Liposuction gives complete reduction of chronic large arm lymphedema afterbreast cancer

About one-third of all women treated for breast cancer develop arm lymphede ma. In addition to the worry of the cancer itself, the swollen and heavy ar m is both a physical and a psychosocial handicap for the patients. Previous surgical and conservative treatments have not always given satisfactory an d permanent results, conceivably because lymphedema causes hypertrophy of t he subcutaneous adipose tissue. From this point of view, liposuction (LS) c ombined with Controlled Compression Therapy (CCT) is an interesting approac h, as the hypertrophied adipose tissue is effectively removed and the outco me sustained by wearing a compression garment. Pre- and postoperative arm e dema volumes were measured using the water displacement technique. Skin blo od flow was recorded using Laser Doppler imaging. Lymph transport in the ar m was assessed by indirect lymphoscintigraphy. LS + CCT reduced the arm ede ma volume completely, compared with a 50% decrease following CCT alone. The use of a compression garment after liposuction is necessary in order to ma intain the normalized arm volume. LS + CCT did not affect the already impai red lymph transport; it merely increased skin microcirculation. A reduced i ncidence of cellulitis was noted.