Liposuction Successful In Treating Chronic Arm
Reduction of chronic non-pitting arm
lymphedema can be achieved through use of liposuction techniques, according
to a plastic surgeon from Sweden who says the treatment effect lasts for
Hakan Brorson, MD, head of the lymphedema unit in the department of plastic
and reconstructive surgery at Malmo University Hospital, said he treated 70
patients with his liposuction procedure. His patients, he explained, have had
complete reduction of the characteristic swelling associated with lymphedema
-- and there has been no recurrence over seven years.
"By removing excess adipose tissue with liposuction, a complete reduction is
possible," Dr. Brorson said at the 4th National Lymphedema Network
conference, in Orlando, FL.
"This is a highly controversial and highly invasive procedure," said Paula
Stewart, MD, assistant professor of medicine at the University of North
Carolina-Chapel Hill, who moderated the oral presentation session at which
Dr. Brorson detailed data on 12 of his patients. Dr. Stewart cautioned that
physicians who attempt the procedure should only perform it in the context of
Most physicians admonish practitioners not to even perform needle sticks in
the affected arm of patients with lymphedema, the common, disfiguring and
sometimes disabling complication that follows breast cancer surgery and/or
radiation treatments. Dr. Brorsonís proposal of invading the swollen arm
through an incision with a liposuction canula clearly disturbed the audience
of patients, therapists and physicians.
"I only make a small incision," said Dr. Brorson in response to questions,
"and I give the patients one to two weeks of antibiotics after the procedure.
I have not had any infections develop." In fact, he said, he had no surgical
complications at all in his patients.
He also demonstrated that by carefully selecting patients who have excess
adipose tissue, the lymphedema can be controlled. In his report, Dr. Brorson
said he removed about 2 liters of tissue and fluid from the arms of the women
in his study. More than 80 percent of the tissue was fat and less than 20
percent was lymph fluid, he said. Magnetic resonance imaging scans of the arm
before and after the treatment confirmed the removal of the fat, he said.
Once the excess fluids and tissue are removed from the arm, the patients are
advised to wear standard compression garments, which maintain the now
normal-looking limb. His patients are limited to "non-pitting lymphedema".
When a physician presses on the swollen arm with his thumb, patients who have
mainly fluid retention will show an obvious depression in the flesh. Those
who have high fat content in the arm will not show the finger "pit" and would
be candidates for liposuction, Dr. Brorson explained.
He said his laboratory work suggests that fatty tissue in the arm continue to
build up and accumulate in patients with chronic lymphedema. In his study,
the average person had been treated with cancer at age 50 and the average
patient had lived with lymphedema for about 14 years before undergoing
He said that the patients who are candidates for liposuction would have
already failed to have excess fluid removed through standard health care
Dr. Stewart said that many plastic surgeons in the United States have
traveled to Sweden to learn the technique from Dr. Brorson and his colleagues
and are now performing the procedures. However, "no one would suggest -- not
even Dr. Brorson -- that liposuction should be used as a first line therapy.
Other treatments should be used first."
By Ed Susman
Thanks to DG News
Federation of European Cancer Societies
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