Lymphoedema 2020-03-22T22:55:57+00:00



Lymphoedema is a result of a dysfunction of the lymphatics or lymph nodes of the upper or lower limbs.

This results in accumulation of extra-cellular fluid in the limbs, resulting in increased inflammation, fibrosis and thickening.


  • Primary (congenital/genetic)
  • Secondary (acquired causes)
    • Cancer (breast cancer causing upper limb lymphedema)
    • Surgery
    • Radiation
    • Infection


Latent or subclinical
I    Early accumulation of fluid, subsides with elevation, pitting may occur
II  Limb elevation alone rarely reduces swelling, and pitting    is common
III  Lymphostatic elephantiasis, skin changes, fibrosis


  • Clinical examination
  • Lymphoscintigraphy
  • ICG Lymphography
  • MRI
  • MRI Lymphography


  • Conservative treatments with a qualified OT is critical in the management of lymphedema.
  • Surgical options include:
    1. Microsurgery
      • Lymphatico-venous anastomosis
      • Free lymph node transfer
        • Cervical
        • Sub-mental
        • Groin
        • Gastro-epiploic
      • Microsurgical techniques have become increasingly popular in the treatment of lymphoedema and is now the gold standard for the surgical correction of this condition especially in secondary lymphoedema.
    1. Excisional techniques
      • Reserved for severe cases

 *Please schedule an appointment for a thorough consultation.

Dr Liakos has travelled extensively, visiting units specializing in microsurgery around the world.  Dr Liakos and his team has performed the first free vascularized lymph node transfer in the country at Charlotte Maxeke Johannesburg Academic Hospital.

Dr Dimitri Liakos is a member of the College of Plastic and Reconstructive Surgeons of South Africa and a member of the Association of Plastic, Reconstructive and Aesthetic Surgeons of South Africa (APRASSA).

He is a member of the World Society of Reconstructive Microsurgeons (WSRM) and the International Society of Aesthetic Plastic Surgeons (ISAPS).