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A professional team of anesthesiologists, making surgery safer Our team is professionally licensed and every operation is fully monitored, giving you and your family peace of mind. Miffy Chia-Yu Lin Miffy Chia-Yu Lin, a Ph.D., is the lymphedema coordinator at the Center of Lymphedema Microsurgery. She is the contact person for patients to book consultations with Dr. Cheng. She can be contacted by phone, email, or WhatsApp. She is extremely knowledgeable in treating lymphedema patients and committed to strive for the continuous improvement of lymphedema care and treatment. She has been working at the center for over a decade. She is also a member of the Sigma Theta Tau International Honor Society of Nursing. A+ Surgery Clinic offers: Primary lymphedema Upper limb lymphedema following breast cancer treatment Lower limb lymphedema following gynecological cancer treatment Lower lymphedema presented after trauma or other surgeries

鳳凰電波特色、探頭比較 ｜需要幾次療程？｜鳳凰電波與電波的差異｜術後保養和注意事項 ｜ 立即預約 與我們聯絡 HELIOS II 8倍淨膚雷射 Helios II 特色 由全世界頂尖光學領域的科學家研發而成，治療以溫和、低痛感受到大眾喜愛 HELIOS II 8倍淨膚會產生光震波及光熱效應，光震波效應藉由1064nm及532nm兩種波長對皮膚不同的穿透深度，可有效破壞淺層及深層的黑色素，而光熱效應可抑制皮脂分泌，促進膠原蛋白新生。 分段光束模式 Virtue 1 提高8倍效能 穿透力更強 除斑更徹底 Virtue 2 分段光束模式 雷射能量更均勻 有效縮短治療時間 Virtue 3 世界級專利低溫淨膚探頭 表皮層易累積過高熱能 可降低術後返黑機率 Virtue 4 特殊1064nm雷射波長 重建膠原蛋白結構 恢復肌膚彈性 Is delayed reconstruction more difficult? Delayed breast reconstruction is slightly more challenging compared to immediate breast reconstruction. Factors such as insufficient skin, scar tissue from previous surgery, and underarm depressions after lymph node clearance are additional considerations. First, during a total mastectomy, if immediate reconstruction is not planned, the breast surgeon will remove excess skin and close the wound with a straight line. Therefore, in autologous tissue breast reconstruction, not only is fat from areas like the abdomen, back, buttocks, or thighs important, but the skin covering the area is also crucial. If the patient opts for implant reconstruction or desires scar placement similar to immediate reconstruction (limited to a smaller area), an additional step is required: inserting a tissue expander to stretch the skin. The second challenge is the scar tissue adhesions or fibrosis within the entire chest area. During the reconstruction surgery, the surgeon must carefully release these scars to create a well-shaped breast. The third issue is the noticeable depression in the underarm, caused by the removal of most lymph nodes. If this depression can be filled during reconstruction, the result will be much more satisfying, particularly improving clothing options and comfort, especially in summer. Another technical challenge arises with free flap breast reconstruction. The surgeon must find a healthy set of blood vessels in the chest to supply blood to the flap. In delayed reconstruction, the thoracodorsal artery may sometimes be unusable due to damage from the first surgery or because severe scarring makes dissection difficult. However, this issue is not the most difficult for experienced surgeons. Most skilled and up-to-date surgeons now use the internal mammary vessels for anastomosis. Although the internal mammary technique is more complex than using the thoracodorsal artery and less experienced surgeons may be hesitant to use it, it yields better results. The fat in the flap survives well due to the abundant blood supply. While delayed reconstruction presents certain challenges, these can be overcome by experienced surgeons. Delayed breast reconstruction can still achieve a natural and beautiful result, making it a highly recommended procedure. Breast cancer survival rates have significantly improved, and we sincerely believe that patients should not have to endure ongoing inconvenience or lifelong feelings of loss and regret due to the absence of a breast. Is delayed reconstruction more difficult? Delayed breast reconstruction is slightly more challenging compared to immediate breast reconstruction. Factors such as insufficient skin, scar tissue from previous surgery, and underarm depressions after lymph node clearance are additional considerations. First, during a total mastectomy, if immediate reconstruction is not planned, the breast surgeon will remove excess skin and close the wound with a straight line. Therefore, in autologous tissue breast reconstruction, not only is fat from areas like the abdomen, back, buttocks, or thighs important, but the skin covering the area is also crucial. If the patient opts for implant reconstruction or desires scar placement similar to immediate reconstruction (limited to a smaller area), an