Ask Dr. David W. Chang, F.A.C.S.

Areas of Expertise:
  • Surgical Management of Lymphedema

David W. Chang, M.D., is professor in the Department of Surgery at The University of Chicago Medicine. He is currently Vice President of the World Society for Reconstructive Microsurgery, and Vice President of the American Society for Reconstructive Microsurgery. Dr. Chang specializes in complex microsurgical reconstructive surgery in cancer patients, and has developed a national and international reputation as an expert and an innovator in the field of breast reconstruction and microsurgical treatment of lymphedema. He has published more than 120 peer-reviewed research articles in high-impact journals as well as dozens of book chapters. He is also a prolific speaker, and has lectured at more than 100 national and international symposiums and meetings, while serving as visiting professor at institutions all over the world. Dr. Chang has been named to Best Doctors in AmericaÒ every year since 2001. He is on the editorial board of numerous leading medical journals including the Plastic and Reconstructive Surgery. He is a recipient of the Godina Traveling Fellowship from ASRM in 2005. Dr. Chang is a board examiner for American Society of Plastic Surgery since 2008.​


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  1. Lymph nodes transplant
    Question (Ghada, ):
    • I very got lymphdema in my hand and fingers since 2 months as a result of left breast cancer mastectomy, there were 20 nodes removed I started to face it just aftery radiation finished, l just read about the transplant surgery, is it possible and doable operation, can't stand my life with the lymphdema and I would risk anything to get cured. Please advice doctor.

    Answer:
    • Jul 2018

      Lymph node transfer is one of the surgical options that may help with lymphedema. I would advice that you visit with a surgeon who have experience in lymphatic surgery to evaluate your situation and discuss options.

  2. Bi-lateral mastectomy with immediate Apex/DIEP Reconstruction
    Question (Sherry, ):
    • I had bilateral mastectomy with immediate APEX/DIEP Flap reconstruction 6.5 years ago, I have always have a thickening, swelling pain in the armpit area. I thought (foolishly, I guess) that because I only had my sentinel node removed, and doctors bandaged the arm in which the sentinel node was to be removed from that I would be somehow immune from getting lymphedema. Well it has been getting worse. Now the entire armpit area, side of the breast, up and around the shoulder area, the bicep and now moving down to the hand, has a weird heaviness feeling, burning like pain, swelling but not in the arm that I can see, top of the breast area has a tight pulling feeling and the lower neck (right at the collarbone area) area at times feels like I have a tight necklace on, bad thing I don't wear a necklace. I go to a Physical Therapist on the 16th to do test to see if it is actually lymphedema. Is there anything I should be doing in the interim? I know you cannot diagnose without seeing it first but your best guess would be awesome. Thank you

    Answer:
    • Aug 2018

      Clinically, sounds like you have lymphedema.
      You may consider lymphoscintigraphy to confirm.

      sincerely,

  3. APEX/DIEP Flap
    Question (Sherry, ):
    • in 2011 I had a bilateral mastectomy with immediate APEX/DIEP Flap reconstruction. I have always have a thickening, swelling pain in the armpit area. I thought (foolishly) that because I only had my sentinel node removed I would be somehow immune from getting lymphedema. Well it has been getting worst. Now the entire armpit area, side of the breast, up and around the shoulder area, the bicep and now moving down to the hand, has a weird heaviness feeling, burning like pain, swelling but not in the arm that I can see, top of the breast area has a tight pulling feeling and the lower neck area at times feels like my necklace is tight, bad thing I don't wear a necklace, I went to the breast specialist and was told they would refer me to a PT specialist but they didn't think it was lymphedema at all. Should I just not worry or should I pursue other avenues.

    Answer:
    • Aug 2018

      You can get lymphedema even after removal of just sentinel nodes.
      Clinically it sounds like you have lymphedema.
      You ca get lymphoscintigraphy to confirm but probably not necessary.

  4. Primary lymphedema
    Question (Sue, ):
    • My 30 year old son has severe lymphedema in both legs and has been told he has no lymphatic channel in one leg. Would liposuction be sensible for him, and also what does node transplant entail ? Any help/advice would be greatly appreciated.

    Answer:
    • Aug 2018

      liposuction can be helpful especially if his lymphedema has significant fat component.  Lymph node transfer involve transferring health lymph nodes from elsewhere in the body to the area of lymphedema. usually requires microsurgery.

  5. Patient
    Question (Michael, ):
    • I have had primary in right leg for near 50 years. About 3+ years ago after a nurse used unapproved later found out laser device several timesI started swelling right side and now into chest area also. Biopsy done right grown January 1973 and told it was chronic lymph disease. Over the years have had all treatment available including lymph air pressure machine, lymph drainage etc. Question: Can I be a candidate for lymph node transplant and what do I need to do to determine since there is limited information and no one doing that in AZ. Are their any trials (transplant) that I could participate in? I am 65 years old and more than basic knowledge of Milroy disease)Lymphedema praecox (Meige disease) Michael

    Answer:
    • May 2015

      Thank you for your question. you have a very long history of lymphedema.
      It would be useful to get lymphoscintigraphy to assess your lymphatic function. Most hospitals with nuclear medicine department can do it.
      Helpful to know your height and weight. any history of venous or vascular problems? Any other health issues, medications?
      You could potentially be a candidate for lymph node transfer or lymphovenous bypass or both.