Lymphoedema · London
Lymphoedema clinic, by a BLS-accredited specialist.
Manual lymphatic drainage, complex decongestive therapy, ICG lymphography, and super-microsurgical LVA and VLNT: one team, one plan, and honest advice about which is right for your stage of disease.
Why patients choose us
- 01
BLS or LSN-accredited therapists, not general massage
A named specialist lymphoedema therapist trained in complex decongestive therapy, registered with the British Lymphology Society or Lymphoedema Support Network.
- 02
ICG mapping before any surgery
Indocyanine green near-infrared lymphography maps your functional lymphatics before we consider LVA or VLNT. No mapping, no super-microsurgery.
- 03
Independent, and free
We are paid by no clinic, so the recommendation is impartial and costs you nothing.
Indicative pricing
What private lymphoedema care costs in the UK.
Indicative ranges across our partner clinics and surgeons. Tell us your stage and we quote firm figures across two or three options.
In short
A private CDT programme in London: £1,800–£3,500, with LVA from £14,000.
| Service | Indicative range | Typical duration | Turnaround |
|---|---|---|---|
| Initial specialist consult + measurement + L-Dex | £280–£450 | 60–90 min | Same visit |
| MLD single session (60 min) | £80–£150 | 60 min | Same visit |
| Intensive CDT (2-week programme) | £1,800–£3,500 | 2 weeks | Ongoing |
| Flat-knit compression garment (made-to-measure) | £180–£380 | 30 min fit | 2–3 weeks |
| Pneumatic compression pump (home use) | £1,200–£2,800 | — | 1 week |
| LVA super-microsurgery (lymphovenous anastomosis) | £14,000–£24,000 | 3–5 hours | Day case / 1 night |
| VLNT (vascularised lymph node transfer) | £22,000–£38,000 | 5–8 hours | 3–5 nights |
| Liposuction for late-stage (Brorson protocol) | £14,000–£28,000 | 2–4 hours | 2–3 nights |
Prices vary by centre, whether you need one or two limbs treated, and whether surgery is combined with intensive CDT. We come back with a firm quote within one working day.
The journey
From referral to maintenance - what happens, in order.
One team from first message to six-monthly reviews. Assessment, imaging, treatment, garments, and skin care.
- 01
Before
You send us the referral or oncology summary
A short, confidential form. Which limb, when it started, prior cancer treatment, any cellulitis episodes, and current garments if you have any.
- 02
Before
We come back with a recommendation
Within one working day: which specialist therapist, whether ICG mapping is needed, and whether LVA or VLNT is worth exploring. An honest read either way.
- 03
Before
We arrange assessment and imaging
Usually within one to two weeks. Limb volume, L-Dex bioimpedance, tissue tonometry, and lymphoscintigraphy or ICG lymphography where indicated.
- 04
At the clinic
Assessment at the clinic
ISL staging, functional mapping, garment fitting or surgical planning. A written care plan by the end of the visit.
- 05
At the clinic
Intensive CDT or same-day surgery
Two to four weeks of daily MLD with multilayer bandaging, or admission for LVA or VLNT under a plastic surgeon.
- 06
At the clinic
Home with a maintenance plan
Self-massage, daytime garment, night-time wrap or pump, skin care and a written cellulitis action plan.
- 07
After
Six-month reviews for life
Re-measurement, garment replacement every 6 months, and a low threshold to escalate if volume creeps up.
Who we see
Primary, secondary, and everything in between.
Post-cancer secondary lymphoedema is our commonest referral, but primary (Milroy, Meige, tarda) and filarial disease all fit the same CDT and surgical framework.
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Post-breast-cancer arm lymphoedema
Axillary lymph node dissection, radiotherapy, or a combination. Most common referral to a UK private lymphoedema clinic.
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Post-gynae or melanoma leg lymphoedema
Groin or pelvic node dissection for cervical, vulval, endometrial cancer or melanoma. Often bilateral and progressive.
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Head and neck lymphoedema
External or internal swelling after H&N cancer surgery and radiotherapy. Needs a therapist with specific H&N training.
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Primary lymphoedema (Milroy, Meige, tarda)
Congenital or later-onset primary lymphoedema. Milroy presents in infancy, Meige in adolescence, tarda after age 35.
