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Jabbour et al. Plast Aesthet Res 2021;8:43 Plastic and
DOI: 10.20517/2347-9264.2021.59
Aesthetic Research

Review Open Access

Recent advancements in supermicrosurgical
treatment of lymphedema

1
Samer Jabbour , Edward I. Chang 2
1
Department of Plastic Surgery, Medstar Healthcare System, Georgetown, Washington D.C. 20007, USA.
2
Department of Plastic Surgery, University of Texas, MD Anderson Cancer Center, Houston, TX 77030, USA.
Correspondence to: Dr. Edward I. Chang, Department of Plastic Surgery, Unit 443, University of Texas, MD Anderson Cancer
Center, 1515 Holcombe Boulevard, Houston, TX 77030, USA. E-mail: eichang@mdanderson.org
How to cite this article: Jabbour S, Chang EI. Recent advancements in supermicrosurgical treatment of lymphedema. Plast
Aesthet Res 2021;8:43. https://dx.doi.org/10.20517/2347-9264.2021.59
Received: 7 Jun 2021 First Decision: 5 Jul 2021 Revised: 12 Jul 2021 Accepted: 28 Jul 2021 First online: 9 Aug 2021

Academic Editor: Matthew L. Iorio Copy Editor: Xi-Jun Chen Production Editor: Xi-Jun Chen

Abstract
Surgical treatment for lymphedema has undergone tremendous advancements over the years, with the earliest
techniques focusing on ablative procedures such as liposuction and direct excision. With modern advancements in
technology, equipment, imaging, and microscope optics, physiologic procedures have emerged as the standard of
care for lymphedema at high-volume institutions and centers of excellence. The lymphovenous bypass and the
vascularized lymph node transfer operations have both proven to be effective means for treatment and improving
the quality of life of patients suffering from lymphedema. However, with the established foundation of knowledge
and experience, innovative approaches to optimize outcomes in patients undergoing supermicrosurgical treatment
are constantly evolving. The present review presents a historical review of the lymphovenous bypass and
vascularized lymph node transfer procedures and introduces some novel expansions of both techniques in the field
of lymphedema surgery.

Keywords: Lymph-venous bypass, vascularized lymph node transfer, prophylactic repair of vessels in the axilla with
immediate LVB

INTRODUCTION
Lymphedema is a chronic, debilitating condition that results most commonly from treatment for cancer in

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