People who have had surgery to remove part of the lymphatic system are at risk of developing lymphedema, a buildup of fluid in soft bodily tissues. Other risk factors for lymphedema include inflammatory disorders, venous conditions, obesity, and immobility.

The lymphatic system is responsible for maintaining fluid levels in the bodily tissues and removing fluids that leak from blood vessels. It is also a critical part of the immune system. If lymph vessels become damaged or blocked, lymphedema can develop.

Lymphedema is the accumulation of protein-rich fluids in the tissues. It causes swelling, heaviness, tight or thickened skin, and repeated skin infections. It progresses over time, so prompt diagnosis and treatment are essential.

This article looks at lymphedema in more detail, including the risk factors and treatment options.

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The risk factors for lymphedema vary depending on whether the condition is primary or secondary.

Primary lymphedema is genetic. It happens when there are faults in the genes responsible for the development of the lymphatic system, meaning that it cannot drain fluid as it should. The main risk factor for primary lymphedema is having close family members with the condition.

Secondary lymphedema is the result of another condition that affects the lymphatic system. The risk factors include:

  • Surgery for cancer: Sometimes, surgeons remove lymph nodes, which are part of the lymphatic system, to stop cancer from spreading. This increases the chance that lymph will not drain properly, resulting in lymphedema. The treatment for cancers such as breast cancer, skin cancer, cervical cancer, and prostate cancer may involve surgery to remove lymph nodes.
  • Radiation therapy: This cancer treatment uses radiation to destroy cancer cells. However, it can also damage healthy tissue, including the lymphatic system, leaving it unable to drain fluid.
  • Tumors: Sometimes, the cancerous tumor itself blocks a lymphatic channel, leading to a buildup of fluid.
  • Immobility: Movement helps with lymph drainage, as muscle activity promotes the movement of fluid along the lymphatic vessels. Therefore, reduced movement can raise the risk of lymphedema. People who experience limited mobility for long periods — for instance, due to illness, nerve damage, or arthritis — may be at risk of developing lymphedema.
  • Injury: Sometimes, extensive bruising and injury to the soft tissues can increase the risk of lymphedema. People who have experienced burns, crush injuries, or other forms of trauma may be at risk.
  • Excess body weight: People with obesity have an increased risk of developing swelling. The reason for this is unclear, but it could be due to extra tissue reducing the flow of fluid through the lymphatic channels.
  • Venous diseases: Conditions affecting how blood flows through the veins can increase the risk of lymphedema. Unhealthy veins may allow fluid to overflow into the tissue spaces. Eventually, this overwhelms the parts of the lymphatic system responsible for draining the fluid.
  • Inflammation: Conditions that cause chronic inflammation, such as arthritis, can increase the risk of developing lymphedema. This is because inflammation can damage or destroy the lymph vessels.
  • Infections: Cellulitis, a bacterial skin infection, can increase the risk of lymphedema. Severe cellulitis can cause damage to the tissue surrounding the lymphatic system. This leads to scarring and poor drainage. A parasitic infection known as filariasis can also cause lymphedema. In people with filariasis, threadlike worms inhabit the lymphatic system and block lymph drainage.

Certain people are more likely than others to get lymphedema. These individuals include those with:

Additionally, people who have had cancer surgery that involves lymph node removal or received radiation therapy as part of cancer treatment are more likely to get lymphedema.

Although lymphedema can be a problem after surgery or radiation therapy for nearly any type of cancer, it is most common in:

One of the jobs of the lymphatic system is to transport fluid that contains waste material, or lymph, away from tissues and organs. Lymph consists of various substances, such as:

  • white blood cells
  • triglycerides
  • bacteria
  • cellular debris
  • water
  • protein

However, the lymphatic system is complex. It consists of many small vessels that branch out from the larger vessels and lymph nodes. The cause of lymphedema is abnormalities in these vessels.

If any part of the lymphatic system becomes blocked or damaged, lymph can build up in the tissues, causing swelling.

People with primary lymphedema may have the condition from birth, or it can appear later. Primary lymphedema is rare and affects just 1 in 100,000 individuals. Secondary lymphedema is more common, affecting about 1 in 1,000 people in the United States.

Lymphedema progresses over time, so early diagnosis and treatment are critical. Whenever possible, doctors should refer the person with lymphedema to a specialist.

The treatment for lymphedema may involve:

  • Decongestive lymphedema therapy (DLT): DLT aims to move lymph around the body and reduce the formation of thickened or fibrous tissue, which can develop in people with lymphedema. DLT is the main treatment for moderate to severe cases.
  • Manual lymph drainage: This light massage moves lymph around the body and helps it drain, reducing swelling.
  • Compression: Wearing stretch bandages or compression garments during the day and night helps reduce swelling. However, poor application can cause skin irritation and increase the risk of skin infections.
  • Skin care: Carefully applying lotion to tight skin helps prevent cracking and infection.
  • Exercise: Physical activity helps move lymph and reduce swelling by increasing protein absorption.
  • Medications: These can ease pain and control secondary infections.

Doctors may also suggest surgical options, including:

  • Lymph node transplantation: In this procedure, a surgeon removes healthy lymph nodes from one area of the body and transplants them to the area with lymphedema. The lymph nodes re-establish lymphatic circulation and improve symptoms.
  • Lymphovenous bypass: This involves connecting lymphatic vessels to small adjacent veins, bypassing the damaged lymphatic vessels.
  • Liposuction: A surgeon removes excess tissue from the area with lymphedema using a thin suction tube.

People with mobility impairments may also benefit from speaking with occupational therapists or physical therapists who specialize in lymphedema for advice and support.

No, there is no cure for lymphedema. However, with early diagnosis and treatment, doctors can manage the condition and reduce its physical and emotional impact.

Lymphedema therapy and surgery can help lessen the symptoms. Following surgery, people often see a reduction in the circumference or volume of their limbs over several months. They may also see improvements in symptoms such as tightness and heaviness.

Lymphedema is a condition that causes swelling in the soft tissues. The main risk factor for primary lymphedema is a family history of the condition, as it is genetic. Secondary lymphedema has many risk factors, including some cancer treatments, injury, inflammatory diseases, and infections.

The condition occurs when there is a problem with the lymphatic vessels, which drain lymph from tissues. This leads to a buildup of fluid.

Treatment may include manual lymphatic drainage, which is a type of massage that moves lymph through the body. DLT, medications, exercise, and compression garments may also be part of a person’s treatment plan.