additional step is required: inserting a tissue expander to stretch the skin. The second challenge is the scar tissue adhesions or fibrosis within the entire chest area. During the reconstruction surgery, the surgeon must carefully release these scars to create a well-shaped breast. The third issue is the noticeable depression in the underarm, caused by the removal of most lymph nodes. If this depression can be filled during reconstruction, the result will be much more satisfying, particularly improving clothing options and comfort, especially in summer. Another technical challenge arises with free flap breast reconstruction. The surgeon must find a healthy set of blood vessels in the chest to supply blood to the flap. In delayed reconstruction, the thoracodorsal artery may sometimes be unusable due to damage from the first surgery or because severe scarring makes dissection difficult. However, this issue is not the most difficult for experienced surgeons. Most skilled and up-to-date surgeons now use the internal mammary vessels for anastomosis. Although the internal mammary technique is more complex than using the thoracodorsal artery and less experienced surgeons may be hesitant to use it, it yields better results. The fat in the flap survives well due to the abundant blood supply. While delayed reconstruction presents certain challenges, these can be overcome by experienced surgeons. Delayed breast reconstruction can still achieve a natural and beautiful result, making it a highly recommended procedure. Breast cancer survival rates have significantly improved, and we sincerely believe that patients should not have to endure ongoing inconvenience or lifelong feelings of loss and regret due to the absence of a breast. Is delayed reconstruction more difficult? Delayed breast reconstruction is slightly more challenging compared to immediate breast reconstruction. Factors such as insufficient skin, scar tissue from previous surgery, and underarm depressions after lymph node clearance are additional considerations. First, during a total mastectomy, if immediate reconstruction is not planned, the breast surgeon will remove excess skin and close the wound with a straight line. Therefore, in autologous tissue breast reconstruction, not only is fat from areas like the abdomen, back, buttocks, or thighs important, but the skin covering the area is also crucial. If the patient opts for implant reconstruction or desires scar placement similar to immediate reconstruction (limited to a smaller area), an additional step is required: inserting a tissue expander to stretch the skin. The second challenge is the scar tissue adhesions or fibrosis within the entire chest area. During the reconstruction surgery, the surgeon must carefully release these scars to create a well-shaped breast. The third issue is the noticeable depression in the underarm, caused by the removal of most lymph nodes. If this depression can be filled during reconstruction, the result will be much more satisfying, particularly improving clothing options and comfort, especially in summer. Another technical challenge arises with free flap breast reconstruction. The surgeon must find a healthy set of blood vessels in the chest to supply blood to the flap. In delayed reconstruction, the thoracodorsal artery may sometimes be unusable due to damage from the first surgery or because severe scarring makes dissection difficult. However, this issue is not the most difficult for experienced surgeons. Most skilled and up-to-date surgeons now use the internal mammary vessels for anastomosis. Although the internal mammary technique is more complex than using the thoracodorsal artery and less experienced surgeons may be hesitant to use it, it yields better results. The fat in the flap survives well due to the abundant blood supply. While delayed reconstruction presents certain challenges, these can be overcome by experienced surgeons. Delayed breast reconstruction can still achieve a natural and beautiful result, making it a highly recommended procedure. Breast cancer survival rates have significantly improved, and we sincerely believe that patients should not have to endure ongoing inconvenience or lifelong feelings of loss and regret due to the absence of a breast. Is delayed reconstruction more difficult? Delayed breast reconstruction is slightly more challenging compared to immediate breast reconstruction. Factors such as insufficient skin, scar tissue from previous surgery, and underarm depressions after lymph node clearance are additional considerations. First, during a total mastectomy, if immediate reconstruction is not planned, the breast surgeon