heart. The heart then circulates the fluid with blood, etc.
Lymphedema results when there is damage to these lymph channels or lymph nodes. The extra fluid then gets backed up and has no where to go. So the area with damage gets extremely swollen.
What causes lymphedema?
A lot of things.
In the world, the most common causes are certain types of parasitic infections.
In the US, these infections are rare. The most common causes include surgery, including especially surgery to remove lymph nodes for cancer, and radiation.
Lymphedema can also be congenital, meaning that you are born with it. But that’s more rare.
What’s the big deal?
Ok, so if you get lymphedema, your leg or arm or what have you gets swollen. Well, that’s uncomfortable enough by itself. Clothes don’t fit. The area gets heavy and sore and painful. Activities are limited. Oh yeah, and you probably don’t love the way it looks. Plus you can get infection and in very rare cases, it can even devolve into cancer.
So, it’s a big deal.
How can you treat lymphedema?
The first step is usually physical therapy, compression, and massage garments. This can help limit the progression of lymphedema. In some early cases, it can reverse the course of disease.
In cases where this doesn’t work, it kind of used to be the end of the road.
However, we now have surgery that can help treat and really fix this disease!
So what kinds of surgery can help improve lymphedema?
There are two main varieties: lymphovenous bypass and vascularized lymph node transfer.
In lymphovenous bypass, we take the damaged lymph channel and connect it to a nearby vein. This bypasses the blockage and provides the extra fluid with a “detour” route back to the lymph nodes and heart. We do this all under a microscope at 40X magnification! This option works when the lymph channels are partially functional.
If the lymph channels are completely non-functional, then we have to bring in new lymph nodes. So, we borrow lymph nodes from somewhere else in the body and transplant them to the area that needs them. I usually take lymph nodes from within the belly. This is called a vascularized lymph node transfer which will stimulate new lymph channels and help soak up the extra fluid.
So, there is always hope!
Many people with lymphedema can start to feel hopeless as this is a difficult thing to treat. However, we continue learning more about the disease and are getting better and better at helping improve outcomes.
I really enjoy these procedures and get immense satisfaction from helping patients with lymphedema! And I’m excited to see what more we learn over my career!
What do you think? Have you ever heard of lymphedema? What do you love to do at your job? Have any ideas for another Sorta Random Sunday post? Let me know!