Treatment of Lymphedema: Liposuction

Since 2009, The Department of Lymphatic Surgery of Beijing Shijitan Hospital Affiliated with Capital Medical University has adopted liposuction to treat lymphedema, which has achieved good results. In our analysis of 30 patients with primary lymphedema of the lower extremities, the total volume of aspirated fat was 900–3900 mL, and the volume of blood loss was 160–1100 mL during liposuction. Regarding the comparison of objective parameters, (1) the volume of lower extremity significantly decreased immediately after surgery and at 3 month follow-up compared with that prior to operation (31.4 ± 16.4 Vs. 6.6 ± 10.0 vs. 12.2 ± 10.7, P < 0.05); (2) Female patients demonstrated greater volume of aspirated fat and higher liposuction rate than males during operation, whereas male patients showed greater volume of blood loss as well as greater percent volume difference prior to operation, immediately after operation and at 3 month follow-up; (3) Patients with history of erysipelas manifested higher volume of blood loss, lower volume of aspirated adipose tissue and lower liposuction rate; (4) Stage II patients demonstrated greater volume of aspirated adipose tissue and higher liposuction rate than Stage III patients during operation, in contrast to less blood loss and lower percent volume difference prior to operation, immediately after operation and at 3 month follow-up than Stage III patients. (5) Regarding subjective assessment, the experienced heaviness and fatigue were significantly alleviated, whereas tenderness and tightness were aggravated. Liposuction is an effective therapy for primary lymphedema of the lower extremities. It is necessary to combine liposuction with other therapeutic methods to improve lymphatic circulation. Patient’s gender, stage of lymphedema, and history of recurrent erysipelas are major factors affecting the technical difficulty of the operation and prognosis.