New research published in the New England Journal of Medicine showed that the liposuction improves lymphatic flow and increases the quality of life in people with lymphedema (a painful, disfiguring swelling of the arms, hands, legs or feet). The surgery actually allows the underlying lymphatic system to move the fluid.
Cancer probably causes about 99% of lymphedema cases and another 1% has it due to a developmental problem. The reason people get lymphedema after cancer treatment is that when cancer spreads to lymph nodes, those nodes need to be removed. Lymph nodes and vessels are part of the body's immune system. When removed, the body's natural drainage system for lymph fluid is disrupted and fluid builds up, sometimes to extreme levels.
Lymphedema can be very uncomfortable and cause a feeling of heaviness. Skin can feel tight. Wounds may heal more slowly, and lymphedema can cause reduced flexibility, the cancer society says. Treatment typically includes wearing compression garments and getting a special type of massage that helps promote fluid drainage.
Liposuction is extremely effective at removing fat from underneath the skin, which makes the arm or legs smaller. Liposuction might help people with lymphedema. The researchers used the surgical technique to remove fat from just underneath the skin in three people with the condition. In all three cases, there was an improvement in the lymphedema after liposuction and the improvement appears to be more effective and lasting than expected.
The study patients who had liposuction only had the procedure on an affected limb. They didn't have liposuction on their hands or feet. However, the two patients who had liposuction on their arm also saw improvement in their hand, and the one who had liposuction on her leg had improvement in the lymphedema affecting her foot.
The study author Dr Arin Greene has emphasized several theories as to why liposuction was more effective than expected. One theory is that by removing the fat, the pressure is taken off of the remaining lymph nodes and vessels, allowing them to function better. Another theory is that the fat may make fluid, too, so removing it might mean less overall fluid.
Dr Douglas Roth, chief of plastic and reconstructive surgery said, "The tissue is already compromised, making concerns about complications more significant. These areas need to be treated very, very carefully. However, this is definitely a breakthrough in thinking about the treatment of the problem, and liposuction is a new procedure that could be very helpful.” While the procedure has not been used for lymphedema in the United States, he would want to see a larger trial on a U.S. population before he would consider it.