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Surgical Treatment of Lymphedema

Dr. Justin Sacks and the surgical team treat lymphedema in Baltimore, Maryland

Lymphedema treatment at Johns Hopkins depends on the severity and extent of the condition. At the onset of lymphedema, your doctor may recommend decongestive treatment including exercise, compression bandages, diet modifications, an arm pump, infection prevention or elevating the limb. If swelling persists, surgical intervention may be recommended. Surgical interventions to prevent and control lymphedema play an key role in improving overall function and quality of life, as there is no cure for this condition.

Surgery for lymphedema requires not just a skilled and experienced surgeon but also a team of doctors and nurses. Our medical team is devoted to providing quality and attentive patient care. From the first consultation to the final check-up, our reconstructive surgeons make themselves available and accessible to patients and their families.

Lymphedema Surgical Treatment: What You Need to Know

the lymphatic system
  • Our experts use state-of-the-art surgical lymphedema treatment approaches, including lymphovenous bypass and lymph node transfer.
  • During a lymphovenous bypass, your surgeon will use microsurgical techniques and equipment to reroute your lymphatic system, bypassing damaged nodes and connecting lymphatic channels directly into your veins.
  • With a lymph node transfer, your surgeon will transplant a group of lymph nodes from a healthy part of your body to the affected area, effectively rewiring the lymphatic system. 
  • Additional surgical treatment approaches may include tissue removal and liposuction. 
  • Our continued focus on conducting research to maximize success rates keeps our surgeons on the forefront of biomedical discovery in the field of lymphedema.

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Lymphedema Surgery | Q&A

Lymphedema is a condition most commonly caused by removal of or damage to lymph nodes during treatment for cancer. Other causes of lymphedema are congenital abnormalities and trauma. Watch as Johns Hopkins plastic and reconstructive surgeon Oluysei Aliu, M.D. discusses new surgical options for the treatment of lymphedema.

 
 

Surgical Treatment Options

Vascularized lymph node transfer surgery (lymphovenous transplant)

During this minimally invasive outpatient procedure, green dye is injected into the patient to identify functioning lymph nodes in part of the body, typically the abdomen, and transplanted into the area of the body with lymphatic obstruction. The properly functioning lymph nodes stimulate the growth of new lymph nodes. The surgical procedure takes approximately four hours and patients are usually released from the hospital within 24 hours. It is important to note that this surgery is not a cure for lymphedema, but rather an effective management tool. 

Lymphaticovenous anastomosis (also referred to as lymphovenous bypass)

Our surgeons reroute the lymphatic system directly to the venous system, bypassing the damaged nodes and connecting the lymphatic channels directly into tiny, almost microscopic veins. This is an outpatient procedure with very small and minimal incisions and very little blood loss. This procedure can significantly reduce the swelling and, in some cases, return the limb to normal function.

Other procedures that may be recommended include liposuction, where the affected tissue can be removed, or the Charles procedure, where affected tissue is removed and our surgeons use part of it as skin grafts to repair the area.

Our Surgeons

Our surgeons specialize in treating lymphedema.

Meet Our Physicians:

Photo of Dr. Oluseyi Aliu, M.D.

Aliu, Oluseyi, M.D.

Assistant Professor of Plastic and Reconstructive Surgery
 
Photo of Dr. Damon Sean Cooney, M.D., Ph.D.

Cooney, Damon Sean, M.D., Ph.D.

Assistant Professor of Plastic and Reconstructive Surgery
Clinical Director, Face Transplant Program, Johns Hopkins Comprehensive Transplant Center
Clinical Co-Director, Penile Transplantation, Johns Hopkins Comprehensive Transplant Center
 
Photo of Dr. Michele Ann Manahan, M.D.

Manahan, Michele Ann, M.D.

Associate Professor of Plastic and Reconstructive Surgery
Department Director of Patient Safety, Department of Plastic and Reconstructive Surgery
 
Photo of Dr. Gedge David Rosson, M.D.

Rosson, Gedge David, M.D.

Associate Professor of Plastic and Reconstructive Surgery
Associate Professor of Oncology
Co-Director, Johns Hopkins Facial Palsy Center
Director of Breast Reconstruction
 
Photo of Dr. Justin Michael Sacks, M.D.

Sacks, Justin Michael, M.D.

Associate Professor of Plastic and Reconstructive Surgery
Director, Oncological Reconstruction