Upper Extremity Lymphedema Connecticut and Houston

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Dr. E. Stirling Craig (left) and lymphedema expert Dr. Corrine Becker (right) operating in France.

Dr. Fusi and Dr. Craig are well versed in the complexity of lymphedema surgery and experienced in the advanced microsurgical techniques these procedures require. Both Dr. Fusi and Dr. Craig had individualized training with lymphedema specialist and pioneer of the vascularized lymph node transfer: Dr. Corrine Becker.

Dr. Fusi F.A.C.S. M.B.A. is a board-certified plastic surgeon with over twenty years of experience specializing in reconstructive and aesthetic procedures.

Dr. Craig is a board-certified plastic surgeon who received her plastic surgeon training at Yale and her microsurgery fellowship at M.D. Anderson Cancer Center.

What is Upper Extremity Lymphedema?

One of the primary functions of your lymphatic system is to drain lymphatic fluid. Upper extremity lymphedema occurs when lymph fluid collects in the arms (upper extremities) rather than draining normally. Patients will notice that their affected arm is noticeably larger and heavier than usual. Lymphedema is usually the result of prior surgical procedures and/or radiation.

Symptoms of Upper Extremity Lymphedema

Symptoms common in patients experiencing upper extremity lymphedema are noticeable increases in:

  • Volume in one or both arms.
  • Weight in one or both arms.
  • Skin tension in one or both arms.

The severity of upper extremity lymphedema is diagnosed based on your medical history, physical exam, and sometimes imaging. Lymphatic mapping can be performed by injecting indocyanine green dye, which is absorbed by lymph vessels, to evaluate the pathway of lymphatic drainage and stage of lymphedema present.

Who is at Risk for Upper Extremity Lymphedema?

Although lymphedema is a side effect of breast cancer and breast cancer treatment, it can remain latent for months before symptoms manifest. Risk factors for developing upper extremity lymphedema include:

  • Obesity.
  • Radiation therapy as part of breast cancer treatment.
  • Removal of axillary lymph nodes as part of breast cancer treatment.

If lymphedema is caught early, less invasive treatment such as physical therapy can sometimes resolve any discomfort and prevent upper extremity lymphedema from advancing.

Diagnosing Upper Extremity Lymphedema

The advanced diagnostic techniques currently available enable Dr. Fusi and Dr. Craig to map out a plan for treatment based on the stage of lymphedema. Prior to surgical intervention, patients will be evaluated during their complete decongestive therapy (CDT) and referred for treatment as soon symptoms appear to progress. To determine the extent of damage to lymph channels, Dr. Fusi or Dr. Craig may perform an MRI lymphangiography to determine the surgical options. This procedure involves injecting dye and then evaluating the viability of lymphatic channels and how the patient’s lymphatic system is functioning.

During your consultation, Dr. Fusi and Dr. Craig will outline different treatment plans and weigh the risks and benefits of each option based on your stage of lymphedema.

Treatment for Upper Extremity Lymphedema

Treatment for upper extremity lymphedema depends on whether you are diagnosed with early stage or advanced stage lymphedema. The two main surgical procedures for upper extremity lymphedema are:

  • Lymphovenous bypass: Can be effective for patients diagnosed with early stage lymphedema.
  • Vascularized lymph node transfer: More invasive but can be effective for early and sometimes even more advanced stages of lymphedema.

Results of Upper Extremity Lymphedema Treatment

Connecticut patients who undergo either lymphovenous bypass or vascularized lymph node transfer for upper extremity lymphedema typically experience a qualitative improvement in the affected arm such as it feeling:

  • Lighter.
  • Softer.

Both procedures create new pathways that allow excess lymph fluid to drain, relieving patient discomfort. However, these procedures still in the experimental phase and result may vary.

For more information about surgical options to treat your upper extremity lymphedema, call our offices in Connecticut at 203-458-4444 or Houston at 713-346-9909.