Lipoaspiration and Controlled Compressive Therapy in Lymphedema of the Upper Extremity: A Comprehensive Systematic Review.

Lipoaspiration followed by controlled compression therapy has been used to treat lymphedema of the upper extremity. We aimed to describe the studies reporting on outcomes of this procedure, in addition to reporting the differences with patients that were treated only with compressive therapy. The PubMed database was queried for studies that evaluated the use of lipoaspiration for upper extremity lymphedema. The keywords "aspiration lipectomy" AND "lymphedema" and synonyms in different combinations were used for the search. From a total of 129 articles, 13 met inclusion criteria. Ten studies reported outcomes of patients treated with lipoaspiration followed by compressive therapy, and three studies compared this procedure with patients that had only compressive therapy. A complete reduction of the edema in the affected limb was found in all the studies. Better results were found in patients who had undergone both procedures. This systematic review suggests that lipoaspiration is recommended for patients with upper extremity lymphedema of any cause in stage two after a long period of compressive therapy that did not produce additional edema reduction.