will remove excess skin and close the wound with a straight line. Therefore, in autologous tissue breast reconstruction, not only is fat from areas like the abdomen, back, buttocks, or thighs important, but the skin covering the area is also crucial. If the patient opts for implant reconstruction or desires scar placement similar to immediate reconstruction (limited to a smaller area), an additional step is required: inserting a tissue expander to stretch the skin. The second challenge is the scar tissue adhesions or fibrosis within the entire chest area. During the reconstruction surgery, the surgeon must carefully release these scars to create a well-shaped breast. The third issue is the noticeable depression in the underarm, caused by the removal of most lymph nodes. If this depression can be filled during reconstruction, the result will be much more satisfying, particularly improving clothing options and comfort, especially in summer. Another technical challenge arises with free flap breast reconstruction. The surgeon must find a healthy set of blood vessels in the chest to supply blood to the flap. In delayed reconstruction, the thoracodorsal artery may sometimes be unusable due to damage from the first surgery or because severe scarring makes dissection difficult. However, this issue is not the most difficult for experienced surgeons. Most skilled and up-to-date surgeons now use the internal mammary vessels for anastomosis. Although the internal mammary technique is more complex than using the thoracodorsal artery and less experienced surgeons may be hesitant to use it, it yields better results. The fat in the flap survives well due to the abundant blood supply. While delayed reconstruction presents certain challenges, these can be overcome by experienced surgeons. Delayed breast reconstruction can still achieve a natural and beautiful result, making it a highly recommended procedure. Breast cancer survival rates have significantly improved, and we sincerely believe that patients should not have to endure ongoing inconvenience or lifelong feelings of loss and regret due to the absence of a breast. Is delayed reconstruction more difficult? Delayed breast reconstruction is slightly more challenging compared to immediate breast reconstruction. Factors such as insufficient skin, scar tissue from previous surgery, and underarm depressions after lymph node clearance are additional considerations. First, during a total mastectomy, if immediate reconstruction is not planned, the breast surgeon will remove excess skin and close the wound with a straight line. Therefore, in autologous tissue breast reconstruction, not only is fat from areas like the abdomen, back, buttocks, or thighs important, but the skin covering the area is also crucial. If the patient opts for implant reconstruction or desires scar placement similar to immediate reconstruction (limited to a smaller area), an additional step is required: inserting a tissue expander to stretch the skin. The second challenge is the scar tissue adhesions or fibrosis within the entire chest area. During the reconstruction surgery, the surgeon must carefully release these scars to create a well-shaped breast. The third issue is the noticeable depression in the underarm, caused by the removal of most lymph nodes. If this depression can be filled during reconstruction, the result will be much more satisfying, particularly improving clothing options and comfort, especially in summer. Another technical challenge arises with free flap breast reconstruction. The surgeon must find a healthy set of blood vessels in the chest to supply blood to the flap. In delayed reconstruction, the thoracodorsal artery may sometimes be unusable due to damage from the first surgery or because severe scarring makes dissection difficult. However, this issue is not the most difficult for experienced surgeons. Most skilled and up-to-date surgeons now use the internal mammary vessels for anastomosis. Although the internal mammary technique is more complex than using the thoracodorsal artery and less experienced surgeons may be hesitant to use it, it yields better results. The fat in the flap survives well due to the abundant blood supply. While delayed reconstruction presents certain challenges, these can be overcome by experienced surgeons. Delayed breast reconstruction can still achieve a natural and beautiful result, making it a highly recommended procedure. Breast cancer survival rates have significantly improved, and we sincerely believe that patients should not have to endure ongoing inconvenience or lifelong feelings of loss and regret due to the absence of a breast.

