Liposuction as treatment for LE????

NatsFan

I spotted this article in which this liposuction clinic touts the benefits of liposuction as a treatment for b/c patients with LE.  Seems like a really dicey claim to me - I didn't see any links in the story to studies that confirm that claim:  http://www.thebaynet.com/news/index.cfm/fa/viewstory/story_ID/21856

Anyone else ever heard of this?  Or is this private clinic just trying to drum up business by jumping on the LE bandwagon?

Binney4

Mary, liposuction for LE has been pioneered in Sweden by Dr. Hakan Brorson. He has published some studies, which you can google. This information from the National Lymphedma Network is based on a talk delivered at their conference by Dr. Brorson:

"Q: Recently I read an article in the NY Post about liposuction for lymphedema in the arm after Breast cancer surgery. As you can imagine, after living with this condition for many years, I was very excited, but not sure where to get further information. Is it true that liposuction can reverse and cure the swelling in my arm? Where can I go for surgery? My doctor was not able to help me. Anxious to hear from you, a long time NLN Member.

A: Liposuction is not a cure for lymphedema. At the present time, there is NO cure for lymphedema. The information you read about refers to a procedure done in Sweden by a Dr. Brorson. He presented this information at the NLN Conference in Orlando this year. He was clear throughout his presentation that he only performs this procedure on long standing, fibrotic, post-mastectomy lymphedema of the arm.

Dr. Brorson emphasized that CDT (combined decongestive therapy), which consists of manual lymph drainage, compression bandaging, skin care, exercise, and self care instruction is still the treatment of choice for lymphedema. He only recommends this liposuction procedure to individuals who could not receive treatment and have developed severe, long-standing, fibrotic lymphedema. He emphasized that after this procedure, the individual must wear compression garments daily and compression bandages nightly, forever. The procedure does not correct the inadequate lymph drainage. It removes large amounts of fibrous tissue from the limb, and necessitates a lengthy operation with extensive scarring.

While it may indeed reduce the overall girth of a very large, fibrotic limb a bit more than a course of CDT by virtue of the fact that the surgeon removes large amounts of subcutaneous tissue, the success of the follow-up home program for both therapies is determined by the compliance of the patient with wearing constant compression on the involved limb and doing the recommended exercise/self-massage program. After the surgery, if an individual decides s/he no longer wants to wear the compression garments/bandages, the limb is at extreme risk of swelling and ballooning out of shape due to the removal of the connective tissue structure of the limb with the liposuction.

This procedure is not without significant surgical risks posed by anesthesia, risk of fat emboli, and risk of post operative wound infection (in a limb with an impaired immune system due to lymph node dissection/radiation therapy). It is distressing to think that a medical insurance plan would probably be willing to pay large fees for liposuction as a "surgical correction for lymphedema" while possibly denying payment for the safer, less expensive course of CDT. Dr. Brorson was the first to say that his first recommendation to an individual with lymphedema post mastectomy, is a course of CDT. Too bad that the reporters who attended the NLN conference chose only to highlight this radical surgical approach to advanced lymphedema. Too bad they missed an opportunity to educate the public about CDT which is safe, non-invasive, and very successful in reducing and managing lymphedema, which to date, has no cure."

So, yes to both your propositions: yes, it's a procedure that's been seriously considered and studied (in at least a preliminary way). But also yes, this looks very much like a clinic trying to drum up business by jumping on this particular bandwagon.

Liposuction is very interesting from a research perspective, and important for us to know about -- thanks for bringing it up! One aspect of progressing LE is inflammation, and one way the body responds to this inflammation appears to be the deposition of an abnormal layer of fat just beneath the skin over time. So the theory is that this special kind of liposuction can reduce that particular side effect of the inflammation caused by the LE. Not a cure, but it does address a real phenomenon of the LE.

Who knew the nearly invisible lymph system could be so, uh, fascinating? Or whatever!
Binney

Binney4

bumping for Cookie...

Happy Sunday, everybody!

cookiegal

Thanks..Binney.

There is a clinical trial of the at the Moffat cancer center in Tampa, so at least the motives are decent. They have not gotten a lot of funding, and it is 15 K a patient, so they are looking for donations. BTW it is for lymphadema stage two and up.

SUPER thanks for this

"One aspect of progressing LE is inflammation, and one way the body responds to this inflammation appears to be the deposition of an abnormal layer of fat just beneath the skin over time. So the theory is that this special kind of liposuction can reduce that particular side effect of the inflammation caused by the LE."

 That is exactly what I have....an abnomal inflamitory response and a blob of fat on my upper arm....which I am guessing could even be from the infection. I have been trying to figure out this "lipodema" thing and this explains it! Yea!

That kind of explains why my breast and lower arm responds to treatment and my upper arm does not.

There is very little fluid and almost no pitting in the arm just inflamed fat, and to be honest MLD does almost nothing to the upper arm.

Cheers and have a good trip!!!

Nordy

I have researched this a little bit as well. My understanding is exactly what Binney has stated above: that lipo for treatment of lymphedema is recommended ONLY for those that do not respond to traditional treatment and wrapping AND that if you do undergo this procedure, that you will forever have to wear compression and wrap because of the risk of exacerbated swelling. It seems that this is a procedure for those whose lymphedema has really progressed and compression no longer works for them. I keep looking for that magic pill/surgery that will "fix" all of us... but so far, it just isn't out there... but I will continue to look... and to some extent, I will even try some things (low level laser, creams, acupuncture, supplements - obviously none "cured" me)... but something that is invasive and cannot be reversed... sorry... not willing to take the hit on that one!

Binney4

bumping for mjjporter

Welcome, mjj!