Your lymphatic system is part of your body’s immune system. It helps protect you from infection and regulates fluid levels throughout your body.
Lymphedema is a condition that occurs when a problem with your lymphatic system causes fluid to accumulate in the space between your body’s cells, resulting in edema (swelling) that usually affects your arms or legs. Lymphedema can be present at birth, or it can occur after the removal of, or damage to, lymph nodes during cancer treatment.
UPMC experts offer comprehensive treatment for lymphedema, including physical therapy, compression, wound care, and more. Our team will work with you to develop a personalized treatment plan that improves your quality of life.
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What Is Lymphedema?
Lymphedema results from abnormal fluid buildup that causes swelling, usually in the arms or legs. It occurs when the lymphatic system — comprising lymph nodes and channels — cannot adequately remove proteins and fluids from the tissues.
The chronic swelling of lymphedema can greatly impact your daily life. It often leads to discomfort, reduced mobility, fatigue, and emotional distress.
At UPMC, our experienced plastic surgeons and certified therapists are here to help you manage and overcome these challenges.
We offer advanced surgical and nonsurgical treatments tailored specifically to your condition. Our specialists thoroughly understand how lymphedema affects your life, regardless of its cause. Whether you seek prevention, diagnosis, or treatment, we provide cutting-edge care from board-certified providers using state-of-the-art techniques.
What are the types of lymphedema?
There are two types of lymphedema:
- Primary lymphedema — Caused by rare, inherited conditions that affect how your lymphatic system develops, including Milroy’s disease, Meige disease, and lymphedema tarda.
- Secondary lymphedema — The most common type of lymphedema, secondary lymphedema is caused by damage to the lymphatic system resulting from surgery, trauma, or radiation therapy. It commonly occurs after breast cancer treatment.
What are the stages of lymphedema?
Stages of lymphedema include:
- Stage 0 — No visible swelling, but the affected area may feel swollen, tight, or heavy.
- Stage I — Occasional visible swelling that goes away with rest and elevation.
- Stage II — Near-constant visible swelling, with skin that feels firmer than surrounding skin.
- Stage III — Significant swelling with changes to skin color and texture.
How common is lymphedema?
- Secondary lymphedema is common, affecting about one out of 1,000 people in the U.S. It most commonly occurs after breast cancer treatment.
- Primary lymphedema is rare, affecting one in 100,000 individuals in the U.S.
What causes lymphedema?
Common causes of lymphedema include:
- Birth anomalies (congenital conditions).
- Cancer treatments (surgery and radiation therapy).
- Trauma or injury.
Lymphedema can also be caused by:
- Breast cancer surgery.
- Heart or blood vessel problems.
- Infection.
- Kidney disease.
- Lack of activity.
- Obesity.
- Pelvic surgery.
- Tumors.
Can breast cancer cause lymphedema?
Breast cancer itself doesn’t cause lymphedema. However, breast cancer treatment can sometimes involve removing lymph nodes, which can cause lymphedema to develop.
Lymphedema risk factors
You may be at an increased risk of developing lymphedema if you have:
- An infection that damages your lymph system.
- Blood vessel conditions.
- Breast cancer surgery that involves removing lymph nodes.
- Obesity, which reduces the flow of lymph fluid.
- Trauma or injury to your lymphatic system.
Complications of lymphedema
Lymphedema may cause complications, including:
- Deep vein thrombosis (DVT), which occurs when a blood clot forms in a leg vein.
- Emotional distress and problems with self-esteem due to visible swelling.
- Infection, such as cellulitis or lymphangitis.
- Lymphangiosarcoma, a rare soft tissue cancer caused by untreated lymphedema.
- Skin problems, such as fissures, ulcers, or papillomatosis.
How can I prevent lymphedema?
You may not be able to completely prevent lymphedema.
However, there are things you can do to reduce your risk, including:
- Asking your doctor about exercises you can do after breast cancer surgery to reduce the risk of swelling.
- Avoiding extreme heat.
- Elevating the affected area.
- Exercising regularly.
- Wearing loose-fitting clothing, unless your doctor recommends compression garments as part of your treatment plan.
What Are the Signs and Symptoms of Lymphedema?
Symptoms of lymphedema may include:
- Clothing or jewelry feeling tight on the skin.
- Feelings of burning or itching.
- Frequent infections.
- Heaviness, fullness, or tightness in your arms or legs.
- Limited range of motion due to swelling.
- Red, puffy skin.
- Swelling in your arms, feet, and/or legs.
- Thickening skin.
- Tingling, numbness, stiffness, or burning sensations.
- Ulcers or sores on the legs, in advanced stages.
Lymphedema symptoms can be similar to those caused by other vascular conditions, including:
- Deep vein thrombosis (DVT).
- May-Thurner syndrome.
When should I see a doctor about my lymphedema symptoms?
