Debulking Lymphatic Liposuction: Are the Therapeutic Effects Limited to the Treated Limb?

Abstract

Lymphedema treatment has traditionally focused on region-specific interventions. However, recent evidence suggests otherwise. This study aims to evaluate whether the benefits of liposuction for lymphedema are confined to the treated limb or extend to other areas of the body. Patients who underwent liposuction for extremity lymphedema between January and June 2023 at Cleveland Clinic were included in the study. Patients with less than 1-year follow-up or incomplete post-operative tracking studies were excluded. Pre- and post-operative evaluations included patient report, 3D volumetric measurements, and indocyanine green lymphography (ICGL). Liposuction was performed under general anesthesia with circumferential removal of pathological bulk. Thirty-eight limbs in 36 patients (33 females, 3 males, mean age 58 years) underwent surgery. All reported marked improvements, with some noting the improvements as "life-changing." Improvements in lymphatic functions were observed in all operative limbs (38) and non-operative contralateral limbs (38), with an average volume reduction of 30.0% and 19.5%, respectively. ICGL further confirmed improved lymphatic drainage in all limbs (76). Liposuction, traditionally considered a region-specific treatment for lymphedema, exerts therapeutic effects beyond the surgical site, suggesting broader systemic benefits.