Lymphatic Surgery

Surgical Lymphedema Prevention and Treatment

The Lymphatic Therapy Clinic at Beth Israel Deaconess Medical Center (BIDMC) offers world-class care for lymphedema. Lymphedema is a condition that causes fluid to build up — typically in the arms or legs.

If you’ve undergone cancer treatment (such as radiation therapy) or certain surgeries, you have an increased risk of developing lymphedema. The experienced team at BIDMC is here to help.

Innovative Lymphedema Prevention for People with Cancer

Before you undergo cancer treatment at BIDMC, your care team will screen you for your lymphedema risk. If your cancer team determines you have an increased risk, you may see the lymphedema team for a preventive visit. We are proud to offer this valuable service to those with cancer.

Comprehensive Lymphedema Care

If your care team has diagnosed you with lymphedema, they will work with you on the first steps in treatment:

• A type of physical therapy known as manual lymphatic drainage
• Compression garments
• Exercise

However, if your lymphedema is severe or does not respond to other treatments, your team may suggest surgery.

Surgical Procedures We Offer

The Lymphatic Surgery Clinic offers a full range of lymphedema surgery:

• Debulking procedures to treat lymphatic disorders
• Lymph node transplantation
• Lymphovenous bypass

Surgery to Prevent Lymphedema

If you are at a high-risk for lymphedema — such as undergoing extensive lymph node removal for cancer treatment — our team will evaluate you for immediate lymphatic reconstruction to reduce your risk of developing lymphedema. The Boston Lymphatic Center has pioneered procedures for immediate lymphatic reconstruction. Our lymphatic surgeons are present at the time of the lymph node removal to re-route damaged lymph channels. This way, lymphatic fluid can drain properly.

This surgery prevents lymphedema in many people. Unfortunately, some people may still develop lymphedema. For that reason, we closely monitor your recovery. After cancer treatment, you will come back to the center for follow-up visits in three- to six-month intervals. (The interval depends on your risk for lymphedema.) These follow-up visits ensure that we can detect any increase in lymph fluid levels before symptoms develop. The earlier lymphedema is detected, the more effective additional interventions are. Additional interventions include compression or massage.

Surgery to Treat Lymphedema

If other treatment options do not help, your care team may suggest one of the following:

• Vascularized lymph node transfer: During a lymph node transplantation procedure, our team removes healthy lymph nodes and vessels from another area of your body. Then, they implant the lymph nodes and vessels into the arm or leg affected by lymphedema. This helps improve the flow of the lymphatic fluid in the affected area. The body can then heal as your swelling reduces and mobility increases. It usually takes about a year for the transplanted lymph nodes and vessels to become fully functional. We will closely monitor your recovery. 
• Debulking: During this procedure, our team removes excess fat accumulated in the arm or leg affected by lymphedema. The reduction in the size of the extremity is maintained long term with compression. You will immediately see the results from a debulking procedure.