Am I A Candidate? 我適合什麼手術？淋巴水腫手術的適合對象、不同治療方案和術後注意事項 Am I A Candidate? Say Goodbye to Compression Garments after Dr. Cheng's Lymphedema Microsurgery Suggested Candidates For Lymphedema Surgery A full medical history and thorough physical exam are required for the initial clinic visit. The circumferential differentiation between the affected and unaffected limbs (in unilateral disease) will be the focus, and measured comprehensively during the physical exam. Who is eligible for lymphedema surgery? A complete history, complete examination and diagnosis of both the lymphedematous limb and the unaffected limb (unilateral disease) are required at the initial visit. Based on the research results, Dr. Cheng's lymphedema grading system can establish a diagnosis and formulate treatment plans for patients. 1 Suggested candidates for Lymphedema surgery are as follows: Lymphedema patients who aggressively receive rehabilitation for more than 6 months without significant improvement. Lymphatic obstruction present in lymphoscintigraphy. The difference of circumference between the affected and non-affected limbs is more than 10%. Cancer patients with the aforementioned indications without tumor recurrence or distant metastasis. Learn more 2 Indications for Vascularized Lymph Node Flap Transfer are as follows: Patients exhibiting a total obstruction on lymphoscintigraphy in late grade II, grade III, and IV. Patients without patent lymphatic ducts on indocyanine green lymphography. Learn more 3 Indications for Lymphovenous Anastomoses are as follows: In some cases, surgery may be performed to alleviate swelling and reduce symptoms. Dr. Cheng has developed a unique technique that involves lymph node transfer. During the procedure, Dr. Cheng transfers lymph node flap to distal recipient site – dorsal wrist in the upper extremity or ankle in the lower extremity. Learn more Lymphedema Treatment Options Accurate diagnosis and appropriate staging assessment are fundamental to the successful treatment of lymphedema. The conventional treatment methods often require the use of antibiotics, massage, and complex decongestive therapy including compression garments and bandages. Innovative surgical treatments have been emerging rapidly in the past 10 years, and the ground breaking vascularized submental lymph node (VSLN) or vascularized groin lymph node (VGLN) flap transfer to distal recipient site that invented by Dr. Cheng create a natural physiologic drainage conduit to alter excess lymphatic fluid buildup and revert side effects like those of tissue fibrosis and skin swelling. Dr. Cheng’s surgical treatment outcomes show significant improvements in the circumferential reduction rates of the affected limb circumference without the use of compression garments. Data source: Asuncion M, Cheng MH, et al. PRS Global Open. 2018;23;6(3):e1691. Cheng MH, et al. Plast. Reconstr. Surg. 2013;131(6):1286-98. A Prospective Evaluation of Lymphedema-Specific Quality-of-Life Outcomes Following Vascularized Lymph Node Transfer. Patel KM, Lin CY, Cheng MH. Ann Surg Oncol. 2015 Jul;22(7):2424-30 Outcomes of Lymphedema Microsurgery for Breast Cancer-related Lymphedema With or Without Microvascular Breast Reconstruction. Engel H, Lin CY, Huang JJ, Cheng MH. Ann Surg. 2017 Jun 7. Contact Dr. Cheng For A Consultation If you have Breast Cancer Related Lymphedema and would like to know more about the most advanced treatments, contact Dr. Cheng. Internationally recognized as a leading lymphedema specialist, Dr. Cheng can discuss treatment options, based on your individual case. Dr. Cheng is a member of the American Society of Reconstructive Microsurgery and has performed numerous VLN surgeries on breast cancer survivors and other lymphedema patients. Learn more

