New surgical options for patients with secondary lymphedema of the arm who no longer benefit from regular treatment

- Three patients are described who developed irreversible lymphedema of the arm following mastectomy because of breast cancer. Despite maximal conservative treatment, a difference in volume between the affected arm and the healthy arm remained (900-1500 ml). The patients underwent reductive surgery by means of circumferential suction assisted lipectomy, involving removal of hypertrophied adipose tissue. This was the first experience with this procedure in the Netherlands. The differences in arm volume were neutralised completely with a significant improvement of the shoulder function. In order to make the results lasting, the patients have to wear medical elastic stockings day and night for the rest of their lives. Long-term volume measurements are essential.