What is Lymphedema? Lymphedema is the collection of lymph fluid that occurs as a result of impaired lymph flow in the limbs such as the arm and leg, depending on factors such as congenital or subsequent surgery. The most common cause of subsequent lymphedema is the removal of the main lymph nodes of the limbs as a result of breast cancer or a cancer to the head.


Stages of Lymphedema



Initially, lymph fluid accumulates in the affected limb. Edema in the extremity is relatively soft. However, over the years, this accumulated lymph fluid increases the fat storage under the skin in the limb. Meanwhile, the edematous limb becomes harder. At the last stage, this accumulated lymphatic fluid also thickens the skin structure and creates cracks, and the frequent attacks of infection, called lymphangitis, are stuck in the limb. Therefore, the patient must be hospitalized frequently and receive long-term antibiotic therapy.


Lymphedema Treatment Stages

Treatment principles are divided into two main parts as surgical and non-surgical.


Nonsurgical Treatment Physical

therapy, including compression therapy and massage, is applied to the patient’s limb. Compression and massage therapy tries to drain the accumulated lymph fluid. The patient continues the compression in his normal life with special clothes between these treatment periods. Surgical treatment methods are started to be applied in cases where the benefit of this treatment is reduced and edema treatment cannot be completely resolved with these treatments.



Surgical treatment

There are several methods here. Depending on the clinical condition of the patient, one of these treatment methods can be chosen or combined treatment methods can be applied.


  1. Tissue Removal Surgery
  2. Liposuction

3.Lymph and vein joining operations (Lymphotic-venous shunt)

  1. Vascular lymph node transplantation


Tissue Removal Surgery

They are the first surgical procedures used in lymphedema treatment. Although an aesthetically difficult appearance emerged, it was an unprecedented surgical method in the early days. However, with the use of other methods in plastic surgery, it was started to be used in less preferred and only selected patients. I in the clinic I have been using this surgical technique gradually, different from the conventionally defined method, in patients with long-term lymph edema and excessive excess skin and adipose tissue in selected patients. I then apply it to my vascular lymph node transplant patients.


Charles Surgery



Although it has been used more frequently in recent years, I choose my patients very carefully in my clinical practice. In my opinion, if liposuction is performed in patients who are not suitable, it will ensure the removal of adipose tissue in the patient, and on the other hand, perhaps the remaining intact lymph channels may also be damaged. For this reason, I also use liposuction surgery for patients who do not accept vascular lymph nodes or tissue removal surgery.


Lymph and Vein Combination Surgeries

In these surgeries, before the blocked lymph vessels area, the intact lymph vessel channel into a vein Combining with super microsurgical technique, it is a method of overcoming this occluded area. Super microsurgical technique With its definition in the scientific world, this surgical method has made a breakthrough in the treatment of lymphedema microsurgery.


Schematic Lymphatic Vascular and Vein Anastomosis


I use this method alone on very rare patients. Combined with vascular lymph node transplantation, I think this method gives very successful results in suitable patients.


Vascular Lymph Node Transplant


After I started to see the successful results of this method, which entered the scientific world in recent years, in national congresses, I started to apply this method in many patients as the first method in lymphedema surgery. In this method, the lympheded limb is transported from elsewhere in the body to the veins of that limb by microsurgical techniques by transporting the lymph nodes with vessels.


In my patients for whom this technique is suitable, I see an average of 30% decrease in the limb volume in the first month without any physical therapy or compression. Although it varies from patient to patient in the long term, the increase in this volume reduction continues.

As a result;

I recommend surgical interventions in which one or more operations are performed in combination according to the history, age, agent and tissue condition of the edematous limb of my patients with lymphedema.




Abdominoplasty Surgeries

Results such as looseness of the abdominal muscles, excessive fat, excessive skin after obesity surgery, weight loss or abdominal muscle looseness after pregnancy can be eliminated by abdominoplasty. Tummy tuck surgery includes two basic surgical principles.


Surgical Principles

One of these is to tighten the muscle membrane, which is called the muscle fascia. Like an inner corset, this structure is tightened with stitches. This eliminates the bulging of the anterior abdominal wall by the internal organs of the abdomen that occurs due to the looseness of the abdominal muscle membrane. In the surgical technique, the repair of this structure is very important aesthetically and if it is done properly, very good results are obtained in patients. In the postoperative period, this tension may cause some discomfort in patients, which is an expected result. These problems will increase more, especially when using the abdominal muscles. However, over time, these problems will regress very quickly in the patient. In the early postoperative period, I would like my patients to walk by leaning forward a little. This will reduce the complaints of the patient due to the tension and will provide less load on the stitches. I do not want my patients to use a corset if I have not applied additional liposuction after surgery. I do not think corset is a very useful application.


The second principle is to remove excessive loose skin and subcutaneous tissue. In this way, while providing an aesthetically beautiful appearance in the abdomen, at the same time, fatty cracks are removed in the lower abdomen for childbirth or weight gain and loss. It is very important to create a new belly button here. The most common mistakes are making a larger or smaller belly button than normal or not being able to plan this structure in the midline.


Schematic view of tummy tuck surgery steps



Almost, I add this technique to all my tummy tuck surgeries. Because abdominoplasty is often insufficient to form the waist pit on both sides. When liposuction is applied to these areas, the desired result can be achieved easily.


Tummy tuck surgery is not a weight loss surgery like liposuctin. However, it gives very good results especially in patients who have lost weight.


Before the Surgery


If possible, I want him to quit smoking a week before. Because smoking is the most important factor that disrupts micro blood circulation. There is a risk of circulation problems with the effect of smoking in the area inside the underwear, which we call the bikini cut, where the abdominal skin is the most tense. Apart from this, I do not have any other suggestions that would restrict the normal life of the patients.


Before Abdominal Lifting


Aesthetic Result In tummy tuck, the incision scar made for the skin remains in underwear. In addition, when liposuction is added to the waist cavities, patients can achieve an ideal abdominal image.


After Abdominal Lifting


kübra akguc Blog , ,
kübra akguc