為維護良好的醫療品質與看診舒適，本院採預約制，您可先以電話、電子郵件、LINE或填寫線上表單等方式預約，我們會盡快與您聯繫！ Let's Connect How to Make an Appointment? To ensure high-quality medical care and a comfortable consultation experience, our clinic operates on an appointment-only basis. You can schedule an appointment via phone, email, LINE, or by filling out the online form. We will contact you as soon as possible! Business Hours: Monday to Friday, 8:00 AM to 6:00 PM. Closed on weekends. Notice Please download and complete the Client Information Form from our website. The information you provide will allow the A+ Surgery Clinic to select the most suitable team of specialists to assist you with your medical or personal needs. On the form, please clearly specify your preferred appointment dates as well as any special requests or personal needs that you may have. We will try our best to make you feel as close to home as possible. Please provide all detailed medical reports at least from the past 3 months, including lab or pathology reports and imaging files (X-rays, CT, MRI, Ultrasounds, Lymphoscintigraphy, etc.). If you have medical information, please provide it. Please send (1) and (2)to A+ surgery clinic at aplussurgery@gmail.com and Miffy Lin. Within two business days, A+ surgery clinic or Miffy Lin will contact you by email with further appointment details or medical questions once we receive and review your application form. Any information you provide will be kept strictly confidential under the Medical and Personal Data Protection Laws in Taiwan. Treatment Plan After gaining understanding of your medical background, our medical team will draft and present to you a treatment schedule specifically tailored to your personal needs. At the same time, a detailed statement describing the treatment process and estimated costs will be sent to you by email. Appointment Confirmation Once you have confirmed and accepted Dr. Cheng’s treatment plan, your medical coordinator will proceed to set up, double check, and confirm your previously made appointment date, as well as make the necessary travel visa preparations, airport pickup, and hotel accommodations for you, to make your stay with us carefree. Address 3rd Floor, No. 337, Fuxing North Road, Songshan District, Taipei City (MRT Zhongshan Junior High School Station) Map Phone (+886) 02-2712-3373 Phone (+886) 0966-523-737 Phone Email care@aplussurgery.com Social Media LINE Name Gender * Male Female Other Email Region * Taiwan Others Phone Convenient contact time 選擇一個時段 Remark Send Appointment successful ！

認識更多原發性淋巴水腫的存在、發展的原因，診斷方式、治療方法，以及為何專業的安德森診所是你最好的選擇。 Primary Lymphedema Say Goodbye to Compression Garments after Dr. Cheng's Lymphedema Microsurgery Symptoms of Primary Lymphedema Primary lymphedema is the presence or development of lymphedema without any relation to any underlying medical condition. Primary lymphedema has a quoted incidence of approximately 1-3 births out of every 100,000 births, with a particular female preponderance to male ratio of 3.5:1 worldly. In North America, the incidence of primary lymphedema is approximately 1.15 births out of every 100,000 births. Primary lymphedema can be classified depending on the age of onset of the patients: at infancy (birth to 1 year), during childhood (1-8 or 9 years), during adolescence (9-21 years), and lastly during adulthood (after 21 years). Mutations in VEGFR3 (Milroy disease), CCBE1 (Hennekam syndrome), SOX18 (hypotrichosis-telangiectasia-lymphedema), and FOXC2 (lymphedema distichiasis) are several eponymous conditions that present at birth and involve the development of lymphedema. Familial lymphedema of the lower extremities that presents itself during adolescence is known as Meige disease. Its underlying genetic abnormality is not known yet, but its familial nature and presentation at adolescence are characteristics of it. Primary lymphedema often occurs at birth and for causes or by mechanisms that are unknown. When primary lymphedema becomes symptomatic in adulthood, these patients often have a long-standing history of lymphedema that is associated with the destruction of lymphatic channels. Adipogenesis or proliferation of adipose tissue coupled with dense fibrosis often results in