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Page 6 of 7 Beederman et al. Plast Aesthet Res 2022;9:54 https://dx.doi.org/10.20517/2347-9264.2022.64

Another potential complication of the harvest of SC lymph nodes is a resulting chyle leak from damage to
surrounding lymphatics. To reduce this risk, we preferentially harvest supraclavicular lymph nodes from the
right (unless the patient has had prior surgery to the right neck or has a history of right upper extremity
lymphedema) to avoid damage to the thoracic duct. If a chyle leak does occur, this can often be managed
expectantly with the initiation of a low-fat diet. Rarely, for high volume leaks, additional measures,
[18]
including surgical intervention, need to be taken .
There is no current consensus on the optimal VLNT donor site when it comes to surgical outcomes in the
treatment of lymphedema. However, results from our group show that patients who underwent SC VLNT
had both objective and subjective improvements in their lymphedema. In a recently published study
examining the impact of physiologic surgery on both upper and lower extremity secondary lymphedema, a
total of 78 patients underwent supraclavicular VLNT, either alone or in combination with LVB. We did not
find any significant difference in outcomes (both quantitative and qualitative measures) between these
[19]
patients and those who underwent VLNT from either the lateral thoracic or groin donor sites .

CONCLUSION
With its favorable risk-benefit profile and relative ease of harvest, we have come to rely on the
supraclavicular lymph node flap as our first-line choice for VLNT, especially in patients who do not require
significant soft tissue resurfacing or who are not undergoing simultaneous autologous breast reconstruction.
Given the important anatomic structures within the harvest area, it is important to have a thorough
understanding of the anatomy of the region.

DECLARATIONS
Authors’ contributions
Made substantial contributions to conception and design of the study and performed data analysis, data
acquisition and interpretation, as well as provided administrative, technical, and material support:
Beederman M, Chang DW

Availability of data and materials
Not applicable.

Financial support and sponsorship
None.

Conflicts of interest
Both authors declared that there are no conflicts of interest.

Ethical approval and consent to participate
Not applicable.

Consent for publication
Written informed consent for publication of patient images was obtained.

Copyright
© The Author(s) 2022.