Skip to main content
SpringerLink
Log in

Suction-Assisted Lipectomy

  • Chapter
Lymphedema

  • 2793 Accesses

Abstract

The various types of treatment of lymphedema are under discussion, and there has been some controversy regarding liposuction for lymphedema. Although it is clear that conservative therapies such as complex decongestive therapy (CDT) and controlled compression therapy (CCT) should be tried in the first instance, options for the treatment of late-stage lymphedema that is not responding to such treatment is not so clear. Improvements in technique, patient preparation, and patient follow-up have led to a greater and a wider acceptance of liposuction as a treatment for lymphedema. This chapter outlines the benefits of using liposuction and presents the evidence to support its use.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 79.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 99.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 129.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Brorson H, Ohlin K, Olsson G, Svensson B. Liposuction of leg lymphedema: preliminary 2 year results. Lymphology. 2007;40(Suppl):250–2.

    Google Scholar 

  2. Brorson H, Ohlin K, Olsson G, Svensson B. Long term cosmetic and functional results following liposuction for arm lymphedema: an eleven year study. Lymphology. 2007;40(Suppl):253–5.

    Google Scholar 

  3. Segerstrom K, Bjerle P, Graffman S, Nystrom A. Factors that influence the incidence of brachial oedema after treatment of breast cancer. Scand J Plast Reconstr Surg Hand Surg. 1992;26(2):223–7.

    Article  CAS  PubMed  Google Scholar 

  4. Petrek JA, Senie RT, Peters M, Rosen PP. Lymphedema in a cohort of breast carcinoma survivors 20 years after diagnosis. Cancer. 2001;92(6):1368–77.

    Article  CAS  PubMed  Google Scholar 

  5. Mansel RE, Fallowfield L, Kissin M, Goyal A, Newcombe RG, Dixon JM, et al. Randomized multicenter trial of sentinel node biopsy versus standard axillary treatment in operable breast cancer: the ALMANAC Trial. J Natl Cancer Inst. 2006;98(9):599–609.

    Article  PubMed  Google Scholar 

  6. Olszewski WL. Lymph stasis: pathophysiology, diagnosis and treatment. 1st ed. Boca Raton: CRC; 1991. p. 648.

    Google Scholar 

  7. Johansson K, Piller N. Weight-bearing exercise and its impact on arm lymphoedema. J Lymphoedema. 2007;2(1):15–22.

    Google Scholar 

  8. Ridner SH. Quality of life and a symptom cluster associated with breast cancer treatment-related lymphedema. Support Care Cancer. 2005;13(11):904–11.

    Article  PubMed  Google Scholar 

  9. Piller NB, Thelander A. Treatment of chronic postmastectomy lymphedema with low level laser therapy: a 2.5 year follow-up. Lymphology. 1998;31(2):74–86.

    CAS  PubMed  Google Scholar 

  10. Brorson H, Ohlin K, Olsson G, Långström G, Wiklund I, Svensson H. Quality of life following liposuction and conservative treatment of arm lymphedema. Lymphology. 2006;39(1):8–25.

    CAS  PubMed  Google Scholar 

  11. Brorson H, Svensson H. Complete reduction of lymphoedema of the arm by liposuction after breast cancer. Scand J Plast Reconstr Surg Hand Surg. 1997;31(2):137–43.

    Article  CAS  PubMed  Google Scholar 

  12. Brorson H, Svensson H. Liposuction combined with controlled compression therapy reduces arm lymphedema more effectively than controlled compression therapy alone. Plast Reconstr Surg. 1998;102(4):1058–67. discussion 68.

    Article  CAS  PubMed  Google Scholar 

  13. Rockson SG, Miller LT, Senie R, Brennan MJ, Casley-Smith JR, Foldi E, et al. American Cancer Society Lymphedema Workshop. Workgroup III: diagnosis and management of lymphedema. Cancer. 1998;83(12):2882–5.

    Article  CAS  PubMed  Google Scholar 

  14. Ryan TJ. Lymphatics and adipose tissue. Clin Dermatol. 1995;13(5):493–8.

    Article  CAS  PubMed  Google Scholar 

  15. Sadler D, Mattacks CA, Pond CM. Changes in adipocytes and dendritic cells in lymph node containing adipose depots during and after many weeks of mild inflammation. J Anat. 2005;207(6):769–81.

    Article  PubMed Central  PubMed  Google Scholar 

  16. Pond CM. Adipose tissue and the immune system. Prostaglandins Leukot Essent Fatty Acids. 2005;73(1):17–30.

    Article  CAS  PubMed  Google Scholar 

  17. Borley NR, Mortensen NJ, Jewell DP, Warren BF. The relationship between inflammatory and serosal connective tissue changes in ileal Crohn’s disease: evidence for a possible causative link. J Pathol. 2000;190(2):196–202.