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Post-radiotherapy tissue fibrosis
Firm, non-pitting swelling with skin change years after radiotherapy. Tonometry and ICG guide whether surgery can help.
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Filariasis (returning travellers)
Wuchereria bancrofti or Brugia malayi acquired abroad. Rare in the UK but the global leading cause of secondary lymphoedema.
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Recurrent cellulitis on a swollen limb
Two or more episodes a year warrants prophylactic penicillin V 500 mg twice daily and a formal skin care plan.
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Red flag: rapid new swelling with pain
Sudden unilateral limb swelling with pain, warmth or breathlessness needs urgent assessment to exclude DVT or PE, not a private booking.
Treatment options
The full ladder, from MLD to super-microsurgery.
Conservative first, surgical when it earns its place. Every option below has a clear indication and honest limits.
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Manual lymphatic drainage (MLD)
Slow, light-pressure skin-stretching strokes by a trained therapist. Vodder, Leduc, Casley-Smith or Foldi schools. Standard element of CDT.
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Multilayer compression bandaging
Short-stretch bandages such as Coban 2 or Comprilan applied in layers over foam padding. Daily in the intensive phase for 2 to 4 weeks.
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Flat-knit garments (class 2 or 3)
JOBST or Medi made-to-measure sleeves, gloves or stockings. Worn daily in the maintenance phase. Replaced every 6 months.
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Night-time compression and Velcro wraps
Ready wraps or MOBIDERM foam wraps for night use. Easier to apply than bandages and improve maintenance compliance.
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Pneumatic compression pumps
Sequential inflation sleeves for home use, 45 to 60 minutes daily. Adjunct to MLD, not a replacement for it.
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Lymphovenous anastomosis (LVA)
Super-microsurgery anastomosing a functional lymphatic vessel (under 1 mm) to a nearby venule. ICG mapping essential. Best for early ISL Stage I to II.
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Vascularised lymph node transfer (VLNT)
Autologous transfer of inguinal, omental or submental lymph nodes to the affected limb. Sometimes combined with LVA for advanced disease.
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Liposuction (Brorson protocol)
For late-stage adipose-dominant lymphoedema. Up to 6 L per session under the Swedish Brorson protocol. Lifelong compression is mandatory afterwards.
Our vetted UK network
Where London goes for lymphoedema.
Royal Marsden Private Lymphoedema Service, St George's Lymphoedema Service, Oxford Lymphoedema Practice (Furniss and Ramsden), HCA The Wellington aesthetic and reconstructive, Cadogan Clinic, Nuffield Health, and independent BLS-registered therapists.
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BLS or LSN-accredited specialist lymphoedema therapists, not general massage practitioners
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ICG near-infrared lymphography and lymphoscintigraphy available before surgical planning
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Super-microsurgical plastic surgeons for LVA and VLNT with published outcome data
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Combined therapy plus surgical pathway when either alone is not enough
Safety and recovery
What to plan for - honestly.
Lymphoedema care is lifelong. Compression, skin care and prompt treatment of cellulitis matter as much as any single procedure.
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Skin care is not optional
Daily emollient, prompt treatment of cuts and insect bites, and a written cellulitis action plan. Recurrent cellulitis destroys any surgical result.
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Prophylactic antibiotics if needed
Two or more cellulitis episodes a year: penicillin V 500 mg twice daily for at least a year, per BLS guidance.
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Compression is lifelong
CDT, LVA, VLNT and liposuction all require ongoing compression. Stopping garments almost always leads to volume recurrence.
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LVA works best early
ISL Stage I to II with preserved lymphatic function on ICG. Late-stage adipose-dominant disease does not respond to LVA.
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VLNT donor-site morbidity is real
Inguinal or axillary node harvest carries a small but genuine risk of donor-limb lymphoedema. Reverse mapping reduces but does not eliminate this.
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Liposuction is not a shortcut
Brorson liposuction is for late-stage limbs that have already failed CDT. It requires 24-hour compression for at least 12 months afterwards, then daytime garments for life.
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Watch for L-Dex creep at review
Bioimpedance detects early sub-clinical fluid before it becomes visible. A rising L-Dex is a trigger to intensify treatment.
