Over the past decade, significant advances have been made in the surgical treatment of lymphedema. The most notable changes have been the reintroduction and evolution of physiologic techniques, including lymphovenous bypass—sometimes referred to as lymphovenous anastomosis in the literature—and vascularized lymph node transplant. These surgical modalities are now often used as first-line surgical options or may be combined with nonphysiologic approaches, including direct excision and suction-assisted lipectomy. Surgeons continue to debate the most appropriate sequence and combination of surgical treatment, particularly for patients at both extremes of the severity spectrum. Furthermore, debate remains around the need to apply different treatment approaches for patients with upper versus lower extremity involvement and primary versus secondary cause. In this article, we provide a summary of the surgical techniques currently used for both primary and secondary lymphedema and provide our recommendations for optimizing the surgical care of patients with lymphedema.

Intended Audience
This educational activity is intended for all CME-related persons including plastic surgery practitioners, residents, and other healthcare professionals.

Learning Objectives
After viewing this course, the participant should be able to:

• Describe current surgical techniques for treating primary and secondary lymphedema.
• Optimize the surgical care of patients with lymphedema.

Faculty
Rebecca M. Garza, MD; Daniel Wong, MD; David W. Chang, MD

Plastic and Reconstruction Surgery®Editors:
Editor-in-Chief:Kevin Chung, MD
Co-Editor:Amy Colwell, MD
Section Editors:John Y.S. Kim, MD

The following ABMS core competencies will be addressed:

• Medical Knowledge
• Patient Care

The American Society of Plastic Surgeons (ASPS) is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

Designation
The ASPS designates this enduring material for a maximum of1.0 AMA PRA Category 1 Credit. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Recognition Statement
The Continuing Medical Education (CME) credits offered by this activity are enhanced by ASPS Learner Credit Reporting for learners who have opted into this reporting. Successful completion of this CME activity enables active American Board of Surgery (ABS) members the opportunity to earn credit toward the CME requirement of the ABS's Continuous Certification program when claimed within 30 days of completion of the activity.

Participants in ASPS-accredited education who want their CME credits reported to certifying and state licensing boards must opt-in to reporting and add their NPI as well as state license ID and/or collaborating board ID(s) before claiming credit.

AMA PRA Category 1 CreditTM: 1.0
Patient Safety Credit: 0.5
Media:Journal Article, video
Release Date: 12/01/2023
Expiration Date: 12/01/2026*
Estimated time to complete this course: 1 hour
*Course access ends on course expiration date

Directly provided by the American Society of Plastic Surgeons® (ASPS®)

The following planners/faculty members/reviewers have no relevant financial relationships or affiliations to disclose:
Rebecca M. Garza, MD; Daniel Wong, MD; David W. Chang, MD

The Accreditation Council for Continuing Medical Education (ACCME) accredits ASPS to provide educational activities and material with Category 1 CME credits. As an official CME provider, ASPS must comply with all ACCME standards, as outlined in the ACCME Standards for Integrity and Independence in Accredited Continuing Education.