    Article  CAS  PubMed  Google Scholar 

  18. Harvey NL, Srinivasan RS, Dillard ME, Johnson NC, Witte MH, Boyd K, et al. Lymphatic vascular defects promoted by Prox1 haploinsufficiency cause adult-onset obesity. Nat Genet. 2005;37(10):1072–81.

    Article  CAS  PubMed  Google Scholar 

  19. Schneider M, Conway EM, Carmeliet P. Lymph makes you fat. Nat Genet. 2005;37(10):1023–4.

    Article  CAS  PubMed  Google Scholar 

  20. Brorson H, Åberg M, Svensson H. Chronic lymphedema and adipocyte proliferation: clinical therapeutic implications. Lymphology. 2004;37(Suppl):153–5.

    Google Scholar 

  21. Damstra RJ, Voesten HG, Klinkert P, Brorson H. Circumferential suction-assisted lipectomy for lymphoedema after surgery for breast cancer. Br J Surg. 2009;96(8):859–64.

    Article  CAS  PubMed  Google Scholar 

  22. Schaverien MV, Munro KJ, Baker PA, Munnoch DA. Liposuction for chronic lymphoedema of the upper limb: 5 years of experience. J Plast Reconstr Aesthet Surg. 2012;65(7):935–42.

    Article  PubMed  Google Scholar 

  23. Brorson H, Ohlin K, Olsson G, Karlsson MK. Breast cancer-related chronic arm lymphedema is associated with excess adipose and muscle tissue. Lymphat Res Biol. 2009;7(1):3–10.

    Article  PubMed  Google Scholar 

  24. Brorson H, Ohlin K, Olsson G, Nilsson M. Adipose tissue dominates chronic arm lymphedema following breast cancer: an analysis using volume rendered CT images. Lymphat Res Biol. 2006;4(4):199–210.

    Article  PubMed  Google Scholar 

  25. Bagheri S, Ohlin K, Olsson G, Brorson H. Tissue tonometry before and after liposuction of arm lymphedema following breast cancer. Lymphat Res Biol. 2005;3(2):66–80.

    Article  PubMed  Google Scholar 

  26. Jones B, Fishman EK, Hamilton SR, Rubesin SE, Bayless TM, Cameron JC, et al. Submucosal accumulation of fat in inflammatory bowel disease: CT/pathologic correlation. J Comput Assist Tomogr. 1986;10:759–63.

    Article  CAS  PubMed  Google Scholar 

  27. Sheehan AL, Warren BF, Gear MW, Shepherd NA. Fat-wrapping in Crohn’s disease: pathological basis and relevance to surgical practice. Br J Surg. 1992;79(9):955–8.

    Article  CAS  PubMed  Google Scholar 

  28. Lantz M, Vondrichova T, Parikh H, Frenander C, Ridderstrale M, Asman P, et al. Overexpression of immediate early genes in active Graves’ ophthalmopathy. J Clin Endocrinol Metab. 2005;90(8):4784–91.

    Article  CAS  PubMed  Google Scholar 

  29. Zampell JC, Aschen S, Weitman ES, Yan A, Elhadad S, De Brot M, et al. Regulation of adipogenesis by lymphatic fluid stasis: part I. Adipogenesis, fibrosis, and inflammation. Plast Reconstr Surg. 2012;129(4):825–34.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  30. Aschen S, Zampell JC, Elhadad S, Weitman E, De Brot M, Mehrara BJ. Regulation of adipogenesis by lymphatic fluid stasis: part II. Expression of adipose differentiation genes. Plast Reconstr Surg. 2012;129(4):838–47.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  31. Damstra RJ, Voesten HG, van Schelven WD, van der Lei B. Lymphatic venous anastomosis (LVA) for treatment of secondary arm lymphedema. A prospective study of 11 LVA procedures in 10 patients with breast cancer related lymphedema and a critical review of the literature. Breast Cancer Res Treat. 2009;113(2):199–206.

    Article  CAS  PubMed  Google Scholar 

  32. Campisi C, Bellini C, Campisi C, Accogli S, Bonioli E, Boccardo F. Microsurgery for lymphedema: clinical research and long-term results. Microsurgery. 2010;30(4):256–60.

    PubMed  Google Scholar 

  33. Maegawa J, Hosono M, Tomoeda H, Tosaki A, Kobayashi S, Iwai T. Net effect of lymphaticovenous anastomosis on volume reduction of peripheral lymphoedema after complex decongestive physiotherapy. Eur J Vasc Endovasc Surg. 2012;43(5):602–8.

