Hybrid approach of massive lipolymphedema of the thigh: A novel surgical technique

Abstract

ObjectiveThe goal of this study was to test the hybrid technique of combined tumescent liposuction and surgical excision in patients with advanced lipolymphedema of the thigh after compression therapy as a gold standard for treatment. MethodsBetween January 2016 and April 2020, 18 female and 1 male patients with massive thigh lipolymphedema were treated with complete decongestive therapy for the whole thigh followed by selective decongestive therapy to the upper and lower thigh to make a lump on the midmedial region. Then, the patient was prepared for surgery. Skin is refashioned and sutured in a manner that leaves no furrows and a cosmetic contour is obtained. Compression therapy is maintained from the day of the surgery starting by compression bandage until full healing of the wound, followed by well-fitted garments. ResultsThis study was conducted on 18 female patients and 1 male patient who presented with massive lipolymphedema of the thigh. The age of the patients ranged from 46 to 65 years old with a mean age of 51.38 years. All patients in this study underwent compression therapy as a preparatory stage to turn the massive lipolymphedema into lumpedema, followed by hybrid technique which consisted of combined liposuction and surgical excision. ConclusionsConversion of massive thigh lipolymphedema into lumpedema followed by tumescent liposuction and surgical excision has proven to be a safe and effective treatment option with a marvelous cosmetic result and low wound morbidity and should be considered as a solution for all patients with this disorder.