Lymphedema Treatment in Chicago
Loren S. Schechter, M.D. Plastic Surgery’s goal is to provide the highest quality care to patients with lymphedema, through a multidisciplinary approach including medical and rehabilitation specialists, oncologists, surgical oncologists, physiotherapists and plastic surgeons. We utilize the latest technologies including super-microsurgical techniques to reconstruct the lymphatic system and to advance the field of lymphedema through research and innovation.
What is Lymphedema and Symptoms
Lymphedema is a chronic progressive disease with various etiologies that can have severe functional impact on patients and affect their quality of life.
Lymphedema can occur when normal lymphatic flow is interrupted by cancer, surgery, radiation, trauma, infection or since birth. This leads to swelling of the affected area from retention of protein-rich lymphatic fluid within the tissues and can lead to fibrosis of the tissues and lymphatic channels. Specifically the removal of lymph nodes for cancer treatment in combination with radiation therapy can increase the risk of developing lymphedema. Patients often experience swelling, a feeling of heaviness, pain and recurrent infections of the affected limb, which can be quite debilitating.
Prevention and Treatment of Lymphedema
Our approach focuses on strategies for prevention, early intervention and treatment of lymphedema. Our prevention strategies involve the use of reverse lymphatic mapping and specialized imaging techniques during oncologic lymph node dissections to reduce the risk of lymphedema. In cases where lymphedema develops, the key is early recognition and immediate treatment by our specialized certified lymphedema therapists. This involves complete decongestive therapy (CDT), consisting of manual lymphatic massage, compression bandaging, therapeutic exercise and skin care. Intermittent pneumatic compression therapy (IPC) can further control and reduce symptoms.
Surgical Treatment Options for Lymphedema
As an adjunct to conservative lymphedema therapy we offer reconstruction of the lymphatic system using microsurgical and super-microsurgical techniques.
Patients undergo a thorough pre-operative evaluation including a detailed history and physical exam, circumferential limb measurements, volumetric limb measurements, evaluation by a lymphedema therapist and radiologic testing to determine the best surgical approach.
The surgical options include vascularized lymph node transfer, lympho-venula anastomosis (LVA), lympho-lymphatic bypass, lympholiposuction and ablative approaches.
Vascularized lymph node transfer involves the transplantation of a few lymph nodes with their vasculature from a donor site to the affected area to reestablish lymphatic function. This can be done as a lymph node transfer alone or in combination with additional vascularized tissues such as the deep inferior epigastric perforator (DIEP) free flap for breast reconstruction.
The lympho-venular anastomosis, or bypass surgery, visualizes dilated lymphatic channels and connects them to very small veins (venulas) to offload the diseased lymphatic system and improve lymphatic drainage. The vessels connected are less than 1mm in size and super-microsurgical techniques have to be used.
The lympho-lymphatic bypass procedure uses lymphatic collectors from a leg donor site and transplants them to the affected limb to bypass the area of removed or diseased lymph nodes and drain the lymphatic fluid back into the system.
Lympholiposuction is a volume reduction technique somewhat similar to liposuction, which does not restore any lymphatic function but can serve as an adjunct to reduce volume in refractory cases.
Ablative procedures involve resection of lymphedematous tissues and grafting of the area. This is a last resort approach in extreme cases.
Schedule An Appointment
At Loren S. Schechter, M.D. Plastic Surgery, we provide the most advanced surgical and non-surgical treatment options for our patients through a patient centered, customized approach in the comfort of a community setting.
For a consultation please contact our office at 847 967 5122 or fill out a confidential contact form below.