A better quality of life through comprehensive treatment

Lymphoedema is a disorder of the lymph system on which lymph fluid pools in the tissue under the skin in an area of the body. This can lead to swelling, pain, infections and compromised movement. Lymphoedema occurs most commonly on the arms and legs. 

We are specialised in the operative treatment of lymphoedema. Our aim is to provide you with the best possible surgical treatment, to achieve the maximum possible restoration of function and thereby to help you minimise or overcome your everyday complaints. 


A specialised surgical team

A specialised surgical team

A specialised surgical team

A specialised surgical team with many years of experience.

A comprehensive treatment concept

A comprehensive treatment concept

A comprehensive treatment concept

A comprehensive treatment concept based on the knowledge and decades of experience of Prof. Hanno Millesi, which we are continuously developing further on the basis of the latest scientific research findings.

A part of the Wiener Privatklinik hospital

A part of the Wiener Privatklinik hospital

A part of the Wiener Privatklinik hospital

As part of the Wiener Privatklinik hospital, we boast the latest equipment.

experienced interpreters

experienced interpreters

experienced interpreters

On request, we can arrange experienced interpreters.

all-round care

all-round care

all-round care

You are provided with all-round care – from your enquiry until you leave the hospital after your treatment. All the necessary examinations, treatment and care take place at the hospital.

Support you after the treatment

Support you after the treatment

Support you after the treatment

We continue to support you after the treatment and carry out corrective therapies if necessary.

surroundings where you feel competently taken care of

surroundings where you feel competently taken care of

surroundings where you feel competently taken care of

It is important to us to offer you surroundings where you feel competently taken care of and at ease.

These are the causes of lymphoedema

Lymphoedema has various causes. These include:

  • Injuries to the lymph vessels
  • Operations in the area of the lymph vessels (e.g. after cancer)
  • Radiotherapy for tumours
  • Chemotherapy
  • Chronic venous function weakness
  • Congenital disorders of the lymph system

Symptoms of lymphoedema

Those affected by lymphoedema suffer from:

  • Swelling of the affected region
  • Feeling of heaviness
  • Tension or pressure pain
  • Itchiness
  • Recurring infections

If the lymphoedema is not treated, it can lead to serious health problems such as skin infections or deformation of the affected limb.

Types of lymphoedema

Lymphoedema can be primary or secondary. Primary lymphoedema is congenital, rare and usually associated with genetic diseases. Secondary lymphoedema is by far the more common form in Europe, which can be caused by an injury, an illness or an operation as an unwanted side effect or complication.

Primary lymphoedema
In the case of primary lymphoedema, there are malformations in the development of parts of or the whole of the lymph system. In most cases one extremity is affected, rarely both. In many cases, primary lymphoedema is associated with other genetic diseases. 

Secondary lymphoedema
Secondary lymphoedema usually occurs

  • as an unwanted side effect or complication of a disease, e.g. breast cancer (20-40 %), prostate cancer (10-20 %)
  • after operative interventions, e.g. after radical prostatectomy and/or lymph node removals (lymphadenectomy)
  • after radiotherapy
  • due to certain chemotherapies
  • due to chronic venous insufficiency
  • due to skin diseases such as erysipelas, lymphangitis or cellulitis
  • as a side effect after a parasitic disease
  • due to obesity

How lymphoedema develops

Lymphoedema develops in four stages:

Stage I: The lymph system is compromised but still does not cause any symptoms.

Stage II: The lymphoedema is clearly in evidence but can be partially reduced by raising the affected part of the body.

Stage III: In this stage, the lymphoedema has already become chronic and can no longer be reduced by raising the affected part of the body.

Stage IV: Elephantiasis: The affected part of the body is misshapen, stretched and is painful to the touch. It is often exacerbated by badly healing wounds and chronic infections.

Millesi Foto

How the diagnosis is made

The diagnosis of lymphoedema takes place in several steps. First, we carry out a clinical examination. This is supported by lymphoscintigraphy, the current diagnostic gold standard, especially for planning an operative treatment strategy.

In order to ascertain the lymphatic volume in more detail, a magnetic resonance lymphangiography and/or a high-resolution ultrasound examination may be necessary.

In addition, before a planned reconstruction of the lymph system, a special colouring agent, namely indocyanine green (ICG) is injected into the lymph vessels to make them visible with a camera. This allows the most detailed planning of the operative strategy.

