NHS Patient Information
Lymphoedema.
National Health Service
Lymphoedema Treatment
Lymphoedema (US spelling: lymphedema) is chronic limb swelling caused by impaired lymphatic drainage. It can be primary (genetic) or secondary, after cancer surgery, radiotherapy, infection, trauma or alongside chronic venous disease. Untreated, it tends to progress and predisposes to recurrent cellulitis and skin breakdown.
KONCEPT® runs a consultant-led lymphoedema service at our Kingston clinic, combining vascular consultant assessment with hands-on Complex Decongestive Therapy delivered by a Lymphoedema-trained Physiotherapist and a compression fitter. Our aim is to confirm the diagnosis quickly, reduce limb volume, control symptoms and protect the skin against infection.
At a glance
Service
Consultant-led
First visit
30 to 45-min consult
Diagnostic adjuncts
Duplex on same visit
Initial consult
£295
Verified statistics
Drawn from NHS, the British Lymphology Society, the International Lymphoedema Framework, the LiMPRINT UK prevalence study and peer-reviewed publications. Every figure links to its citation in the References section at the bottom of this page.
How common lymphoedema is
Outcomes after structured Complex Decongestive Therapy
Lymphoedema is chronic swelling caused by a build-up of lymphatic fluid in the tissues when the lymphatic system is overloaded or damaged. It most commonly affects the legs and arms but can also affect the trunk, face, head and neck, breast or genitals.
It is classified as primary when the lymphatic system has not developed normally (this often shows in adolescence or early adulthood) or secondary when an external event has damaged or removed lymphatic tissue, most commonly cancer surgery, radiotherapy, recurrent cellulitis, trauma, chronic venous insufficiency or filarial infection (rare in the UK)[1][4][5].
Lymphoedema is distinct from lipoedema (a build-up of fat) and from ordinary oedema (short-term fluid retention from heart, kidney or liver causes), but the three conditions can coexist. The patient instructions guide groups them under one allied-health pathway because the day-to-day skin-care, compression and exercise advice overlaps.
Differential diagnosis
| Lymphoedema | Lipoedema | |
|---|---|---|
| What it is | Build-up of lymph fluid in the tissues | Disproportionate build-up of fat tissue |
| Who is affected | Either sex, often one limb (post-cancer, post-surgery) or both (primary) | Almost exclusively women, both legs symmetrically |
| Feet involved? | Feet are often involved, Stemmer’s sign positive | Feet are typically spared (cuff at the ankle) |
| Tender to touch? | Usually not tender unless cellulitis is present | Yes, often very tender, bruises easily |
| Pitting? | Pits on pressure in early stages, becomes non-pitting as fibrosis develops | Does not pit |
| Tests | Stemmer’s sign, lymphoscintigraphy, ICG lymphography in selected cases | Clinical diagnosis, duplex to rule out venous cause |
Patients with both conditions (lipo-lymphoedema) are common in lipoedema Stage 4[4][6]. KONCEPT® assesses for both at the same visit and runs a dedicated Lipoedema clinic alongside the lymphoedema service.
Clinical staging
The International Society of Lymphology stages lymphoedema by clinical severity[3][4]:
No visible swelling but lymph transport is already impaired. Symptoms of heaviness or aching may precede swelling by months or years.
Pitting oedema that reduces with elevation overnight. No skin changes.
Limb does not return to normal with elevation alone. Skin starts to fibrose. Pitting may become harder to elicit.
Marked fibrosis, skin changes (hyperkeratosis, papillomatosis), high risk of cellulitis. Stemmer’s sign positive (you cannot pinch and lift the skin at the base of the second toe).
The earlier lymphoedema is recognised and treated, the better the long-term outcome. Stage 0 and Stage 1 lymphoedema are reversible with proper care. Stage 2 and 3 require lifelong management to stabilise[4][5].
If several of these apply, lymphoedema is worth assessing. Many patients with cancer-related lymphoedema are not warned in advance and only notice it months or years after their primary treatment[1][9].
Diagnosis
Lymphoedema is diagnosed clinically in most cases. There is no single blood test that confirms it. Our clinic combines:
Initial lymphoedema consultation with clinical assessment is £295. Where a duplex scan is added, please see the pricing page for the full schedule.
