Lymphedema Surgery

Lymphoedema is long-term swelling of an arm or leg caused by damaged or absent lymph channels, most often after cancer surgery or radiotherapy to the lymph nodes. Lymphoedema surgery includes microsurgical operations that reroute or restore lymph drainage, and liposuction that removes the solid fat that builds up in a long-standing swollen limb.

Surgery can reduce limb volume, heaviness and the number of skin infections, and may reduce reliance on compression. It is not a cure. Most patients still need compression garments afterwards, and surgery works alongside, not instead of, specialist lymphoedema therapy.

What Lymphedema Surgery involves

Assessment maps your lymph channels with ICG lymphography, in which a fluorescent dye injected between the fingers or toes is filmed with an infrared camera. In lymphaticovenous anastomosis (LVA), the surgeon makes several 2 to 3 centimetre cuts, finds working lymph vessels less than a millimetre wide and joins them to tiny nearby veins under a high-power microscope, so lymph drains straight into the bloodstream. In vascularised lymph node transfer (VLNT), a small group of nodes with its artery and vein is taken from the groin, neck, chest wall or the omentum and connected to vessels in the affected limb. For late, non-pitting swelling, circumferential liposuction removes the excess fat, followed by lifelong compression.

Who is a good candidate for Lymphedema Surgery?

Surgery is considered when swelling persists despite at least 6 months of proper compression and decongestive therapy.

• Early to moderate lymphoedema with lymph channels still visible on ICG imaging, for LVA
• More advanced disease with few working channels, for node transfer
• Firm, non-pitting swelling dominated by fat, for liposuction
• Repeated cellulitis in the swollen limb
• People committed to wearing compression and attending therapy after surgery

It is usually not the right choice if:

• Active or untreated cancer, or recurrence not yet excluded
• Swelling from heart, kidney, liver or vein disease, or lipoedema mistaken for lymphoedema
• Body mass index above about 35, which itself impairs lymph flow and worsens results
• Active skin infection or open wounds on the limb
• Anyone unwilling to continue compression

الخيارات التقنية

• Lymphaticovenous anastomosis (LVA): Supermicrosurgery through small cuts, often under local anaesthetic. Best in early stages.
• Vascularised lymph node transfer (VLNT): Brings new nodes to the limb. Effect builds over 6 to 12 months. Small risk of lymphoedema at the donor site, reduced by reverse mapping.
• Combined with breast reconstruction: Groin nodes can be transferred to the armpit together with a DIEP flap.
• Liposuction for lymphoedema: Removes fat deposits in late-stage disease. Reliable volume reduction if compression is worn continuously afterwards.
• Excisional (debulking) surgery: Removal of skin and tissue, reserved for extreme cases.

ماذا يحدث خلال علاجك

LVA takes 2 to 4 hours, often under local anaesthetic or light sedation, with 1 night in hospital or as a day case. Node transfer takes 4 to 6 hours under general anaesthetic with 3 to 5 nights in hospital and a drain at the donor site. Liposuction takes about 2 hours under general anaesthetic, and compression bandaging is applied in theatre.

الإعداد لرحلتك

Plan for 7 to 14 days in Istanbul. Your surgeon reviews photographs and your medical history before you book, and you meet in person the day before surgery for examination, marking and consent with a professional interpreter.

• Stop smoking and nicotine at least four weeks before and after surgery; it is the single biggest avoidable cause of wound problems
• Tell the team about every medicine and supplement you take; blood thinners, some herbal products and hormone treatment may need to be paused on your doctor's advice
• Arrange for someone to travel with you or to be reachable, and keep the first days at home free of work and lifting
• Book a changeable return flight; your surgeon confirms when you are fit to fly

التعافي والنتائج

After LVA the limb is raised and lightly bandaged, with compression restarted at 2 to 4 weeks. After node transfer, the flap is monitored for several days, the limb rested for 2 weeks and therapy restarted gradually. Changes in volume and softness appear over 3 to 12 months. After liposuction, made-to-measure garments are worn day and night and refitted several times as the limb shrinks. Work is usually possible after 1 to 3 weeks.

• Back to everyday activity: 1 to 3 weeks
• When results show: Gradual change over 3 to 12 months
• How long they last: Variable; compression usually continues for life

سياسة السلامة والمخاطر والتنقيح

Results vary widely and are hard to predict for an individual; ask for the unit's own measured outcomes.

• Little or no lasting reduction in swelling
• Blocked anastomoses over time after LVA
• Failure of the transferred node flap, in a small percentage
• New lymphoedema at the node donor site, uncommon with careful technique
• Wound infection, seroma or lymph leak
• After liposuction, rapid return of swelling if compression is stopped
• Numbness or scarring around the incisions

Every written proposal arranged through Clinic-Y states what the clinic covers if a correction is needed. Ask for it before you book, not after.

Cost of Lymphedema Surgery in Türkiye

Clinic-Y does not publish a single price for Lymphedema Surgery, because the honest figure depends on your case. What moves it:

• Type of operation: LVA, node transfer, liposuction or a combination
• ICG lymphography or lymphoscintigraphy beforehand
• Microsurgical theatre time and nights in hospital
• Custom compression garments, which need regular replacement
• Lymphoedema therapy sessions before and after

Send your photographs or reports and you receive written, all-inclusive proposals from suitable teams, side by side. Reviewing your case is free.

الأسئلة المتكررة