    Article  CAS  PubMed  Google Scholar 

  34. Brorson H, Svensson H, Norrgren K, Thorsson O. Liposuction reduces arm lymphedema without significantly altering the already impaired lymph transport. Lymphology. 1998;31(4):156–72.

    CAS  PubMed  Google Scholar 

  35. Brorson H. From lymph to fat: liposuction as a treatment for complete reduction of lymphedema. Int J Low Extrem Wounds. 2012;11(1):10–9.

    Article  PubMed  Google Scholar 

  36. Brorson H, Ohlin K, Olsson G, Svensson B, Svensson H. Controlled compression and liposuction treatment for lower extremity lymphedema. Lymphology. 2008;41(2):52–63.

    CAS  PubMed  Google Scholar 

  37. Brorson HFC, Ohlin K, Svensson B, Åberg M, Svensson H. Liposuction normalizes elephantiasis of the leg—a prospective study with an eight-year follow-up. Lymphology. 2012;45(Suppl):292–5.

    Google Scholar 

  38. Clayton DN, Clayton JN, Lindley TS, Clayton JL. Large volume lipoplasty. Clin Plast Surg. 1989;16(2):305–12.

    CAS  PubMed  Google Scholar 

  39. Klein JA. The tumescent technique for lipo-suction surgery. Am J Cosmet Surg. 1987;4(4):263–7.

    Google Scholar 

  40. Wojnikow S, Malm J, Brorson H. Use of a tourniquet with and without adrenaline reduces blood loss during liposuction for lymphoedema of the arm. Scand J Plast Reconstr Surg Hand Surg. 2007;43(5):1–7.

    Google Scholar 

  41. Baumeister RG, Siuda S. Treatment of lymphedemas by microsurgical lymphatic grafting: what is proved? Plast Reconstr Surg. 1990;85(1):64–74. discussion 5–6.

    Article  CAS  PubMed  Google Scholar 

  42. Andersen L, Hojris I, Erlandsen M, Andersen J. Treatment of breast-cancer-related lymphedema with or without manual lymphatic drainage—a randomized study. Acta Oncol. 2000;39(3):399–405.

    Article  CAS  PubMed  Google Scholar 

  43. Campisi C, Davini D, Bellini C, Taddei G, Villa G, Fulcheri E, et al. Lymphatic microsurgery for the treatment of lymphedema. Microsurgery. 2006;26(1):65–9.

    Article  CAS  PubMed  Google Scholar 

  44. Baumeister RG, Frick A. [The microsurgical lymph vessel transplantation]. Handchir Mikrochir Plast Chir. 2003;35(4):202–9.

    Article  CAS  PubMed  Google Scholar 

  45. Brorson H. Liposuction in arm lymphedema treatment. Scand J Surg. 2003;92(4):287–95.

    CAS  PubMed  Google Scholar 

  46. Brorson H, Svensson H. Skin blood flow of the lymphedematous arm before and after liposuction. Lymphology. 1997;30(4):165–72.

    CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. The Lymphedema Unit, Department of Clinical Sciences, Lund University, Plastic and Reconstructive Surgery, Jan Waldenströms gata 18, 2nd floor, Skåne University Hospital, SE-205 02, Malmo, Sweden

    Håkan Brorson M.D., Ph.D., Barbro Svensson B.S., P.T., L.T. & Karin Ohlin B.S., O.T.

Authors
  1. Håkan Brorson M.D., Ph.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Barbro Svensson B.S., P.T., L.T.
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Karin Ohlin B.S., O.T.
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Håkan Brorson M.D., Ph.D. .

Editor information

Editors and Affiliations

  1. Department of Plastic and Oral Surgery, Boston Children’s Hospital, Boston, Massachusetts, USA

    Arin K. Greene

  2. Division of Plastic Surgery, Beth Israel Deaconess Medical Center, Brookline, Massachusetts, USA

    Sumner A. Slavin

  3. Plastic and Reconstructive Surgery, Skåne University Hospital, Malmö, Sweden

    Håkan Brorson

Rights and permissions

Reprints and permissions

Copyright information

© 2015 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Brorson, H., Svensson, B., Ohlin, K. (2015). Suction-Assisted Lipectomy. In: Greene, A., Slavin, S., Brorson, H. (eds) Lymphedema. Springer, Cham. https://doi.org/10.1007/978-3-319-14493-1_28

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-14493-1_28

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-14492-4

  • Online ISBN: 978-3-319-14493-1

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation