Diagnosis
How We Can Help You
Lymphedema is a painful, chronic condition that causes parts of the body to swell with fluid. Most people with lymphedema develop it after damage to their lymphatic system from lifesaving cancer treatment.
At Stanford, our experienced, compassionate doctors and other care providers help you manage lymphedema and avoid complications. We offer leading-edge therapies, clinical trials, and surgical options to help you live your best quality of life.
What We Offer You For Lymphedema
- Patient-centered care from compassionate specialists who provide you with an all-encompassing, personalized plan for treating and managing lymphedema.
- Collaborative approach between experts in multiple fields, including internal medicine, oncology, and radiology to provide a thorough treatment plan.
- Advanced treatment options that may include physical therapy, liposuction, or lymphatic surgery, tailored to your specific needs.
- Robust support services including lymphedema support groups, psychologists, and nurse coordinators who walk you through the entire process.
- Research-based clinical trials program that uses the latest studies, findings, and technology to provide the most comprehensive lymphedema treatment.
Lymphedema Treatment
Our specialists will tailor a plan to your needs. Although there is no cure for lymphedema, treatment to manage the condition improves symptoms. Your personalized plan may consist of one or a combination of treatments including massage therapy, medication, clinical trials, and surgery.
Should your condition not respond to first-line therapies, you may be a good candidate for surgery. As the only surgical lymphedema treatment center in the Bay Area, we use the latest scientific advances. In fact, Stanford is the only lymphedema treatment center in the U.S. that offers all available forms of surgical treatment options.
Our average reduction in limb size is 60%, one of the best success rates in the U.S.
What is Lymphedema?
Early Stage
Advanced Stage
Early Stage Lymphedema Treatment
We use the lymphedema staging classification developed by the International Society of Lymphology. In early-stage lymphedema (Stages 0–2), the condition may be reversible if caught and treated early. The earlier you get medical intervention, the better the outcome will be.
Precise Diagnosis using L-Dex Assessment
We pass a safe, low-level electrical current through the limb and compare the amount of fluid to other areas of the body to determine if lymphedema is present.
Nonsurgical Treatment for Early-Stage Lymphedema
Our doctors usually begin treatment for early-stage lymphedema with nonsurgical options that include:
- Physiotherapy: Physical therapists who specialize in treating lymphedema use manual lymphatic drainage, a massage technique that can reduce swelling. This gentle therapy moves excess fluid to areas where the lymphatic system is working, for proper drainage.
- Compression therapy: A provider will prescribe a custom-made compression garment for you to wear to prevent swelling and fluid buildup.
Surgical Treatment for Early-Stage Lymphedema
If nonsurgical treatments do not provide the desired results, we will discuss the surgical options with you, including:
- Lymphovenous bypass: In this minimally invasive procedure, the surgeon connects healthy lymph vessels to reduce swelling by rerouting drainage around obstructed vessels. Your doctor will advise whether you need to wear lightweight compression garments and for how long.
- Lymph node transfer: In an inpatient surgery, we transplant healthy lymph nodes from other parts of the body to the area with lymphedema. Stanford is one of the few centers in the country that uses reverse lymphatic mapping (injecting a safe dye into the lymph system to see how it drains). This procedure ensures that the donor site does not develop lymphedema after surgery. You will need to wear a lightweight compression garment after surgery until your doctor advises you otherwise.
Advanced Stage Lymphedema Treatment
In Stage 3, the affected area becomes very large and swollen, and the skin develops a leathery appearance. At this stage, fluid and thick, fibrous tissue have accumulated, and fungal infections of the skin and nails may be common.
The first step in treating advanced-stage lymphedema is to restore function to the limb by reducing its size through debulking or liposuction. After your recovery from one of these procedures, you may be a candidate for other treatments, such as lymph node transfer or lymphovenous bypass. These options can help reduce symptoms for the long term and give you a better quality of life.
Debulking
Depending on where the lymphedema is located, we may need to remove tissue and fluid through surgery. At Stanford, we save as much of your skin and tissue as possible and use skin grafts from other parts of the body, if necessary.
