ABSTRACT
Lymphedema is a chronic, clinical condition due to impaired fluid transport through the lymphatic system as a result of either an impaired lymphatic system or a disbalance between filtration and fluid transport capacity. It is divided into primary and secondary forms. Initially, the treatment focuses on early recognition, lifestyle changes, and conservative treatment with decongestive lymphatic therapy. In the maintenance phase, patients wear compression garments and perform self-management. However, long-lasting stasis of lymphatic fluid leads to an increase in inflammation, lymphangiogenesis and eventually to adipose tissue formation leading to an increase in discomfort for the patient, secondary morbidity as erysipelas, and functional impairment, and can lead to social isolation and dysfunctioning. As liposuction is a treatment for adipose tissue removal, since the 1980s, the technique of circumferential suction-assisted lipectomy has been evaluated as the option for treatment of lymphedema in its late stage. Most patients studied were diagnosed with secondary lymphedema, the most common type. This chapter shows that circumferential suction assisted lipectomy in a multidisciplinary setting can be the treatment option for end-stage primary lymphedema as well.
