Lymphedema is the condition of localized fluid retention and tissue swelling caused by a compromised lymphatic system. The lymphatic system returns fluid via the thoracic duct into the bloodstream, where it is recirculated back to the tissues.

After axillary lymph node surgery, including sentinel lymph node biopsy or axillary lymph node dissection, lymph nodes are removed from the axilla. Combination of this surgery with postoperative radiation therapy puts patients at risk of developing lymphedema.

During breast reconstruction procedures, lymph nodes can be transferred to the axilla to replace the removed lymph nodes. These new lymph nodes can help reestablish the missing link and redirect the flow of lymphatics back into the bloodstream. This procedure is termed “vascularized lymph node transfer” (VLNT), and requires delicate microsurgical technique to improve the outcome and ensure success.