Lymphatic Microsurgical Preventive Healing Approach (LYMPHA)
Featured Expert
May 26, 2026
Lymphatic microsurgical preventive healing approach (LYMPHA) is a procedure to help prevent lymphedema after breast cancer surgeries such as mastectomies or breast reconstruction.
Damon Cooney, associate professor of plastic and reconstructive surgery at Johns Hopkins Medicine, discusses this option.
Key Points
- LYMPHA is a surgery done alongside breast cancer surgery to help prevent developing lymphedema after surgery.
- The surgery is usually done using the same incision as the breast surgery, which means shorter recovery time.
- It greatly lowers lymphedema risk for people who need their axillary lymph nodes removed due to breast cancer.
- The surgeon connects lymph channels to a nearby vein so fluid can drain normally.
What is LYMPHA?
The lymphatic microsurgical preventive healing approach (LYMPHA) is a specialized, preventive microsurgery performed during breast cancer surgery to significantly lower the risk of developing lymphedema. LYMPHA is an option for patients who need an axillary lymph node dissection (ALND), which is usually required when patients have a more advanced stage breast cancer with lymph node spread. While there are treatment options for lymphedema if it develops, a preventive procedure like LYMPHA performed during breast cancer surgery reduces future lymphedema risk. The surgery is completed at the same time as the initial breast cancer surgery so there is no additional need for surgical downtime. The procedure adds about 60–90 additional minutes to the surgery.
Why might I need LYMPHA?
After breast cancer surgeries like mastectomy or breast reconstruction, it’s possible that patients can develop lymphedema, which causes swelling after lymph node removal in the armpit.
- Lymphedema risk is 30%–40% after complete axillary lymph node dissection, which is when all lymph nodes are removed from the area as opposed to single node biopsy, called sentinel lymph node dissection.
What makes the chance of developing lymphedema after breast surgery higher?
There are several factors that can make a patient’s risk of developing lymphedema after ALND higher.
These risks include:
- History of radiation or impending radiation
- Chemotherapy
- High BMI
Talk to your doctor about whether you’re a candidate for LYMPHA.
What happens during LYMPHA?
During LYMPHA surgery, your surgeon will sew the lymphatic channels into a nearby vein, thereby allowing the lymphatic fluid to drain there. This helps prevent the buildup of fluid that causes lymphedema.
This procedure is almost always performed using the same incision that the breast surgeon used to remove the lymph nodes; therefore, a second incision is usually not needed. This surgery can also be combined with the first stage of breast reconstruction surgery.
Recovery
Here is what to expect for recovery from LYMPHA. Your doctor will provide you with a personalized recovery plan.
- Wound care: Small incisions are closed with stitches or staples, usually removed in two to three weeks.
- Limb elevation: Keep the arm elevated to support lymph flow.
- Compression: Compression garments help maintain new lymphatic connections and limit swelling.
Potential Complications
- Mild swelling or discomfort is common for up to six weeks.
- Temporary nerve sensitivity around the incision is typical.
- Fluid buildup may occur.
Call your doctor immediately if you have:
- Fever
- Chills
- Signs of infection at the incision site (such as increased redness, swelling or drainage)
- Sudden rise in swelling
Is the LYMPHA procedure covered by insurance?
Not all insurance plans covers this preventive procedure. Talk to your insurance company to discuss your options.
Medically reviewed by Damon Cooney, M.D., Ph.D.
