A prospective randomized controlled clinical study included 80 women aged 54.9 +/- 8 years, who underwent radical surgery for breast cancer and had late postmastectomy lymphedema (II to IV degree). No evidence of erysipelas was observed for the last 3 months. MATERIAL AND METHODS: The severity of lymphedema and treatment outcomes were assessed using water plethysmography in relative units (in %). Changes in the subcutaneous adipose tissue thickness were measured by ultrasound. To assess the severity of liposuction complications, the Clavien-Dindo classification was used. Three homogeneous groups of patients were treated. In group 1 (n = 30), conservative methods (intermittent pneumatic compression of the arm, electrostimulation of skeletal muscles, magnetic therapy, massage, therapeutic exercises, compression bandaging) were performed in the preoperative period; in group 2 (n = 30) -- in the late postoperative period of liposuction; in group 3 (n = 20) liposuction was followed by compression bandaging. RESULTS: The average volume excess in the edematous upper extremity significantly decreased, being 84.2 +/- 10.0% in group 1 patients, 87.8 +/- 9.3% in group 2 and 72.2 +/- 9.6% in group 3 (p < 0.001). The regression rate of grade 2 lymphedema was 94.8 +/- 1.2% in group 1 patients, 96.1 +/- 0.7% in group 2 patients and 82.1 +/- 2.5% in group 3 patients. The regression rate of grades 3 lymphedema was 81.7 +/- 2.2% in group 1, 86.9 +/- 2.2% in group 2 and 65.2 +/- 0.8% in group 3. The regression rate of grades 4 lymphedema was 71.0 +/- 2.8% in group 1, 73.4 +/- 2.2% in group 2 and 62.6 +/- 4.2% in group 3 (p < 0.001). Early complications of grade 1 liposuction occurred in 5% patients. Favorable immediate treatment outcome (reduction in lymphedema by 50100% and reduction in the thickness of subcutaneous fat by 50%) was noted in 100% of patients of groups 1 and 2 and in 90% patients of group 3. A good long-term result (after 12 to 18 months) was observed in 93.3% of group 1 patients, in 100% of group 2 patients and in 55% of group 3 patients. CONCLUSIONS: The results obtained show that the elimination of excess adipose component without improving the drainage function of the lymphatic system does not lead to good long-term treatment outcomes for late lymphedema.

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