Management
The internationally recognised standard for lymphoedema management is Complex Decongestive Therapy (CDT), which has two phases[4][5]:
Delivered over a defined block of appointments, typically two to four weeks:
Lifelong, designed to hold the gains of Phase 1:
For patients with mixed lymphoedema-and-venous disease, or lipo-lymphoedema, we coordinate input from:
For selected patients with established lymphoedema that has not responded to optimal conservative therapy, microsurgical and supermicrosurgical procedures (Lympho-Venous Anastomosis, Vascularised Lymph Node Transfer) are described in the international literature[4][5][8].
KONCEPT® does not perform lymphatic surgery at the Kingston clinic. Where surgery is being considered, your consultant will discuss the published evidence with you and, if appropriate, support a referral to a suitable specialist centre. This referral pathway, the second opinion and the post-procedure follow-up sit within our scope.
First visit
For full pre-care and post-care instructions, see our Patient instructions page. Lymphoedema sits alongside the Lipoedema and Compression pathways in that guide.
You receive a written quote before any treatment is booked.
Insurance
Lymphoedema treatment is recognised by most major UK private medical insurers when there is a clinical indication, particularly where lymphoedema follows cancer treatment, surgery or trauma. Cover for compression garments, ongoing MLD and any onward referral varies by policy.
Recognition at KONCEPT® is at both clinic and consultant level, and cover is expanding. Call 020 8129 1011 with your insurer and policy details and we will come back to you within one working day with confirmation, before any appointment is booked.
Read more on the Insurance & access page →
Your consultants and team
Lymphoedema consultations at KONCEPT® are carried out by one of our Consultant Vascular Surgeons, both on the GMC Specialist Register for Vascular Surgery and both Platinum BUPA Consultants. They hold substantive NHS consultant posts at St George’s University Hospitals NHS Foundation Trust and see private patients here on a practice-privileges basis.
Day-to-day Complex Decongestive Therapy, including Manual Lymphatic Drainage and multi-layer bandaging, is delivered by our Lymphoedema-trained Physiotherapist (HCPC registered), and compression-garment fitting is delivered by our compression specialist.
FAQs
Lymphoedema is chronic swelling caused by a build-up of lymphatic fluid when the lymphatic system is overloaded or damaged. It can be primary (the lymphatic system has not developed normally) or secondary (an external event such as cancer surgery, radiotherapy, trauma or recurrent infection has damaged lymphatic tissue). It most commonly affects the legs and arms but can also affect the trunk, breast, genitals, head and neck.
The most common UK causes are cancer treatment (particularly breast, gynaecological and pelvic cancers with lymph-node clearance or radiotherapy), recurrent cellulitis, chronic venous insufficiency, trauma and primary genetic disorders of lymphatic development. Filarial infection is a global cause but rare in the UK.
Diagnosis is mostly clinical. At KONCEPT® we use a 30 to 45-minute consultation, detailed history, examination including Stemmer’s sign and pitting, limb-volume measurement, photography with consent, and duplex ultrasound where clinically indicated. Lymphoscintigraphy or ICG lymphography is reserved for unclear cases or where lymphatic surgery is being considered.
Lymphoedema is a build-up of lymph fluid. Lipoedema is a build-up of fat. Lymphoedema usually involves the feet (Stemmer’s sign positive) and can affect one limb. Lipoedema spares the feet, affects both legs symmetrically, is tender to touch and affects almost exclusively women. Some patients develop both (lipo-lymphoedema). See the comparison table above for a full breakdown.
Lymphoedema itself is not usually painful, although patients describe heaviness, fullness or tightness. Pain usually means something else is going on (cellulitis, a deep-vein thrombosis, fissuring of fibrosed skin, or coexisting lipoedema), and should be reviewed promptly.
Lymphoedema is not curable, but it is treatable. Properly managed, limb volume can be reduced substantially in the intensive Phase 1 of Complex Decongestive Therapy, and the gains can be held in Phase 2 with compression, skin care and exercise. Stage 0 and Stage 1 lymphoedema are reversible if recognised and treated early.