severe lymphedema of the limb and a more severe presentation. Severe fibrosis occurs with long-standing lymphedema due to the accumulation of protein-rich fluid in the interstitial spaces coupled with inflammation repeated bouts of cellulitis. Diagnosis of Primary Lymphedema Pre-operative lymphoscintigraphy and indocyanine green (ICG) lymphography are used to detect the presence of any intact lymphatic channels. If a lymphatic duct is available at ICG lymphography, the patient is offered the lymphovenous anastomosis (LVA), whereas those without patent lymphatic ducts are indicated for vascularized lymph node transfers (VLNT). If the lymphoscintigraphy shown total obstruction, the patients are offered VLNT directly. Ultrasound Doppler is used to evaluate the concomitant vascular lesions at the proximal site. Single-photon emission computed tomography (SPECT) is indicated for those patients with suspected concomitant chylous ascites. MRI is prescribed for the evaluation of donor site lymph node basins of neck if the vascularized lymph node flap is indicated. Lymphoscintigraphy computed tomography (CT) indocyanine green (ICG) lymphography Treatment Of Primary Lymphedema Both Vascularized lymph node transfers (VLNT) and lymphovenous anastomosis (LVA) are surgical treatments that have been proven effective in treating secondary lymphedema. VLNT involves the microsurgical transfer of lymph node-containing tissue to a lymphedematous limb, which works based on the movement of lymphatic fluid from the affected limb into the transferred lymph node and drainage via the newly anastomosed venous route. We have reported a paper to compare the results of VLNT and LVA treatments of lymphedema. 80% of primary lymphedema required a VLNT for the functional recovery and 20% of primary lymphedema may undergo a LVA. At a mean follow-up of 20 months, mean circumferential reduction of limb circumference and episodes of cellulitis were 3.7 ± 2.9 cm and 1.9 ± 2.9 cm; 5.1 ± 2.8 times/year and 4.2 ±0.5 times/year in VLNT and LVA groups, respectively (p = 0.7). Improvements in overall score of the Lymphedema quality of life questionnaire (LYMQoL) (from 3.9 ± 1.2 to 6.4 ± 1.1, p < 0.05) in VLNT group had statistically significant difference than that (from 3.0 ± 1.4 to 5.0 ± 2.4, p=0.07) in LVA group. Both VLNT and LVA surgeries can effectively treat primary lymphedema patients. The reduction of above-knee circumference, body weight, episodes of cellulitis, and the improvement of LYMQoL was significantly greater in LVNT compared to LVA. All of the patients did not use compression garments post-operatively! Anderson, Your safe choice Medical Center Specifications and Equipment The operating room is equipped with Mitaka microscopes, of which there are only four in Taiwan. They have a resolution of up to 16 million pixels and can magnify 42 times optically. They are very suitable for the anastomosis of lymphatic vessels and veins of 0.5 mm and are often used in lymphatic venous anastomosis, such as preoperative evaluation and intraoperative evaluation of the permeability of sutures, making the operation more stable and safe. Recommended reading journal Vascularized lymph node flap transfer and lymphovenous anastomosis for klippel-trenaunay syndrome with congenital lymphedema. Qiu SS, Chen HY, Cheng MH. Plast Reconstr Surg Glob Open. 2014 Jul 9;2(6):e167. https://www.ncbi.nlm.nih.gov/pubmed/25289360 Successful Outcomes of Vascularized Lymph Node Transfer and Lymphovenous Anastomosis for Treatment of Primary Lymphedema. Charles, Cheng MH. Plast Reconstr Surg Glob Open. 2018 [Epub ahead of print] Contact Dr. Cheng For A Consultation If you have Breast Cancer Related Lymphedema and would like to know more about the most advanced treatments, contact Dr. Cheng. Internationally recognized as a leading lymphedema specialist, Dr. Cheng can discuss treatment options, based on your individual case. Dr. Cheng is a member of the American Society of Reconstructive Microsurgery and has performed numerous VLN surgeries on breast cancer survivors and other lymphedema patients. Learn more

