Concierge microsurgery · UK
Vascularised lymph node transfer in the UK, by a specialist microsurgeon.
A microsurgical operation for lymphoedema - VLNT, LVA or combined - done in one of the handful of UK centres that actually do this work, with honest staging and honest expectations.
Why patients choose us
- 01
A specialist microsurgeon, at a real lymphoedema centre
Not a general plastics list. A named consultant microsurgeon at one of six-to-ten UK centres that actually do this work - Oxford, Cambridge, London, Manchester or Bristol.
- 02
LVA, VLNT or combined - the honest choice
For early-stage lymphoedema, LVA is often enough. For advanced fibrotic limbs, liposuction may do more. We say what fits your stage before you commit.
- 03
Independent, and free
We are paid by no clinic, so the recommendation is impartial and costs you nothing.
Indicative pricing
What private lymphoedema microsurgery costs in the UK.
Indicative ranges across specialist UK centres. Send the details and we quote firm figures across two or three options - including whether NHS funding may apply.
In short
Private VLNT in the UK: £15,000–£30,000, five to ten nights in hospital, improvement over 6–24 months.
| Procedure | Indicative range | Typical duration | Recovery |
|---|---|---|---|
| LVA (lympho-venous anastomosis) - early stage | £10,000–£20,000 | 3–5 hours | Day case or 1 night |
| VLNT (vascularised lymph node transfer) | £15,000–£30,000 | 4–8 hours | 5–10 nights |
| Combined LVA + VLNT | £20,000–£40,000 | 6–10 hours | 5–10 nights |
| SAPL / liposuction (Brorson) - advanced fibrotic | £8,000–£14,000 | 2–3 hours | 1–2 nights |
| Lymphoscintigraphy + ICG staging | £1,200–£2,500 | Half-day | 1 week report |
| MR lymphangiography | £1,200–£2,000 | 45–60 min | 1 week report |
| Consultation only | £300–£500 | 45 min | Same visit |
Prices vary by centre, by microsurgeon, by donor site, and by whether LVA and VLNT are staged or combined. Secondary lymphoedema after cancer treatment is often NHS-funded at a specialist reconstructive centre - we say when that applies.
The problem
The right centre, the right stage, the right operation.
Lymphoedema surgery is done well in a small number of UK centres and done badly, or oversold, in a long tail of others. We route you to a real microsurgeon and to the operation that matches your stage.
-
Not sure it will help you?
ISL Stage 0 or very early? Compression and MLD first. We say so before you agree to microsurgery.
-
Worried about expectations?
This is a reduction, not a cure. We are honest about the 6–24 month curve and the lifelong compression that follows.
-
Want it done properly?
A named consultant microsurgeon at a UK centre with two-team theatres, operating microscope and integrated lymphoedema physio.
The journey
From enquiry to recovery - what happens, in order.
One clinician from first message to long-term review - including the slow, six-to-twenty-four-month improvement curve.
Phase 1 · Before your procedure
Concierge, off-stage for you
Phase 2 · On the day
A long day in a specialist theatre
Phase 3 · After
Months of gradual improvement
- 01
Before
You tell us what is going on
A short, confidential form. Which limb, how long, what caused it - usually cancer treatment - and what compression and MLD you are already doing.
- 02
Before
We come back with a recommendation
Within one working day: the right centre, the right procedure (LVA, VLNT or combined), and an indicative price. If you are ISL Stage 0 or very early, we say CDT first.
- 03
Before
Imaging and staging
Lymphoscintigraphy, ICG lymphography, and often MR lymphangiography. Reverse ICG mapping protects the donor site.
- 04
On the day
Admission and theatre
Two-team microsurgery in a tertiary centre. Flap harvest, transfer, and 1–2 mm artery-and-vein anastomosis under the operating microscope. Four to eight hours.
- 05
On the day
HDU or ICU overnight
Flap monitored hourly for viability for the first 24–48 hours. Warmth, colour, capillary refill and handheld Doppler.
- 06
After
Hospital 5–10 days, then home
Compression restarted early. Physio and manual lymphatic drainage continue. Wound review at two weeks.
- 07
After
Improvement over 6–24 months
Oedema settles gradually, not overnight. Compression and CDT continue indefinitely - surgery is an adjunct, not a cure.
Typical end-to-end: 4–8 weeks from enquiry to theatre. Full improvement: 6–24 months.
When it helps
When lymph node transfer is the right step.
The situations we see most, plus the one red flag that means an emergency rather than an appointment.
-
Post-cancer arm lymphoedema
Swelling of the arm after breast cancer treatment - axillary node clearance, radiotherapy or both. The commonest indication in the UK.
