Lymphedema Bypass Connecticut and Houston

Dr. Fusi and Dr. Craig specialize in breast reconstruction and the treatment of lymphedema caused by breast cancer. With over twenty years of experience as a plastic surgeon Dr. Fusi, F.A.C.S. M.B.A. is a clinical faculty in the Section of Plastic Surgery at Yale University School of Medicine. Besides being a pioneer there in microvascular breast reconstruction using DIEP flaps and other types of perforator flaps, he has introduced the surgical treatment of lymphedema using lymphovenous bypass, lymph node transfer, and at times liposuction.

Dr. Craig is a board certified plastic surgeon who received her plastic surgery training from Yale and obtained microsurgical training from MD Anderson Cancer Center in Connecticut and Houston, where she then became faculty and refined her understanding and experience in lymphedema surgery. Both Dr. Fusi and Dr. Craig have trained with eminent lymphedema surgeon Dr. Corrine Becker in France to provide patients with the latest advancements in lypmphovenous bypass surgery.

What is a Lymphovenous Bypass?

Lymphedema is a progressive and painful disorder that occurs when excess fluid is unable to drain normally from lymph vessels. Patients diagnosed with lymphedema can undergo a lymphovenous bypass or lymph node transfer as indicated to relieve the pain and discomfort that results from the build-up of excess lymph fluid in the limbs. This procedure involves bypassing lymph pathways in favor of new channels established with microsurgery.

Who Can Benefit from a Lymphovenous Bypass?

Lymphedema is a common byproduct of breast cancer surgery and treatment with women often experiencing upper extremity lymphedema after some or all of their lymph nodes are removed. Other risk factors include:

  • Radiation therapy.
  • Hereditary problems.
  • Damage to lymph nodes.
  • Obesity: body mass index (BMI) of 30 or higher.

The majority of patients diagnosed with early stages of lymphedema can often experience significant relief from their symptoms and volume reduction in their affected limb using this technique.

What Will Happen During the Procedure?

Prior to surgery, Dr. Fusi and Dr. Craig will evaluate the benefits and disadvantages of different surgical options. In some cases, patients with advanced lymphedema will be recommended a vascular lymph node transfer instead of a lymphovenous bypass.

On the day of your surgery, a qualified anesthesiologist will administer anesthesia and Dr. Fusi and Dr. Craig will:

  • Use a minimally invasive technique to inject indocyanine green dye that maps a pathway of lymph vessels for your bypass.
  • Make an incision in the affected limb in the location of viable venules and lymphatics in the area.
  • Apply advanced microsurgical methods to suture lymphatics and venules less than 0.8 mm in diameter. This method will create new channels to drain excess lymph fluid.
  • Close the incision with a scar minimizing aesthetic approach.

The surgery will take between two to four hours depending on the number of bypasses performed.

Recovery from a Lymphovenous Bypass

Patients recovering from a lymphovenous bypass must set aside time for recovery and limit their activity while healing. Depending on the location and extent of surgery, Dr. Fusi and Dr. Craig will provide you with recommendations on how to care for your surgical area. To relieve the discomfort and enhance healing, aftercare includes:

  • Loosely wrapping the surgical site in compression bandages.
  • Elevating the affected limb on a pillow.
  • A course of antibiotics to prevent infection.

The first few weeks after surgery may initially cause some pain and discomfort as your arm heals. Dr. Fusi and Dr. Craig may prescribe pain medication to help with pain management. Manual drainage and non-invasive therapy will be restarted after surgery.

Results and Prognosis

Patients can experience significant improvement after their lymphovenous surgery. After a few months of recovery, the affected limb can sometimes:

  • Decrease in size and volume.
  • Cause the patient less pain.
  • Feel lighter and softer, according to patients who have undergone the surgery.

While patients with early stages of lymphedema report the highest success rates, this surgery is still considered experimental and results can vary.

If you are suffering from the painful symptoms of lymphedema, call our offices in Connecticut at 203-458-4444 or Houston at 713-346-9909.