瞭解更多手臂淋巴水腫的成因及症狀，以及為何安德森整形外科是您的安心選擇，有任何問題歡迎電話及線上諮詢。 Upper Extremity Lymphedema Say Goodbye to Compression Garments after Dr. Cheng's Lymphedema Microsurgery What Is Upper Extremity Lymphedema? Breast cancer patients who underwent axillary lymph node dissection following radiotherapy are at a higher risk of developing extremity lymphedema – Breast Cancer-Related Lymphedema (BCRL), a condition that results in tissue swelling and liquid retention in the arms. While it is possible to manage the condition with some home care, surgery may be necessary to significantly improve an individual’s comfort and quality of life. Ming-Heui Cheng, MD, FACS, a pioneer in plastic microsurgery and internationally renowned lymphedema specialist, performs vascularized lymph node flap transfers on lymphedema patients whose symptoms have not improved or continue to worsen six months after they emerged. Symptoms Of Lymphedema Of The Arm The affected limb may develop inflammation, infection, adipogenesis, and fibrosis of the tissue. The protein-concentrated fluid that accumulates inside the interstitial tissue may further block or make the drainage of the lymph fluid less efficient or even create an obstruction. Lymphedema of upper extremity causes pain, heaviness, skin hyperkeratosis, fibrosis, discomfort when wearing certain clothes and jewelry, cosmetic problems and limitation of daily activities for patients. It is common for lymphedema patients to experience depression, due to physical discomfort, emotional distress and lower quality of life. Anderson, Your safe choice Medical Center Specifications and Equipment The operating room is equipped with Mitaka microscopes, of which there are only four in Taiwan. They have a resolution of up to 16 million pixels and can magnify 42 times optically. They are very suitable for the anastomosis of lymphatic vessels and veins of 0.5 mm and are often used in lymphatic venous anastomosis, such as preoperative evaluation and intraoperative evaluation of the permeability of sutures, making the operation more stable and safe. Surgical Techniques 1 Lymphaticovenous Anastomosis, LVA LVA is an advanced minimally invasive super-microsurgical technique used to relieve lymphedema. During the procedure, Dr. Cheng will make small incisions, which expose lymphatic channels and small veins just beneath the skin. Learn more 2 Vascularized Lymph Node Flap Transfer, VLNT In some cases, surgery may be performed to alleviate swelling and reduce symptoms. Dr. Cheng has developed a unique technique that involves lymph node transfer. During the procedure, Dr. Cheng transfers lymph node flap to distal recipient site – dorsal wrist in the upper extremity or ankle in the lower extremity. Learn more Case 61-year-old female with breast cancer-related lymphedema in the right upper limb Before Surgery: This is a 61-year-old female who had suffered from breast cancer-related lymphedema of the right upper extremity for 10 years after mastectomy, axillary 19 lymph nodes dissection, and radiotherapy. With the combined use of compression garments and the treatment of complete decongestive therapy, she had developed 2 episodes of cellulitis per year. After Surgery: At 75- months follow-up, the circumferential reduction rates of the affected limb circumference without the use of compression garments were 100% and 40% above and below the elbow, respectively. 53-year-old patient, right upper limb lymphedema clinical grade II Before Surgery: A 53-year-old patient with grade II breast cancer-related lymphedema of the right upper extremity for 36 months after modified radical mastectomy, axillary lymph node dissection, and radiation. She developed 2 episodes of cellulitis per year and was refractory to conservative decongestive therapy. After Surgery: At 36- months follow-up, the circumferential reduction rates of the affected limb circumference without the use of compression garments were 100% and 85% above and below the elbow, respectively. 