Liposuction
In this outpatient procedure, we insert a small vacuum-like tool through the skin of the limb with lymphedema to remove extra fluid and tissue. This procedure is less invasive than traditional debulking and offers a shorter recovery time and less scarring. Liposuction reduces the size of your limb but does not cure lymphedema. You will have to wear a compression garment consistently to prevent future fluid and tissue buildup.
Early Stage Lymphedema Treatment
We use the lymphedema staging classification developed by the International Society of Lymphology. In early-stage lymphedema (Stages 0–2), the condition may be reversible if caught and treated early. The earlier you get medical intervention, the better the outcome will be.
Precise Diagnosis using L-Dex Assessment
We pass a safe, low-level electrical current through the limb and compare the amount of fluid to other areas of the body to determine if lymphedema is present.
Nonsurgical Treatment for Early-Stage Lymphedema
Our doctors usually begin treatment for early-stage lymphedema with nonsurgical options that include:
- Physiotherapy: Physical therapists who specialize in treating lymphedema use manual lymphatic drainage, a massage technique that can reduce swelling. This gentle therapy moves excess fluid to areas where the lymphatic system is working, for proper drainage.
- Compression therapy: A provider will prescribe a custom-made compression garment for you to wear to prevent swelling and fluid buildup.
Surgical Treatment for Early-Stage Lymphedema
If nonsurgical treatments do not provide the desired results, we will discuss the surgical options with you, including:
- Lymphovenous bypass: In this minimally invasive procedure, the surgeon connects healthy lymph vessels to reduce swelling by rerouting drainage around obstructed vessels. Your doctor will advise whether you need to wear lightweight compression garments and for how long.
- Lymph node transfer: In an inpatient surgery, we transplant healthy lymph nodes from other parts of the body to the area with lymphedema. Stanford is one of the few centers in the country that uses reverse lymphatic mapping (injecting a safe dye into the lymph system to see how it drains). This procedure ensures that the donor site does not develop lymphedema after surgery. You will need to wear a lightweight compression garment after surgery until your doctor advises you otherwise.
close Early Stage
Advanced Stage Lymphedema Treatment
In Stage 3, the affected area becomes very large and swollen, and the skin develops a leathery appearance. At this stage, fluid and thick, fibrous tissue have accumulated, and fungal infections of the skin and nails may be common.
The first step in treating advanced-stage lymphedema is to restore function to the limb by reducing its size through debulking or liposuction. After your recovery from one of these procedures, you may be a candidate for other treatments, such as lymph node transfer or lymphovenous bypass. These options can help reduce symptoms for the long term and give you a better quality of life.
Debulking
Depending on where the lymphedema is located, we may need to remove tissue and fluid through surgery. At Stanford, we save as much of your skin and tissue as possible and use skin grafts from other parts of the body, if necessary.
Liposuction
In this outpatient procedure, we insert a small vacuum-like tool through the skin of the limb with lymphedema to remove extra fluid and tissue. This procedure is less invasive than traditional debulking and offers a shorter recovery time and less scarring. Liposuction reduces the size of your limb but does not cure lymphedema. You will have to wear a compression garment consistently to prevent future fluid and tissue buildup.
close Advanced Stage
Clinical Trials
At Stanford, we continuously have clinical trials for new drugs, treatments, and surgical procedures that may reduce the effects of lymphedema.
We are the leading site of a groundbreaking National Institutes of Health (NIH)-funded clinical trial on the use of lymph node transfer with BioBridge, a bioengineered nanofibrillar collagen scaffold that helps to regenerate lymphatic vessels.
Open trials refer to studies currently recruiting participants or that may recruit participants in the near future. Closed trials are not currently enrolling, but similar studies may open in the future.
To learn more about the clinical trials we offer, contact Leslie Roche, RN at (650) 723-1396.
Our Clinics
Our specialists provide a range of advanced treatment options, including diagnostic and therapeutic regimens, to treat adults and children with lymphatic disorders.
RELATED CLINICS
1st Floor
Palo Alto, CA 94304
Phone: 650-498-6000
To request an appointment at the Lymphedema Surgery Clinic Palo Alto, call 650-498-6004.
To request an appointment at the Lymphedema Surgery Clinic South Bay, call 408-426-4900.
To request an appointment at the Center for Lymphatic and Venous Disorders, call 650-723-6459.