-
Post-cancer leg lymphoedema
Swelling of the leg after gynaecological, melanoma or urological cancer treatment with pelvic or groin node clearance.
-
Head and neck lymphoedema
Facial or submental swelling after head-and-neck cancer surgery and radiotherapy - submental or supraclavicular flaps are often the best fit.
-
Primary lymphoedema
Milroy, Meige or lymphoedema praecox - congenital or early-onset. Careful staging decides whether LVA, VLNT or combined is right.
-
Recurrent cellulitis
Repeated skin infections in a swollen limb - a hard sign that lymphatic drainage is failing and worth surgical assessment.
-
Traumatic lymphoedema
Swelling after major trauma, degloving or extensive scar tissue that has interrupted the lymphatic channels.
-
ISL Stage 2–3 with fibrosis
Established, pitting-to-firm swelling where compression alone is no longer enough. VLNT increasingly indicated, sometimes with liposuction.
-
Red flag: rapid unilateral swelling
New, rapid swelling of one limb with pain, warmth or breathlessness is not a clinic booking - same-day A&E to rule out DVT, PE or infection.
Procedure options
VLNT is not the only option.
What each operation on the table actually involves - bypass, transfer, combined, and liposuction for advanced fibrotic limbs.
-
LVA (lympho-venous anastomosis)
Supermicrosurgical bypass - a superficial lymphatic vessel is joined to a nearby small vein under 0.3–0.8 mm precision. Best for early-stage lymphoedema with preserved channels.
-
VLNT - groin donor
A flap of lymph nodes from the superficial inguinal region. The historical workhorse; small risk of donor-site lymphoedema, minimised with reverse ICG mapping.
-
VLNT - supraclavicular donor
Nodes from above the collarbone. Good size match, cosmetically favourable scar, low donor-morbidity profile.
-
VLNT - submental donor
Nodes from beneath the jaw - a useful option for facial and upper-limb lymphoedema, with a well-hidden neck scar.
-
VLNT - omental (laparoscopic)
Nodes taken with the omentum from inside the abdomen. No risk of donor-limb lymphoedema - gaining popularity across UK centres.
-
VLNT - lateral thoracic donor
Nodes from the side of the chest wall - often chosen when transferring to an upper limb after mastectomy.
-
Combined LVA + VLNT
Bypass plus transfer in one operation for complex or intermediate-stage cases. Longer procedure, broader lymphatic benefit.
-
SAPL / liposuction (Brorson)
Suction-assisted lipectomy for advanced fibrotic limbs where the swelling is fat, not fluid. Compression must continue lifelong afterwards.
Our vetted UK network
A handful of centres, we picked them.
Consultant plastic microsurgeons in Oxford, Cambridge, London, Manchester and Bristol. Not listed publicly - introductions are made privately, once we understand your stage and prior treatment.
Selection criteria
How we choose every microsurgeon in our network.
-
Consultant plastic microsurgeons in one of six-to-ten UK lymphoedema centres
-
Two-team theatre with operating microscope and supermicrosurgery capability
-
Pre-op lymphoscintigraphy, ICG lymphography and MR lymphangiography on site
-
Integrated lymphoedema physiotherapy and MLD service post-operatively
Safety and recovery
What to expect afterwards - honestly.
Modern microsurgery is safe, and flap failure is rare - but this is major reconstructive surgery for a chronic disease. Realistic expectations decide who is glad they had it done.
-
Surgery is an adjunct, not a cure
Compression, MLD and skin care continue indefinitely. VLNT and LVA reduce the burden - they do not remove the need for CDT.
-
Improvement is gradual over 6–24 months
You will not wake up with a normal limb. Circumference reduction, softer tissue and fewer cellulitis episodes emerge over many months.
-
Flap failure is rare with modern microsurgery
Under 5% in specialist UK centres. Flap monitoring in the first 48 hours is why the HDU stay matters.
-
Donor-site lymphoedema - 1–2% with reverse mapping
The historic worry with groin flaps. Reverse ICG mapping identifies and preserves the leg-draining nodes before harvest.
-
Cellulitis episodes usually roughly halve
Around a 50% reduction in reported series. Fewer hospital admissions, less antibiotic exposure, better quality of life.
-
Circumference reduction of 60–80% is realistic
In well-selected patients. Complete resolution is not - expectations shape satisfaction more than any other single factor.
-
DVT, seroma and wound issues
The usual major-surgery risks - thromboprophylaxis, drains and wound checks are standard. Chronic pain and dehiscence are less common.
-
Further procedures may be needed
Complex cases are often staged - LVA first, VLNT later, or liposuction added once the fluid component has settled.
