Liposuction for Lymphoedema

What is liposuction for lymphoedema?
Liposuction is a surgical procedure for removing fat. In patients with longstanding lymphoedema there are often fatty changes in the limb, which become resistant to compression garments and manual lymphatic drainage. Liposuction can remove these fatty deposits permanently. When performed alone, liposuction will result in immediate reduction in the size of the limb. However it is essential that you continue to wear compression garments, as the limb will swell again if compression is not maintained. For patients who have had a lymph node transfer then liposuction is an adjunctive procedure to achieve a final contour. It is possible that compression garments will not be required if the lymph nodes are fully functioning and have resolved the lymphoedema. The assessment of a lymphoedema nurse is essential to the process.

What does the surgery involve?

Suction-assisted liposuction involves the use of a cannula (a thin, hollow tube) to manually loosen and remove fat to create a nicer shape. The cannula is inserted through tiny incisions in the skin and suction is applied to remove fat from the body.

It takes between two to three hours to perform liposuction depending on the size of the treatment area. The tiny incisions are closed with a small dissolvable stitch and a waterproof plaster applied. You will need regular review by a lymphoedema nurse to ensure that the compression is maintained as the size of your limb reduces.

Liposuction procedures for lymphoedema are generally carried out under general anaesthetic where you are fully asleep.

The area where the fat is removed is tender and aching. You will be able to mobilise the next day and will be given regular painkillers. An overnight – 2 nights stay is often necessary with lymphoedema nurse review to adjust your compression as necessary.

What are the risks and side effects of surgery?

Having lymphoedema surgery can be a very positive experience. Complications are infrequent and usually minor. However, no surgery is without risk and it is important that you are given a clear picture.

Scar – scars are very small and hidden in a skin crease. They should be barely perceptible. However some people heal with thick scars and this can make them more noticeable.

Bruising and swelling – this is very common and bruising may take a couple of weeks to settle.

Infection – is not common but may require a course of antibiotics. You will be given a course of prophylactic antibiotics to cover you during the healing process.

Contour irregularities – it is possible to have indentations or loose skin following this procedure. Massaging should resolve this but occasional further surgery may be required to correct this.

DVT/PE/fat embolus – following any surgical procedure it is possible to develop a blood clot in your legs, which could potentially break off and move to your lungs. If the blood clot is large enough it could prove fatal. In order to reduce any risks of this we give you special stockings to wear in bed and a blood thinning injection if you are not mobile.

Further liposuction – this may be necessary to give the desired result, as only a certain amount of fat can be removed at one operation. Most patients will only need one session. However, if you require more liposuction then a second procedure gives the flexibility to add this.

All the risks will be discussed in detail at your consultation. However, if you have further questions or concerns, do not hesitate to discuss these with your surgeon.

What happens after the operation?

At the end of the procedure, a compression garment will be applied to the area to help the skin conform to the new shape and to reduce any lymphoedema. You will be fitted for these using measurements of your normal limb. Our lymphoedema nurse will ensure you have the correct amount of compression.

As long as you are feeling well after the operation, you will be able to go home the same day or the following day. You will not be able to drive yourself home from hospital and ideally, you should have someone to stay with you for a few days to lend a hand.

Before you leave the hospital, a follow up appointment will be booked with the nurse for 1 week and an appointment with me for 6 weeks or sooner should you have any problems.

What is the estimated time for recovery, absence from work and return to usual activities?

Recovery times vary from person to person but most patients take 1-2 weeks off work. You can drive after 1-2 weeks and can return to normal activities by 4 weeks. If you have any concerns during this period, do contact the hospital team for advice.