If you have symptoms of lymphedema, schedule an appointment with your doctor right away. Getting early treatment can reduce your risk of complications and improve your quality of life.
How Do You Diagnose Lymphedema?
If your doctor suspects lymphedema, they will:
- Ask about your symptoms.
- Perform a physical exam.
- Order imaging tests.
- Review your health history and medications.
Tests to diagnose lymphedema
Imaging tests to diagnose lymphedema may include:
- CT scan — A painless, noninvasive test that uses x-ray technology to capture multiple cross-sectional images of organs, bones, and tissues inside your body.
- Magnetic resonance imaging (MRI) — A safe, noninvasive imaging test that uses a magnetic field and radio waves to produce highly detailed images of the inside of your body without radiation exposure.
- Ultrasound (sonography) — A painless, noninvasive test that uses high-frequency sound waves to produce real-time images of blood flow.
What to Expect
At UPMC, patients receive comprehensive care from a multidisciplinary team that includes surgeons, physician assistants, physical therapists, and dietitians who are all certified in lymphedema management.
Your personalized treatment plan will begin with:
- Advanced diagnostic testing (including bioimpedance technology — SOZO).
- A thorough medical history and physical exam.
- Customized garment fittings and supplementary therapies such as lymphatic pumps.
- Precise measurements to track progress.
We offer coordinated care in a supportive, patient-focused environment, ensuring continuous monitoring and adjustments tailored to your recovery.
Lymphedema prognosis
Lymphedema is a chronic condition that can’t be cured, but symptoms can be managed with treatment and lifestyle changes.
What is the life expectancy of someone with lymphedema?
With treatment, lymphedema typically does not reduce life expectancy.
How Do You Treat Lymphedema?
The goals of lymphedema treatment are to reduce symptoms and improve quality of life.
UPMC offers a full spectrum of care, from early surveillance to conservative therapy and microsurgical interventions. Treatment plans are personalized based on a patient’s stage, symptoms, and goals. Many patients start with complete decongestive therapy (CDT) and may be candidates for surgery.
Treatment may include:
Nonsurgical treatment options
Certified lymphedema therapists provide personalized care, including all components of CDT:
- Compression bandaging — Multilayer bandaging that helps reduce swelling and maintain fluid movement.
- Maintenance phase — Includes compression garments and self-care techniques to manage long-term symptoms.
- Manual lymphatic drainage (MLD) — A gentle massage technique that stimulates fluid movement through the lymphatic system.
- Therapeutic exercise — Improves lymph flow and mobility.
Lifestyle changes
Your doctor may recommend lifestyle changes, including:
- Avoiding extreme heat.
- Elevation.
- Exercise.
- Taking breaks from sitting to move around.
- Wearing loose-fitting clothing for comfort.
- Weight loss.
Physical therapy
Physical therapists with advanced training in lymphedema care may recommend treatments including:
- Compression therapy — Wearing bandages, specialized garments, or pump devices that provide pressure to prevent fluid accumulation and swelling.
- Manual lymphatic drainage (MLD) — A form of gentle massage that can be performed by a physical therapist or on your own.
Surgical treatment options
For patients who need additional support, our board-certified plastic and reconstructive surgeons offer cutting-edge surgical options, including:
- Debulking procedures — A procedure for very severe lymphedema, debulking removes excess tissue and fat accumulation through techniques such as liposuction or direct excision, typically covering the area with a skin graft.
- Immediate lymphatic reconstruction (ILR) — Performed simultaneously with lymph node removal to restore lymphatic flow and reduce the risk of developing lymphedema.
- Lymphovenous anastomosis (LVA) —A minimally invasive supermicrosurgery technique that connects lymph vessels directly to veins, bypassing damaged areas and reducing swelling, pain, and infection risk.
- Vascularized lymph node transfer (VLNT) — A plastic surgery for lymphedema, this procedure transfers healthy lymph nodes from one area to an affected region, promoting improved drainage.
Why Choose UPMC for Lymphedema Care?
When you choose UPMC for lymphedema care, you will receive:
- Certified lymphedema therapists — Our therapists provide comprehensive, personalized care programs combining manual lymphatic drainage, compression therapy, exercise, and patient education.
- Collaborative multidisciplinary team — We foster a friendly, integrated team approach, ensuring the best outcomes through coordinated care.
- Comprehensive breast cancer expertise — The breast cancer experts at UPMC provide state-of-the-art care for every form of breast cancer at every stage of the disease.
- Expert plastic surgeons — Our board-certified plastic surgeons are leaders in supermicrosurgery, an innovative and highly specialized technique for treating lymphedema. UPMC is among the few centers nationally offering this advanced approach.
- Management of treatment side effects — Our experts collaborate to help you manage the side effects of your treatment, including lymphedema.
- Supportive services tailored to your needs — Our approach to breast cancer care honors your preferences with supportive services for the best possible results.