-
Red flags after discharge
A dusky or cold flap, spreading redness, fever, calf pain or breathlessness - call the ward directly the same day.
Reading your operation note
Your operation note in four parts. Read the last one first.
Whichever donor site was used, the note the microsurgeon sends you keeps to the same shape.
A quiet reminder
Microsurgical language is precise and can read coldly - we translate it for you.
If you would like us to talk you through the note before your review, just ask.
- 01 Header
Indication, stage and donor site chosen
Why the operation was done - post-cancer or primary lymphoedema, ISL stage - and which donor site was used (groin, supraclavicular, submental, omental or lateral thoracic).
- 02 Technique
Anastomosis, ischaemia time and Doppler check
Vessels anastomosed, calibres, ischaemia time, and the intra-operative Doppler signal at the end of the case.
- 03 Findings
Lymphatic mapping and recipient bed
ICG findings, quality of the recipient bed (axilla, groin or distal wrist/ankle) and any scarring released during the same operation.
- 04 Impression
Compression plan, MLD restart and review
Read this first: when to restart compression, when MLD resumes, expected trajectory over 6–24 months, and the follow-up schedule.
Recognised by major UK insurers
Cover for lymphoedema microsurgery varies by insurer and by indication. Secondary lymphoedema after cancer treatment is often supported; primary cases are typically self-pay or NHS-funded. We confirm cover before booking.
Frequently asked
Everything we get asked about lymph node transfer.
Quick answers on VLNT vs LVA, cost, donor sites, recovery time, and what surgery can - and cannot - do.
-
What is vascularised lymph node transfer?
A microsurgical operation in which a flap of functioning lymph nodes - with its own artery and vein - is moved from a donor site (groin, supraclavicular, submental, omental or lateral thoracic) to a limb affected by lymphoedema. The vessels are joined under an operating microscope to restore lymphatic drainage over time.
-
How is VLNT different from LVA?
LVA (lympho-venous anastomosis) is a bypass - a tiny superficial lymphatic vessel is joined directly to a small vein. It is best for early-stage lymphoedema with preserved channels. VLNT transplants whole functioning nodes and is usually chosen for ISL Stage 2–3, or combined with LVA for complex cases.
-
Is this available on the NHS?
Yes, at specialist reconstructive centres - typically for secondary lymphoedema after cancer treatment. Access varies by region and referral criteria. Private VLNT is £15,000–£30,000, LVA £10,000–£20,000, combined £20,000–£40,000 in the UK.
-
Will surgery cure my lymphoedema?
No. It reduces limb volume, cellulitis episodes and the compression burden - but complete decongestive therapy (compression garments, MLD, skin care and exercise) continues lifelong. Any surgeon promising a cure is misleading you.
-
How soon will I see improvement?
Not immediately. Some patients notice softening within weeks, but meaningful circumference reduction develops over six to twenty-four months as new lymphatic connections mature. Roughly 60–80% circumference reduction is achievable in well-selected patients.
-
What are the risks?
Flap failure is under 5% in specialist UK centres. Donor-site lymphoedema is 1–2% with reverse ICG mapping. Other risks are infection, seroma, wound dehiscence, DVT, chronic pain and - importantly - incomplete resolution of swelling.
-
Which donor site is best?
It depends on your anatomy and prior surgery. Groin has the most track record but a small donor-lymphoedema risk. Supraclavicular and submental are cosmetically favourable. Omental (laparoscopic) has no donor-limb lymphoedema risk and is gaining ground across UK centres.
-
What about liposuction of the limb?
Suction-assisted lipectomy - the Brorson technique - is a different operation for advanced fibrotic limbs where the excess volume is fat rather than fluid. It gives dramatic size reduction but requires lifelong compression. It is sometimes staged after LVA or VLNT.
-
Do I need to keep wearing compression garments?
Yes, indefinitely, though many patients reduce the class or hours of wear over time. Stopping compression after surgery is the commonest reason for volume rebound.
-
When should I go to A&E rather than book a clinic?
Rapid new limb swelling with calf pain or breathlessness (DVT/PE), spreading redness and fever (cellulitis or sepsis), or a dusky, cold post-operative flap. All are same-day emergencies, not appointments.
Related treatments
Looking for something else?
-
Liposuction (Brorson)
Suction-assisted lipectomy for advanced fibrotic lymphoedema.
Learn more -
Breast reconstruction
Autologous and implant-based options after mastectomy.
Learn more -
All tests & procedures
Every test and procedure we arrange.
Learn more -
MR lymphangiography
Detailed imaging of deep lymphatic anatomy.
Learn more