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Air travel and heat
Wear your compression garment on long-haul flights and be cautious with saunas and hot baths, which can trigger flare-ups.
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Red flags after discharge
Sudden increase in swelling, pain, redness, fever or breathlessness: contact the unit or attend A&E the same day.
Reading your lymphoedema report
Your report in four parts. Read the last one first.
Whichever centre assessed you, the report keeps to the same shape.
- 01 Header
ISL stage, limb volume and L-Dex
Which limb, ISL Stage 0 to III, absolute and interlimb volume difference in millilitres, and L-Dex bioimpedance ratio.
- 02 Imaging
Lymphoscintigraphy and ICG mapping
Transport index, dermal backflow pattern, and whether functional lymphatics were seen on ICG suitable for LVA.
- 03 Plan
CDT phase, surgery or both
Intensive versus maintenance CDT, garment prescription, and whether LVA, VLNT or liposuction is being offered.
- 04 Impression
Skin care and cellulitis plan
Read this first: emollient regime, cellulitis action plan, prophylactic antibiotic decision, and review interval.
Recognised by major UK insurers
CDT and MLD cover varies by insurer and cancer pathway. LVA, VLNT and liposuction are usually self-pay. We confirm cover before booking.
Frequently asked
Everything patients ask about lymphoedema care.
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What is complex decongestive therapy (CDT)?
CDT is the gold-standard conservative treatment for lymphoedema. It has two phases. The intensive phase runs for 2 to 4 weeks and combines daily manual lymphatic drainage by a trained therapist, multilayer short-stretch compression bandaging, skin care and remedial exercises. The maintenance phase is lifelong and combines self-massage, a daytime flat-knit compression garment, a night-time wrap or pneumatic pump, and daily skin care.
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How much does private lymphoedema treatment cost in the UK?
An initial specialist consult with measurement is £280 to £450. Single MLD sessions are £80 to £150. A 2-week intensive CDT programme is £1,800 to £3,500. Made-to-measure flat-knit garments are £180 to £380 and are replaced every 6 months. Pneumatic pumps are £1,200 to £2,800. LVA super-microsurgery is £14,000 to £24,000, VLNT is £22,000 to £38,000, and Brorson liposuction is £14,000 to £28,000.
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What is the difference between LVA and VLNT?
LVA (lymphovenous anastomosis) is super-microsurgery that connects a functional lymphatic vessel under 1 mm to a nearby small vein, giving stagnant lymph a new escape route. It works best in early ISL Stage I to II with preserved lymphatic function on ICG mapping. VLNT (vascularised lymph node transfer) is an autologous transfer of a small group of lymph nodes, most often from the groin, omentum or under the jaw, to the affected limb, where they grow new lymphatic connections over time. VLNT is generally offered for later-stage disease or after LVA has been used, and the two can be combined.
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Who is a candidate for Brorson liposuction?
Liposuction under the Swedish Brorson protocol is offered for late-stage adipose-dominant lymphoedema, when the limb is firm and non-pitting because it has already replaced most of the fluid with fat. It is not a first-line treatment and it does not cure lymphoedema. Up to 6 L is removed per session, and the patient must wear 24-hour compression for at least 12 months afterwards and daytime compression for life. Skip either and the volume returns.
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Do I really need to wear compression forever?
Yes. Lymphoedema is a chronic condition of the lymphatic drainage system. Compression, whether a garment, a wrap or a pump, is what keeps interstitial fluid moving after treatment has reduced the volume. Every study of long-term outcomes after CDT, LVA, VLNT and liposuction points the same way: patients who stop compression almost always see the volume return within 6 to 12 months.
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What is ICG lymphography and why does it matter?
Indocyanine green (ICG) near-infrared lymphography is a real-time bedside imaging test in which a tiny amount of ICG dye is injected into the skin and a near-infrared camera watches how the lymphatics move it. It shows whether you still have functional lymphatic channels big enough to anastomose (needed for LVA) and it maps dermal backflow patterns that stage the disease more sensitively than clinical exam. No serious LVA or VLNT surgery in the UK is planned without it.
Ready when you are
Speak to a specialist lymphoedema therapist this week.
Tell us which limb, when it started and any prior cancer treatment. We come back within one working day with a firm quote and two or three named options.
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