What is lymphedema?

The lymphatic system is a network throughout our bodies that is made up of lymph nodes and vessels, which store, filter, and carry lymph, a protein-rich fluid. It is part of the body’s immune system and can mobilize disease-fighting cells (lymphocytes) to fight infection and the growth of tumors.

When the lymphatic system is damaged or blocked, a buildup of lymph fluid can happen in the fatty tissues under the skin, causing swelling (edema). Called lymphedema, this swelling happens most often in the body’s extremities (arms or legs). It creates a sensation of fullness and tightness in the skin, sometimes causing itching or burning, along with pain and discomfort. Complications of lymphedema most commonly are trouble with mobility due to swelling around a joint, daily activities as sometimes clothing no longer fits properly, and skin infections (cellulitis).

What causes lymphedema?

Lymphedema can happen as a result of cancer or cancer treatment, particularly surgery to remove or dissect the lymph nodes or radiation therapy targeted at the lymph nodes. Lymphedema happens more commonly with breast cancer, but can also develop after melanoma, throat cancer, genitourinary, and gynecological cancer treatments.

Though lymphedema occurs most frequently in the first two years after treatment for cancer, it can develop at any point in time. It is important to receive early education and intervention for lymphedema. Left untreated, lymphedema can worsen and cause severe swelling and permanent changes to the tissues under the skin, such as thickening and scarring. It is important that lymphedema is diagnosed and managed upon onset of symptoms to enhance quality of life.

Lymphedema Treatments

Treatment plans are determined by the stage and cause of the condition. Plastic surgeons perform a number of reconstructive surgical interventions including vascularized lymph node transfer, lymphovenous bypass, and a type of liposuction to reduce swelling. Nonsurgical techniques focus on Complete Decongestive Therapy (CDT). CDT includes Manual Lymphatic Drainage (MLD), multi-layer bandaging, compression garments, and therapeutic exercises. The goal is to redirect fluid into working lymph nodes so the fluid can drain, reducing buildup and limb volume. Self-management includes compression garments, pneumatic pumping devices, skin care, and lifestyle modifications.