Established lymphoedema increases the risk of recurrent cellulitis, which in severe cases can lead to hospital admission. The lymphatic skin changes themselves are not life-threatening, but recurrent infection in older or immunocompromised patients can be serious. This is why infection prevention and rapid antibiotic response are core parts of management.
Phase 1 (intensive reduction) is typically a 2 to 4-week block of MLD and bandaging appointments. Phase 2 (maintenance) is lifelong but consists of self-management at home with periodic review and garment replacement every 3 to 6 months.
Medical-grade compression is the cornerstone of lymphoedema management. Correctly fitted garments hold the gains of Phase 1, prevent re-expansion, support the skin and reduce the risk of cellulitis. Our compression fitter measures, fits and replaces garments as needed (Class 1 to Class 3 depending on severity).
Yes, with care. Long-haul flights can worsen lymphoedema, so we advise patients to wear their compression garment, stay well hydrated, move regularly during the flight and keep their skin moisturised. Patients prone to cellulitis should travel with a course of standby antibiotics agreed with their GP.
Cancer-related lymphoedema is the most common form of secondary lymphoedema in the UK, particularly after breast, gynaecological and pelvic cancers. Treatment follows the same Complex Decongestive Therapy framework, often coordinated alongside the patient’s oncology team. Early referral, ideally as soon as symptoms start, gives the best outcome.
For self-pay, no, you can book directly. Most insurers also allow direct booking. A small number still require a GP referral letter, we will confirm what your insurer needs when you enquire.
The first appointment is 30 to 45 minutes with a Consultant Vascular Surgeon. Allow 60 to 75 minutes for your visit including arrival and reception time.
Primary lymphoedema is lymphoedema caused by the lymphatic system not having developed normally. It often presents in adolescence or early adulthood (Meige’s disease, lymphoedema praecox) and sometimes from birth (Milroy disease). It is rarer than secondary lymphoedema.
Surrey catchment also includes Esher, Cobham, Weybridge, Walton-on-Thames, Oxshott and Hampton.
Related vascular services
To book a lymphoedema consultation with one of our Consultant Vascular Surgeons, or to discuss your case, get in touch.
Email info@konceptmedicalclinic.com · Visit 46-48 Wood Street, Kingston upon Thames, KT1 1UW · See full self-pay pricing →
Regulation and standards
KONCEPT® Medical Clinic is registered with the Care Quality Commission (CQC) for the regulated activities provided at our Kingston upon Thames premises. All consultants are on the General Medical Council (GMC) Specialist Register for Vascular Surgery and remain personally accountable to the GMC under Good Medical Practice. Allied-health clinicians supporting the lymphoedema service are registered with their relevant professional bodies (HCPC for physiotherapists). Information on this page is written to be factual and verifiable in line with the Committee of Advertising Practice (CAP) Code and Advertising Standards Authority (ASA) rules for medical advertising.
Claims about prevalence, staging, diagnosis, treatment and outcomes on this page are drawn from NHS, the British Lymphology Society, the International Lymphoedema Framework, the LiMPRINT UK prevalence study and peer-reviewed publications. Each source is linked for verification.
Lymphoedema.
National Health Service
Lymphoedema, symptoms, causes and treatment.
BUPA
The diagnosis and treatment of peripheral lymphedema, 2020 Consensus Document.
Lymphology 2020, 53(1), 3-19
Guidelines on the diagnosis and management of lymphoedema.
BLS
Best Practice for the Management of Lymphoedema, International Consensus.
ILF
Management of Chronic Venous Disease, Clinical Practice Guidelines of the European Society for Vascular Surgery (ESVS).
European Journal of Vascular and Endovascular Surgery 2015, 49(6), 678-737
Chronic oedema, a prevalent health care problem for UK health services (LiMPRINT).
International Wound Journal 2017, 14(5), 772-781
Lymphatic venous anastomosis (LVA) for treatment of secondary arm lymphedema.
Journal of Surgical Oncology 2017, 115(2), 226-232
Lymphoedema.
Macmillan
What is lymphoedema.
LSN
Last clinical review: Dr Maryam Attarzadeh, Medical Director (GMC 7193218), 2026-05-28. Next review due: 2026-11-28. Statistical claims are re-verified every 6 months, or sooner if peer-reviewed evidence changes.