The treatment of lymphoedema

In most cases, lymphoedema is very unpleasant and compromises the quality of everyday life to varying degrees. Depending on the severity of the lymphoedema and the general state of health of the patient, the following treatments are available as part of the initial treatment and as accompanying measures:

1. Complex physical decongestive therapy (CDT)
Complex physical decongestive therapy is usually already carried out regularly by the affected person to reduce the discomfort of pressure at least temporarily. This type of treatment comprises manual lymph drainage, bandaging, compression dressing, special skin care and hygiene measures, as well as kinesitherapy.

2. Nutritional advice
Lymphoedema patients need, in addition to conservative and surgical measures, a special and individually composed nutrition that can be ensured by trained and experienced nutritionists.

Operative treatment can help to halt the progression of lymphoedema and to ease the symptoms. In some cases, an operation can lead to the lymphoedema regressing completely and lymph flow normalising. On the basis of supermicrosurgery, we are technically able to operatively restore the function of the lymphatic system.


Supermicrosurgery is a further development of microsurgery that allows the preparation and suture of vessel diameters of under 1 mm. Not only are specially made, superfine instruments required for this but also extremely high-resolution microscopes (up to 70-fold magnification). The necessary suture materials are smaller than 0.1 mm.

Always depending on the individual situation and the clinical severity of the lymphoedema, we offer a range of operation methods:

a)  Lymphovenous Anastomosis / LVA
In order to bypass a local drainage problem, it is possible with the help of supermicrosurgical operation techniques to reconstruct the drainage of the lymph through the suture of several lymph vessels on superficial veins. Patients in the lymphoedema stages I and II are suitable for this operation method.

b) Lymph node transfer 
Healthy lymph nodes can be transplanted into a congested lymph drainage area and be connected by means of supermicrosurgical operation methods to an arterial supply and a venous drainage. The transplanted lymph node thus takes over the drainage of lymph fluid. In some cases, such as in stage III, lymphovenous anastomosis can be combined with a lymph node transfer. 

c) Lymphoceles
Lymphoceles usually occur as a consequence of operative interventions, after which lymph fluid flows freely into the tissue and pools. Lymphoceles usually regress by themselves after some weeks. In cases of persistent lymphoceles, lymph flow can be restored by means of LVA (Lymphovenous Anastomosis) using supermicrosurgical operation techniques.

Millesi Team Foto

We can help you under these conditions:

You are suffering from lymphoedema, whatever the cause, are looking for a lasting restoration of the disturbed lymph flow and would like to gradually stop complex physical decongestive treatment or at least reduce it. 

After a detailed clinical examination and assessment of the findings, we advise you on the available surgical options and put together a complete treatment plan for you. 



Arrange an initial consultation at your convenience, by e-mail or telephone. If you already have a longer history of illness, we kindly request that you complete our free questionnaire. Your answers help us to prepare your first appointment optimally.


We choose the optimal treatment for you. The aim is to achieve the best possible outcome for you and to help you to overcome or minimise your complaints.


After the treatment at the hospital, we take care of the necessary aftercare. This includes mobility and physical therapies, as well as wound management and check-ups.



Millesi Team Foto


If you already have a long history of illness behind you regarding your physical complains, we kindly request that you fill in our free questionnaire. Your answers provide us with information about your complaints and your prior medical history. This helps us to prepare your first consultation, to make a diagnosis and to choose the suitable treatment.



At an early stage, in many cases supermicrosurgical measures can significantly improve or even eliminate the lymphoedema. In many cases, complex decongestive treatment can also be avoided.

Depending on the reconstructive operation method, it is followed by rapid postoperative mobilisation and the supporting continuation of complex decongestive therapy. 

For a microvascular lymph node transfer, an in-patient stay of five to seven days is expected.

In case of lymphovenous anastomosis, patients can reckon on an in-patient stay of two to three days.

Consistent complex decongestive therapy and nutritional therapy are helpful. However, if the cause of the resulting lymphoedema is not resolved, the lymphoedema progresses like a chronic disease.

A disturbed lymph flow unfortunately worsens over time and becomes chronic. More and more lymph vessels are affected. An operative reconstruction by means of supermicrosurgical methods is currently the only option for lasting improvement.