Women experience a wide range of health conditions that affect them more frequently and uniquely when compared to men, often requiring specialized care and attention. These conditions can stem from biological, hormonal, and anatomical differences, and may also arise during significant life stages such as pregnancy, childbirth, or recovery from illnesses like breast cancer. At The Institute for Advanced Reconstruction, highly skilled surgeons provide cutting-edge surgical solutions to conditions including lymphedema, post-mastectomy pain syndrome (PMPS), and pudendal neuralgia.
Lymphedema
Lymphedema is a chronic condition that often manifests as an abnormal buildup of fluid, causing swelling, most commonly in the arms or legs. This swelling may be present from birth or develop without a known reason. Lymphedema can also develop after radiation or certain cancer-related surgeries. Secondary lymphedema can occur in the arms when lymph nodes from the underarm, called axillary lymph nodes, are damaged or removed, which oftentimes occurs during mastectomies or lumpectomies.
According to the Lymphatic Education & Research Network, an estimated 1 in every 1,000 people in the United States suffers from lymphedema. Among cancer survivors, the prevalence is higher, with about 20-40% of breast cancer survivors developing lymphedema, particularly post-surgery and radiation therapy.
The Institute for Lymphatic Surgery and Innovation, a division of The Institute for Advanced Reconstruction, aims to address a critical need in the medical community by providing surgical solutions for patients suffering from lymphedema and related conditions. It has been awarded a Center of Excellence designation by the Lymphatic Education and Research Network. It is the only center of its kind in New Jersey.
"There is no cure for lymphedema, but its management focuses on reducing swelling and preventing complications through an individualized care plan,” says Dr. Joseph Dayan, Director of The Institute for Lymphatic Surgery and Innovation. “There are four different surgical procedures we use to treat lymphedema and we tailor them to each patient’s case.”
The four surgical procedures include: lymphaticovenous anastomosis (LVA), free lymph node transfer, lymphedema liposuction, and lymphedema mass excision.
Post-Mastectomy Pain Syndrome (PMPS)
PMPS refers to lingering pain in the chest wall, armpit, or arm following a mastectomy and other breast-conserving surgeries. Between 20-40% of post-mastectomy patients develop PMPS after surgery. PMPS can arise from nerve damage during surgery, leading to sensations like burning, aching, or stabbing pain, sometimes accompanied by numbness or a feeling of tightness. Factors such as the extent of the surgery, the presence of lymph node dissection, and individual nerve sensitivity can contribute to its onset. The condition can significantly impact daily life and emotional well-being. The pain is often described as shooting or aching, while others experience more mild chronic pain. If a patient does not find relief from conservative treatment methods, surgery may be an option.
“We are proud to provide cutting-edge surgical nerve treatments for patients with PMPS,” says Dr. Kari Colen. “Surgery typically begins with a nerve block to help diagnose the cause of the pain.”
Depending on the extent of an individual’s nerve damage, surgical options can include neurolysis, neuroma excision, nerve repair and nerve transfer.
Pudendal Neuralgia
After childbirth, women’s bodies undergo a wide range of physical and hormonal changes as they recover from pregnancy and delivery. During this period, it can be challenging to differentiate between discomfort that is part of the normal healing process and pain that may signal an underlying medical issue. One such condition to be aware of as a cause of chronic pelvic pain is pudendal neuralgia.
Pudendal neuralgia is a chronic pain condition caused by irritation, inflammation, or entrapment of the pudendal nerve—a major nerve that provides sensation and motor control to the pelvic region. This condition can develop due to childbirth-related trauma, including prolonged labor, operative delivery (e.g., use of an episiotomy), or other factors that place strain on the pelvic floor and pudendal nerve.
“Without proper diagnosis and treatment, pudendal neuralgia can result in chronic discomfort, significantly affecting daily activities such as sitting, going to the restroom, or engaging in intimate relationships,” explains Dr. Chris Lakhiani,
a board certified plastic and reconstructive surgeon at The Institute for Advanced Reconstruction and Chief of Plastic Surgery at Jersey Shore University Medical Center.
Conservative treatment options, such as pelvic floor physical therapy, medications, or nerve blocks, can often alleviate symptoms. However, for patients whose symptoms persist despite these measures, surgical intervention may be necessary.
“One option is pudendal nerve decompression surgery, a procedure that carefully releases areas of compression along the pudendal nerve pathway,” says Dr. Lakhiani. “By decompressing these points of pressure, we aim to restore normal nerve function and reduce pain, helping patients regain their quality of life. This is analogous to doing a carpal tunnel decompression surgery, except it is happening in the pelvis instead of the wrist.”
Recognizing the symptoms of pudendal neuralgia—such as pelvic pain that worsens with sitting, pain or numbness extending around the perineum or genitalia, and discomfort that persists despite typical postpartum recovery—is essential. Early evaluation and treatment can help mitigate symptoms much more effectively than delaying treatment.
Providing Hope and Pain Relief
With cutting-edge treatments available at specialized centers like The Institute for Advanced Reconstruction, patients are not only finding relief but also regaining control over their lives. As medical advancements continue to evolve, these procedures stand as a testament to the power of innovation and compassionate care, paving the way for a future where no woman has to suffer in silence.
To learn more, please visit advancedreconstruction.com or call 732-401-8404 to schedule a consultation.
To find an office that treats lymphedema near you, visit:
To find an office that treats post-mastectomy pain syndrome near you, visit: advancedreconstruction.com/breast/post-mastectomy-pain-syndrome
To find an office that treats pudendal neuralgia near you, visit: advancedreconstruction.com/distinguished-centers/pudendal-neuralgia
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