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Liposuction Swelling
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Question: About 11 weeks post lumpectomy and node clearance, my wife has been told
that she needs to wear a sleeve for the rest of her life, at least for a
good part of every 24 hour period. We are both very upset though I suppose
we've been expecting it after continued swelling and pain. Christine has
been self massaging following instruction by the way.
We were told about the need for the sleeve by the physiotherapist and that
no relief was possible even by operation (she deals only in breast related
therapy). Is it true that there is no channel reconstruction possible?
Would seeing a consultant be a waste of time?
Accepting the lymphodema is not going to go away, is there any comfort to be
had? Once she wears the sleeve a lot, will there be periods where it's use
is not necessary? Will exercise help or hinder the condition by producing
more lymph?
Answer: A unique operation by Swedish surgeon Håken Brorson is bringing new hope to
breast cancer patients who suffer from persistent lymphoedema - a disabling
condition resulting in grossly swollen and painful arms and loss of mobility in
the affected limbs.
He is using liposuction - a treatment more usually associated with the beauty
industry - to treat the condition, and has transformed the lives of his
patients.
When lymph glands in the armpit are removed during breast cancer surgery to
prevent the cancer spreading the lymph often cannot drain away properly and
lymphoedema occurs, leading gradually to an increase in the volume of the
subcutaneous fatty tissue. This phenomenon is poorly understood, according to
Dr Brorson, and is rarely mentioned when speaking of lymphoedema treatment as
both patients and therapists believe that the arm swelling is caused only by
accumulated lymph. The swelling of the arm causes pain, lack of mobility and,
in many cases, considerable emotional distress.
Between 30% and 40% of breast cancer patients are affected to some degree by
lymphoedema after breast surgery and radiotherapy. Current treatment by massage
such as manual lymph drainage (MLD) and the wearing of a compression sleeve can
remove the lymph component of the swelling if carried out early enough.
However, in long-standing cases where fatty tissue hypertrophy (enlargement)
has developed it is not always successful as adipose tissue cannot be removed
by massage or compression. Nor are there any surgical techniques that are
completely effective.
Consultant plastic and orthopaedic surgeon Dr Brorson and his team at the
Department of Plastic and Reconstructive Surgery at Malmö University Hospital,
have developed a novel type of liposuction which removes the fatty tissue and
accumulated lymph via about 20 small (2mm) incisions along the arm. Patients
are then instructed to wear a compression sleeve permanently, taking it off
only for a short time for special occasions.
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