The Granzow SystemSM

What is the Granzow System?

The Granzow System utilizes a combination of advanced surgeries and conservative therapies to treat patients with lymphedema. It is the first system to effectively address both solid and fluid excess and swelling in lymphedema, and it provides significant, long-term improvements to both limb size and symptoms for lymphedema patients. The system includes:

  • Conservative lymphedema therapy
  • Granzow SAPL™ (Suction Assisted Protein LipectomySM )
  • Vascularized Lymph Node Transfer (VLNT)
  • Lymphaticovenous Anastomoses (LVA)

How is the Granzow system unique?

The Granzow System was the first successful integrated system of surgery and therapy for lymphedema. It addresses both solid and fluid build-up and swelling in lymphedema patients and is one of the most effective treatments for lymphedema worldwide.

What are the goals of the Granzow System? The goals of the Granzow System are to:

  • Reduce the risk of dangerous infections such as cellulitis
  • Reduce arm or leg size to normal
  • Improve mobility and functionality
  • Restore the ability to complete daily activities
  • Restore the ability to wear normal clothing or footwear
  • Allow patients to feel better, restore confidence, and improve psychological well-being
  • Restore intimacy and closeness with the patient’s spouse and loved ones
  • Reduce the social stigma of lymphedema

Why can’t a single surgery “cure” my lymphedema? Why do I need the rest of the treatment?

Lymphedema is a complex disease that, unfortunately, cannot be “cured.” It is a chronic condition that can be managed through a combination of surgeries and conservative therapies. While surgery will reduce the swelling and build-up within a limb, maintaining that limb size requires ongoing therapies.

Dr. Granzow utilizes a variety of surgeries and conservative therapies to significantly and permanently reduce limb swelling and lymphedema pain. This not only normalizes the size of the affected arm or leg, but also reduces the amount of therapy and effort required to maintain the permanent improvements.

The best results are achieved when the patient continues to maintain a relationship with their home therapist after surgery and continues to take careful lymphedema precautions when performing activities such as flying, gardening, and other at-risk activities. The Granzow team can also advise on changes in diet and exercise to maximize long-term results.

What type of lymphedema surgery is appropriate for me?

Each patient’s lymphedema history and symptoms are different and must be evaluated individually by Dr. Granzow and his team. Patients with Stage 1 fluid-predominant lymphedema tend to benefit most from lymphedema therapy and microsurgeries such as VLNT, and LVA. Patients with advanced, Stage 2 solid-predominant lymphedema require Granzow SAPL surgery. Dr. Granzow evaluates each individual case and makes specific recommendations at the first consultation.

Have you published any medical articles about lymphedema surgeries or the Granzow System?

Yes, Dr. Granzow has published multiple studies in some of the world’s most prestigious medical journals. See his publications here.

Patient Eligibility

Is it too late for me to get lymphedema surgery?

It is almost never too late to get treated for lymphedema. The Granzow Lymphedema and Lipedema Center treats patients with Stage 0 to Stage 2 lymphedema. Recommended treatment is typically dictated by the stage of a patient’s lymphedema rather than how long they have knowingly had the disease. The stage of the disease may dictate how many surgeries are necessary, but it is never too late to seek help.

Do you treat patients with primary or congenital lymphedema using the Granzow System?

Yes! We have successfully treated many patients with congenital lymphedema, even if their disease has progressed to Stage 2 lymphedema. Read their stories.

Am I a candidate for surgery if I am severely overweight?

Patients who are severely overweight tend to have higher surgical risks and a less favorable surgical outcome with any type of surgery, including lymphedema surgery. Excess weight also worsens and can even cause lymphedema. In general, we do not recommend lymphedema surgery for severely overweight patients and recommend weight loss first as the lymphedema can tremendously improve with weight loss alone.

Would my previous history of radiation therapy or lymph node dissection surgery prevent me from having success with lymphedema surgery?

Many of Dr. Granzow’s patients developed their lymphedema symptoms following radiation therapy, lymph node dissection surgery, or both. He has extensive experience with patients that have had these treatments. So prior operations will not prevent a patient from having success with lymphedema surgery.

Risks and Effectiveness of Surgery

How successful is the Granzow System?

The Granzow System, which includes VLNT, LVA and Granzow SAPL surgeries, is proven to be very effective in treating chronic lymphedema and attaining significant, long-term improvements in both limb size and lymphedema symptoms. Patients who have been through the Granzow System are able to reduce their reliance on therapy and compression garments. Average volume reductions range from 86% to 111%. Explore our gallery of before-and-after photos to see real examples of patient results or read through our success stories to see how the Granzow System improves patient quality of life.

How many patients have you helped with the Granzow System?

Since 2005, the Granzow Lymphedema and Lipedema Center has successfully treated over 1,000 patients from all over the world. Dr. Granzow is one of the world’s preeminent lymphedema surgeons, and the Granzow System is the first comprehensive system in the world to use conservative therapies and surgeries to treat lymphedema.

What is the risk of infection after lymphedema surgery?

