Vascular Lymph Node Transfer
Vascular lymph node transfer is a surgery to help cure lymphedema, a condition that can be caused by different treatments for breast cancer, namely axillary node dissections (removing lymph nodes from the armpit that may be cancerous) and radiation therapy (sometimes used to kill cancer cells in the armpit.)
Lymphatic vessels carry fluid from the arm to the “filters” of the body called “lymph nodes.” When these lymphatic vessels are disrupted (either by surgery or radiation), the fluid sometimes doesn’t have anywhere to drain. This removal or disruption of the lymph nodes can cause scar tissue that compresses nerves and vessels in the area, which may result in symptoms of pain, numbness, swelling, heaviness, weakness, and overall decreased function of the affected arm. Lymphedema can also cause recurrent infections of the arm called “cellulitis” and in some cases may even cause cancer of the lymphatic channels called “lymphangiosarcoma.”
Until recently, the options for treating lymphedema have been very limited in the United States. Until very recently, the only options for treatment of upper extremity lymphedema have been physical therapy, compression therapy, and massage therapy. Though these therapies have been used to help treat the symptoms of lymphedema, they are not cure.
Vascularized lymph node transfer has been performed in Europe for years. It is currently making its way into the U.S. market, where it is performed at the most advanced and forward-looking plastic surgery centers. East Coast Advanced Plastic Surgery is proud to offer this life-altering surgery to our clients.
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What happens during a vascular lymph node transfer procedure?
Typically during this procedure, 1-3 healthy lymph nodes are harvested and detached from an unaffected site (such as the groin) and microsurgically placed into the area where the lymph nodes had been removed. Using microsurgical techniques, the surgeon then connects the blood supply of those lymph nodes to blood vessels in the diseased area, stimulating new lymphatic channels to grown. This procedure has shown promising long-term results with reduction of swelling in the arm, and has also shown an overall decrease (if not complete resolution) of lymphedema symptoms.
Am I a good candidate for vascular lymph node transfer surgery?
You may be a candidate if one or more of the following are true:
- You recently had breast cancer and have been diagnosed with lymphedema as a result
- All scar tissue has fully matured and post operative edema has completely settled from your breast surgery (this usually takes at least 6 months)
- You are not currently receiving chemotherapy
- You have persistent debilitating pain in the arm/armpit
- You have had a number of infections due to lymphedema
An honest discussion of your full medical history, including any medical conditions, previous surgeries or treatments, drug allergies, current medications, and use of alcohol, tobacco or illegal substances with your East Coast plastic surgeon will help make your Lymph Node surgery successful. If you use tobacco, you are not a candidate for any elective procedure as the risks double for those who use tobacco. We are happy to assist you in your quitting process, and once the blood is nicotine free for 4 weeks, you may be considered for surgery.
Special Considerations for Vascular Lymph Node Transfer:
Vascularized lymph node transfer is a relatively new procedure in the United States. This means that everyone may not have the same results. Early evidence is promising and much more successful than older techniques, however.
Vascular lymph node transfers are complicated procedures, and not everyone is a candidate for surgery. As with any surgical procedure, there are potential complications that can occur. Infection, bleeding, blood clots, fluid collections, unsightly scars, and even lymphedema of the area where the lymph nodes had been harvested are all possible side effects. However, we at ECAPS believe that the benefits for good candidates far outweigh the risks.
Surgery and Recovery
Vascular lymph node transfer is an inpatient surgery that is performed with general anesthesia. The process usually takes between 4-6 hours, depending on the amount of scar tissue you have, the extent of your disease and your individual anatomy. The procedure can be combined with procedures like DIEP-FLAP for delayed breast reconstruction and treatment of lymphedema simultaneously.
You should be able to walk immediately following surgery. Swelling and discoloration may occur but resolve within one month. The caring professionals at ECAPS will recommend they follow you closely both in the hospital and in the office to evaluate your healing process. A detailed list of normal symptoms, signs of complications and instructions for recovery will be given to you to assure that your recovery process is safe and successful. As always, it is imperative that you follow doctor’s orders for the best possible outcome.