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Liposuction Gives Complete Reduction of Arm Lymphedema following Breast Cancer Treatment-A 5-year Prospective Study in 105 Patients without Recurrence.
Hoffner, Mattias MD, PhD *,+; Ohlin, Karin OTR ++; Svensson, Barbro PT, LT ++; Manjer, Jonas MD, PhD *,++; Hansson, Emma MD, MA, PhD *,[S]; Troeng, Thomas MD, PhD [P],||; Brorson, Hakan MD, PhD *,++
[Article] Plastic and Reconstructive Surgery - Global Open. 6(8):e1912, August 2018.

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Background: Arm lymphedema is a well-recognized complication after breast cancer surgery that negatively impacts patients' quality of life, both physiologically and psychologically. Lymph stasis and inflammation result in excess formation of adipose tissue, which makes removal of the deposited subcutaneous fat necessary to eliminate the excess volume. Liposuction, combined with postoperative controlled compression therapy (CCT), is the only treatment that gives complete reduction of the excess volume. The aim of this study was to evaluate the 5-year results after liposuction in combination with CCT.

Methods: Patients consecutively operated on between 1993 and 2012 were identified from the lymphedema registry, comprising all patients with nonpitting lymphedema treated with liposuction and CCT in our department. Standardized forms were used to collect pre-, peri-, and postoperative data.

Results: One hundred five women with nonpitting edema were treated. The mean interval between the breast cancer operation and lymphedema start was 2.9 /- 5.0 years, the mean duration of lymphedema was 10 /- 7.4 years, and the preoperative mean excess volume was 1,573 /- 645 ml. The mean volume aspirated was 1,831 /- 599 ml. Postoperative mean reduction 5 years postoperatively was 117% /- 26% as compared with the healthy arm.

Conclusion: Liposuction is an effective method for the treatment of chronic, nonpitting, arm lymphedema resistant to conservative treatment. The volume reduction remains complete after 5 years.