What is Lymphedema?
Many women and men who have had a breast or breasts removed will develop a condition called secondary lymphedema from the damage or excision of the lymph nodes at the surgical site. What does post-mastectomy lymphedema really mean for a person who has had breast cancer surgery? It means that your body is not properly draining lymphatic fluids. Lymphedema can show up in your everyday life as excessive swelling, pain, stiffness, and pressure near the underarm. While microsurgery by our board-certified plastic and reconstructive surgeon, Dr. Aldona J. Spiegel, is not a cure for the condition, it can significantly control the symptoms of lymphedema.
You may have tried ultra-conservative treatments, like lymphatic drainage massages, compression garments, and more, only to be disappointed in the mediocre relief they provide. At Aldona J. Spiegel, M.D., we invite you to learn more about our surgical procedures that reroute the fluid in a way your body can no longer channel out of your body. Lymphaticovenous bypass (LVB) or a vascularized lymph node transfer (VLNT) are specialized, superfine microsurgeries that Dr. Spiegel can perform for appropriate candidates. Explore your treatment options with our Houston, TX team located within Houston Methodist Hospital.
How Do I Manage Lymphedema?
Lymphedema is an unfortunate high risk for every person who has a breast or breasts removed. With the lymph nodes missing or impaired after a mastectomy, there are some lifestyle habits you may want to consider and improve your quality of life:
- Wear compression garments
- Schedule regular lymphatic drainage massages
- Use a pneumatic arm pump or a compression sleeve to direct lymphatic fluid out of the area with strategically placed pressure
- Stay well hydrated and avoid foods that cause bloat
- Eat a healthy, fiber-filled diet that is low in sodium to help with fluid retention
- Keep active and workout as recommended by your doctor
- Wear clothing and accessories that are comfortable and not tight on your arm
- Sunburns or accidental burns on the arms can aggravate symptoms of lymphedema (and may make discomfort much worse)
- Elevate your arm or arms with a bed pillow while you are sleeping or sitting
- Skin infections should be closely monitored and treated by a physician
- Do you best to limit your skin's exposure to cuts, burns, sores, bites, and dry weather
We understand that this is a short, limited list of what you can do to control your lymphedema at any stage. Dr. Spiegel will also talk to you about how to better care for yourself when lymphedema is in an inflamed state.
"Dr. Spiegel was highly recommended by my oncologist. It had become necessary that I look into reconstruction and a lymph node transplant. Dr. Spiegel does amazing work. She loves what she does and it shows in the results that she achieves. I am very happy that I chose her for this journey! Her support staff are wonderful to work with as well!"- D.M. / Google / Jul 08, 2019
When Do I Need Surgery?
After a mastectomy, you run the risks of developing lymphedema. When the lymph nodes are removed, your body does not have an easy way to eliminate lymphatic fluid buildup. Without the lymph nodes there to drain this fluid, you will experience swelling, fluid retention, pain, discoloration of your skin. A candidate with the symptoms of lymphedema after a mastectomy would need to have medical treatment to control the discomfort and pressure from fluid retention in the underarm or nearby area.
Lymphedema Surgical Techniques
During your consultation process, Dr. Spiegel will request imaging performed in the area of concern within or close to the underarm to check for lymph nodes or damaged lymphatics. Once the problem has been identified, Dr. Spiegel will make her recommendations for your care. She may perform a lymphaticovenous bypass, a vascularized lymph node transfer, or a combination of both. These procedures will require general anesthesia and will take approximately 4 – 8 hours in the operating room.
With a microsurgery called lymphaticovenous bypass (LVB), Dr. Spiegel will create a new vascular pathway for drainage of lymphatic fluid.
Vascularized lymph node transfer
Dr. Spiegel can also harvest and transfer healthy lymph nodes from one area of the body to the lymphedema site. This is called a vascularized lymph node transfer (VLNT).
Once your surgical procedure is finished, you will be taken to our post-op recovery room. A dedicated post-op nurse will be checking your vital signs, caring for your incision, and helping manage your discomfort.
After Lymphedema Surgery
Dr. Spiegel will discharge you with instructions on how to care for yourself at home. You can also expect to have a follow-up appointment at our office in the first week after your surgery. Recovery time for the LVB or the VLNT can range from 1 – 3 weeks. How your body responds to the surgery can also factor into how long you will need to recover from surgery. For complications at your surgical incision sites, like infection (with or without a fever), excessive fluid buildup, or unmanageable pain, we recommend you call our office for immediate assistance.
When You Have Lymphedema...
Because of her vast experience in microsurgery, Dr. Spiegel is highly qualified to diagnose and treat lymphedema caused by breast cancer surgery. You may have tried to alleviate your pain and swelling with manual treatments, like massage or compression garments, yet you are still not satisfied with how it makes you feel day-to-day. Please consider having a surgery consultation in Houston, TX with Dr. Spiegel who has exceptional talents in microsurgery to perform your procedure. Request a consultation online or schedule an appointment with our front office staff today.