Ask Dr. Roman Skoracki

Areas of expertise:

  • Surgical treatment of lymphedema (Extremity and head and neck lymphedema)
  • Multiple Lymphaticovenular Anastomoses – for treatment as well as in the prophylactic /immediate setting
  • Liposuction for Lymphedema
  • Liposuction for Lipedema
  • Lymph node transplant
  • Diagnostic imaging of lymphedema
  • Screening for patients at risk of lymphedema
  • Multidisciplinary care of lymphedema

Bio:

Roman Skoracki, is the Division Chief for Oncologic Plastic Surgery at the OSUCCC – James. His focus is on reconstruction for cancer patients, particularly microsurgery and surgical treatment for lymphedema. He is one of a small number of surgeons in the country who perform surgical treatments to relieve lymphedema, has developed several surgical techniques in the field and is one of only a few surgeons’ world-wide treating patients for lymphedema of the head and neck. These micro-vascular surgeries treat symptoms of lymphedema by re-routing lymphatic channels to allow proper fluid drainage or re-introducing lymph nodes to the affected region.

He has published more than 60 peer-reviewed manuscripts and three book chapters, along with co-editing the textbook Advanced Therapy of Breast Diseases published in 2012 and a textbook on head and neck reconstruction. He has a keen clinical and research interest in lymphedema, a field he has focused on for the past 10 years of his practice. He is currently engaged in multiple clinical trials as well as basic science projects examining lymphedema and its treatment.

My expertise and experience have prepared me for to make a strong contribution to the proposed study.


Submit a New Question
  1. Radioactive Iodine
    Question (Gina, ):
    • Is it possible to develop lymphedema of the neck (either internal or external) as a result of radioactive iodine treatment for thyroid cancer? I'm a CLT, but don't know how to answer this question for my patient. Thank you!

    Answer:
    • Jul 2024

      Response from Dr. Skoracki:

      Not unless there was widespread lymph node involvement with cancer prior to the radioactive iodine treatment. In that case other surgery would usually be indicated and radioactive iodine alone would not likely be the only therapy. Short answer – I have never seen lymphedema of the head and neck develop after radioactive iodine treatment alone.

      Hope that helps

  2. Lymph Node Removal
    Question (Janet, ):
    • Following a lumphectomy in June 2023, a total of 11 lymph nodes were removed. Follow-up treatment was radiation. I was diagnosed with lymphedema. In January 2024 my eye lids have turned red and swollen. Wonder if the eye lid problem is a result of poor drainage?

    Answer:
    • Jul 2024

      Dr. Skoracki’s response:

      The eyelid issues are unrelated. The drainage from the head and neck is to a different set of lymph nodes. Having said that, depending on the systemic treatment of the breast cancer, this can have effects on other parts of the body including generalized swelling. If that is the case, your medical oncologist will want to know.

  3. Facial Neck LVA/LVB
    Question (P, ):
    • Do you have expertise or a referral in the USA or worldwide for a super micro/micro surgeon who does LVA/LVB of the Face/Neck after Node Trauma (Buccal and Preauricular) obstructive symptoms. Thank you

    Answer:
    • Dec 2023

      Dr. Skoracki’s response:

      The answer is yes. Our group does perform LVB and VLNT for head and neck lymphedema.

  4. Peri ocular Lymphedema
    Question (Valerie, ):
    • Dear Doctor, Do you test for lymphatic issues in upper and lower eyelids or can you direct me to a doctor who could ? This is not cancer related. It is swelling that is getting worse potentially due to aggressive rubbing. I was rubbing bc of mild swelling initially.

    Answer:
    • May 2023

      As per Dr. Skoracki:

      The eyelids are designed to respond to even minor trauma with significant swelling. Thankfully this will settle in the absence of further irritation within days to weeks, unless it is irritated again.
      I am not aware of isolated prolonged lymphedema isolated to the eyelids alone, this is usually in combination with a lymphatic disruption in the neck and/or lower face that involves the lower face and may include the eyelids as well.
      I am not sure of anyone else who sees or treats a significant number of head and neck lymphedema patients beyond our center in the US.

      Thanks,
      Roman

  5. Enlarged Parotid Lymphnodes
    Question (Michael , ):
    • Hello I'm a 54 y/o Caucasian male. Have 2 painless reactive lymphnodes in parotid gland for15months 2xnormal size. Core needle biopsy showed no lymphocytes/malignancy. Appeared days after 3rd full Moderna vaccine. Had 2 additional boosters +mild Covid since. Have taken two courses of antibiotics. Still won't shrink. Any ideas?