Lymphedema surgeries, just like all other low-risk surgeries, carry the small risk of post-operative infection. However, lymphedema surgery actually dramatically decreases the risk of dangerous cellulitis infections as has been described in our lymphedema publications.

Are the lymphedema surgeries in the Granzow System safe for me?

The lymphedema surgeries that are part of the comprehensive Granzow System are safe, meaning that they have standard surgical risk comparable to other surgical procedures of a similar length of time. Patients having lymphedema surgeries as part of the Granzow System have experienced significantly decreased rates of infection and cellulitis. Please note that debulking procedures, such as the Charles Procedure, are not part of the Granzow System.

Can early intervention prevent the deposition of lymphedema fat and solids?

Yes, the chances of lymphedema swelling progressing from a fluid-predominant to a solid-predominant stage can be reduced with early intervention such as lymphedema therapy, compression, and appropriately selected surgery.

Are lymphedema surgeries more successful in arms than legs?

Due to gravity, swelling in the body tends to accumulate more swelling in the legs than in the arms for almost all medical conditions, including lymphedema. Legs are also much larger than arms. Therefore, the lymphedema swelling is typically easier to treat in arms than in legs.

Choosing the Right Doctor

Why should I work with a trained lymphedema therapist?

Patients should be evaluated and treated by a trained lymphedema therapist prior to being considered for surgery to determine if surgery is necessary or to improve their condition before surgery. Dr. Granzow believes that a patient should be treated by their own therapist in their home area both before and after surgery whenever possible.

Why should I go to a lymphedema surgeon who is trained and experienced with performing different types of lymphedema surgery?

Lymphedema surgery is a very specific procedure that varies greatly from standard plastic surgery. So it’s essential to work with a doctor who is board-certified by the American Society of Plastic Surgeons (ASPS). Board certification in plastic surgery is difficult to achieve and involves completing a full-time plastic surgery residency and successfully passing a rigorous exam. If a surgeon doesn’t have the proper training in lymphedema microsurgery techniques, they could potentially cause more damage, elongating the path to recovery.

Patients suffering from lymphedema have varied symptoms, degrees of severity, and progression of the disease. The characteristics of each patient’s lymphatic system also are different. So, a particular lymphedema surgery may be suited for one patient but not another patient. Only a highly trained lymphedema surgeon will be able to determine which specific combination of surgeries will result in the best outcome.

What do all the letters behind Dr. Granzow’s name mean?

  • MPH: A Master of Public Health is typically a one- or two-year program of study. Dr. Granzow’s MPH includes an additional specialization in Health Systems Management.
  • FACS: Fellow, American College of Surgeons indicates that Dr. Granzow’s professional qualifications, education and training, ethical conduct, and surgical competence have passed a rigorous evaluation and are consistent with the high standards required by the College of Surgeons. The American College of Surgeons, which is the largest organization of surgeons in the world, evaluates the eligibility of applicants by investigating their entire surgical practice. The investigation ensures, among other things, that the surgeon has a certification from an American surgical specialty board that is appropriate to the applicant’s specialty practice. The investigation also looks at ethical fitness and professional proficiency as determined by an appropriate College Credentials Committee.
  • AOA: Alpha Omega Alpha is the only national honor medical society dedicated to recognizing and enhancing academic excellence, professionalism, service, and leadership within the medical profession. Membership in this society is granted only to the top students in a given medical school class year at graduation. Dr. Granzow graduated in the top 10% of his medical school class.

Working with Our Office

How many doctors work at your practice?

Dr. Granzow is the only surgeon in our office, but we have a whole team of specialists who will work on a treatment plan.

Do you offer physical therapy and conservative therapies?

Our physical therapists may work with patients directly before and after surgery to maximize results. However, we recommend having a physical therapist near a patient’s home that they can work with to manage their condition over time.

How do I determine my course of treatment?

Treatment will look different for every patient, so all Granzow Lymphedema and Lipedema Center patients start with a consultation appointment and an evaluation to determine the type and stage of their lymphedema as well as the characteristics of their lymphatic system. From there, conservative therapies will be prescribed potentially in combination with one or multiple surgeries that aligns with their condition.

Why does Dr. Granzow believe that lymphedema surgery is a team effort?

Dr. Granzow’s philosophy is based on a patient-centered rather than physician-centered system of care to achieve the best results possible. The patient and every member of our team are essential in achieving an optimum treatment plan. We have also seen the greatest results when surgery is paired with conservative therapies administered by a trained lymphedema therapist.

Will insurance pay for my lymphedema surgery?

We spend tremendous time and effort with each patient to maximize their insurance coverage. Our Patient Advocacy team, led by our Director of Patient Advocacy, has a tremendous success rate in achieving insurance coverage for our patients, regardless of their ability to pay.

My insurance said they won’t cover lymphedema surgery. Can you help?

Yes, our Patient Advocacy team helps patients take legal action to ensure treatment is covered by insurance, even if they have previously been denied coverage.

I’m an out-of-town patient. Can your office help me plan a visit?

Yes, many of our patients travel long distances to be seen and treated by Dr. Granzow and his team. Our office will be happy to assist with planning a visit.