Liposuction as an effective treatment for lower extremity lymphoedema: a single surgeon's experience over nine years

Publication date: Available online 2 December 2017
Source:Journal of Plastic, Reconstructive & Aesthetic Surgery
Author(s): C.J. Stewart, D.A. Munnoch
BackgroundLymphoedema is a chronic, debilitating condition caused by a compromised lymphatic system. In recent years, the success of treating upper extremity lymphoedema with liposuction has been translated to patients with lower extremity lymphoedema (LEL), yet there remains a paucity of clinical evidence firmly supporting its use within this patient group.Methods69 patients with LEL (72 legs) were consecutively treated with liposuction by a single surgeon. Compression garments were applied in theatre and continued post-operatively.ResultsMean preoperative volume of oedema was 4372 mL (range 229 -15166 mL), and mean volume of aspirate was 4550 mL (range 575 – 12150 mL). There were no major surgical complications. An average reduction in volume of leg oedema of 85% was found at 3 months (n=72), 88% at 1year (n=60), 94% at 2 years (n=41) and 90% at 5 years (n=15).ConclusionsWe have demonstrated that liposuction combined with continuous compression therapy (CCT) is a safe and effective technique for treatment of primary and secondary LEL, with a significant reduction of the original excess limb volume. Male patients with primary lymphoedema have the poorest outcomes. Limbs with secondary lymphoedema respond best to this treatment.