    Answer:
    • Jan 2023

      As per Dr. Skoracki:

      Thank you for your inquiry.

      We are seeing a number of patients with prolonged lymphadenopathy after COVID vaccinations. Usually these do decrease to a more normal size over time, but this process may take many months (no good data available as to exact duration). Having said all that, I would recommend continued close follow up with a head and neck surgeon for serial physical examinations and likely FU imaging studies and if there is any change other than a decrease in size over time a repeat biopsy.

      -Dr. Skoracki

  6. Patient advocacy
    Question (Joseph, ):
    • I think I have a head/neck lymphedema based on my symptom set and much open ended research which led me here. Doctors are unwilling to give credence to my reported symptoms; actively, baselessly resist the possibility of lymphedema. What can I do?

    Answer:
    • Nov 2022

      As per Dr. Roman Skoracki:

      There are fantastic teams of lymphedema specialists around the country especially those in LE&RN;‘s Centers of Excellence (https://lymphaticnetwork.org/centers-of-excellence) who would be very happy to assess you and design a treatment plan for you.

  7. Head and neck internal lymphedema
    Question (Dixie, ):
    • My sister is suffering from head/neck internal lymphedema, after tongue and lymph node surgery, and radiation seven months ago. She has very little external lymphedema, but a hard neck. Is internal lymphedema harder to treat than external? Are they treated in the same? Are compression and lymphedema pump effective? -Dixie

    Answer:
    • Nov 2022

      Posted on behalf of Dr. Skoracki:

      The best starting point would be to see a certified lymphedema therapist. The majority of head and neck lymphedema resolves with time. That process can be significantly accelerated with MLD and potentially compression.

      The tightness may not be lymphedema, but rather post-surgical and radiation fibrosis. For a definitive diagnosis of internal swelling, an endoscopic examination would be the gold standard.
      In terms of lymphedema treatment, there are several options, but the most common surgical options would be lymphovenous bypass and vascularized lymph node transplant, where the latter is more commonly the treatment of choice for isolated internal lymphedema.

      Hope this helps.

      Thank you for your inquiry

  8. possible new area
    Question (Melissa, ):
    • Question (Melissa, ): I was prescribed a lymphatic massage pump for lower body for swelling associated with venous disease and it helps dramatically. A month ago I had gum graft. Still experiencing internal neck swelling - Med catch, smaller bites, feeling of fullness, neck pressure, headaches. No neck imaging yet. I am going to LANA PT in Sept. What imaging should I expect?

    Answer:
    • Oct 2022

      As per Dr. Skoracki:
      I will defer this question to one of my PT colleagues.
      In general, I am not sure there will be any imaging ordered or performed by a lymphedema therapist. You will likely undergo a thorough history and physical examination and develop a treatment plan for your swelling. Your therapist may also recommend that you see additional specialists who may order additional testing.
      Our PT added:
      I agree, the lymphedema therapist will perform a thorough subjective and objective assessment and develop a treatment plan based on your needs. The lymphedema therapist would not be ordering any imaging but they work closely with the other members of the medical team to assure a comprehensive approach to care.

  9. Possible new area of lymphadema
    Question (Melissa, ):
    • I was prescribed a lymphatic massage pump for lower body after clotting event, helps dramatically. A month ago I had gum graft. Still experiencing internal neck swelling - Med catch, smaller bites, feeling of fullness, neck pressure, head aches. How long until can say long enough could be lymphatic?

    Answer:
    • Aug 2022

      LE&RN; is posting the answer on behalf of Dr. Skoracki. Here is his response:

      Thank you for your inquiry. Do you have congenital lymphedema to the lower extremities or leg swelling associated with venous disease?

      It would be incredibly rare to develop lymphedema of the head and neck after a gum grafting procedure, unless there is a significant underlying lymphatic defect. Have you had any imaging?

  10. Cystic Hygroma in Adult
    Question (Karen, ):
    • A friend is diagnosed with a Cystic Hygroma, very large, extending from neck to thorax. Specialist said neither surgery nor draining is an option. Looking for names of specialists anywhere who she could contact for help. Worried about her prognosis as she is told she has a very rare case.

    Answer:
    • Sep 2021

      Thank you for your inquiry. We do care for complex head and neck as well as thoracic masses, including cystic hygromas. Our usual approach would be a multidisciplinary team approach especially if this is a complex lymphatic (+/- vascular) malformation, including interventional radiologists, head and neck, thoracic and plastic surgeons. I would be happy to review the patients history and imaging to give you a better idea of possible treatment options.
      Hope this helps