39-year-old female, left upper limb lymphedema, grade 1 Before Surgery: This is a 39-year-old female with left upper limb lymphedema for 6- months after left mastectomy and axillary 31 lymph nodes dissection and radiation. After Surgery: At a 3- months of follow-up, the circumferential reduction rates of the affected limb without the use of compression garments were 35% and 60% above the elbow and below the elbow, respectively. 49-year-old female, right upper limb lymphedema, grade 1 Before Surgery: This is a 49-year-old female with right upper limb lymphedema for 6- months after right mastectomy and axillary lymph nodes dissection and radiation. After Surgery: At a 20- months of follow-up, the circumferential reduction rates of the affected limb without the use of compression garments were 85% and 60% above the elbow and below the elbow, respectively. Recommended reading journal Vascularized groin lymph node transfer using the wrist as a recipient site for management of postmastectomy upper extremity lymphedema. Lin CH, Ali R, Chen SC, Wallace C, Chang YC, Chen HC, Cheng MH. Plast Reconstr Surg. 2009 Apr;123(4):1265-75 https://www.ncbi.nlm.nih.gov/pubmed/19337095 Vascularized groin lymph node flap transfer for postmastectomy upper limb lymphedema: flap anatomy, recipient sites, and outcomes.. Cheng MH, Chen SC, Henry SL, Tan BK, Lin MC, Huang JJ. Plast Reconstr Surg. 2013 Jun;131(6):1286-98. https://www.ncbi.nlm.nih.gov/pubmed/23714790 Outcomes of Lymphedema Microsurgery for Breast Cancer-related Lymphedema With or Without Microvascular Breast Reconstruction. Engel H, Lin CY, Huang JJ, Cheng MH. Ann Surg. 2017 Jun 7 https://www.ncbi.nlm.nih.gov/pubmed/28594742 Greater Omental Lymph Node Flap for Upper Limb Lymphedema with Lymph Nodes-depleted Patient. Chu YY, Allen RJ Jr, Wu TJ, Cheng MH. Plast Reconstr Surg Glob Open. 2017 Apr 25;5(4):e1288. https://www.ncbi.nlm.nih.gov/pubmed/28507857 The Submental versus Groin Vascularized Lymph Node Transfer Flaps: A Head-to-Head Comparison of Surgical Outcomes for Breast Cancer Related Lymphedema Ho OA, Lin CY, Cheng MH. Plast Reconstr Surg Glob Open. 2018 [Epub ahead of print] Contact Dr. Cheng For A Consultation If you have Breast Cancer Related Lymphedema and would like to know more about the most advanced treatments, contact Dr. Cheng. Internationally recognized as a leading lymphedema specialist, Dr. Cheng can discuss treatment options, based on your individual case. Dr. Cheng is a member of the American Society of Reconstructive Microsurgery and has performed numerous VLN surgeries on breast cancer survivors and other lymphedema patients. Learn more

除皺復新~永保平滑V臉的最高肌密 對抗皮膚鬆弛下垂,不論是法令紋、抬頭紋、木偶紋或魚尾紋等，可以靠注射肉毒桿菌，玻尿酸，脂肪填充等微整形讓妳恢復青春美麗。也可以做內視鏡拉皮手術，讓您有感皮膚的緊緻。 除皺緊緻療程 Wrinkle removal Treatment 保養品達不到的效果，漸進式拉提能幫妳 路見不平，立即熨平~~ 除皺復新~永保平滑V臉的最高肌密 對抗「臉部、眼周、全身性」皮膚鬆弛下垂 平皺補凹、緊緻肌膚、 重塑輪廓線條 最新皮膚「熨平技術」強勢登場，幫妳快速找回年輕感 都有在用保養品，為什麼我的皺紋還是越來越多呢？ 皮膚表面是由彈性纖維及膠原蛋白所組成的，隨著年齡增長或保養不足，都會影響皮膚的彈性和緊緻度，日積月累就會造成皮膚鬆弛及表面出現皺摺細紋，此現象不只會出現在臉上，也會發生在全身各部位 。 醫師會怎麼診斷和治療皺紋？ 醫師會經由直接觀察臉部表情及肌肉活動來進行評估，可了解皺紋的種類、形成的原因，以便提供對症有效的治療建議。 皺紋的形成原因有哪幾種？ 根據出現的位置及形成原因，皺紋可分為2大類： 1.動態紋： 面部表情需經肌肉收縮及皮膚拉伸才能產生，長期下來形成的紋路稱為動態紋，又稱表情紋，如抬頭紋、眉間紋、魚尾紋及笑紋。 2.靜態紋 主要因素為膠原蛋白流失及彈性纖維斷裂，當臉部沒有做任何表情時，就已存在的紋路，稱為靜態紋，如法令紋、木偶紋、頸紋。 想讓皺紋消失，有哪些治療方式可以選擇？ 以下是改善皺紋問題常見的幾種治療方式： 1.日常保養 外出時要避免長時間陽光曝曬，可選擇合適的防曬產品來阻絕紫外線，以延緩肌膚老化；每日清潔臉部時可挑選溫和型卸妝品，減少拉扯及搓揉肌膚；保養品方面優先選擇保濕類產品，更能有效鎖住水分，維持肌膚光滑。 2.注射肉毒桿菌 肉毒桿菌是從細菌的分泌物經高科技純化，萃取出來的蛋白質，可以用來阻斷運動神經末梢的傳導功能，治療過度活耀的肌肉，使引起皺紋的肌肉放鬆。治療過程中會有針扎感，但只作用在治療部位，並不影響其他表情動作，不會有臉部僵硬的問題，效果通常可維持4~6個月。 3.注射玻尿酸 外用塗擦的玻尿酸僅有保濕效果，無法減少皺紋;而注射用玻尿酸是一種透明的多醣類膠狀物質，可用來填補皮膚的印痕及凹陷處。在注射肉毒桿菌減少表情皺紋活動的同時，建議一併注射玻尿酸將皺紋填平，以達到相輔相成的加強效果。 4.注射維生素 以高濃度的維生素透過點滴注射，促進膠原蛋白增生，並加強肌膚修護力，但須頻繁施打。 5.脂肪填充手術 醫師從治療者身體取出定量脂肪，多選擇腹部、背部或大腿等處的脂肪，經特殊的離心洗淨與淘選後，再注射到想填補的皺紋處，其優點為利用自體脂肪可降低排斥問題，傷口僅約為針孔大小，術後脂肪穩定期約3個月，建議此期間內勿減肥，以維持更好的效果。 6.內視鏡拉皮手術 做法是將皮膚的皺褶拉緊，切除多餘的脂肪和皮膚後進行縫合，通過手術修復臉部結構和組織，減少皺紋並改善臉部輪廓。因使用的是內視鏡手術，只需要在前額髮線後開小洞即可手術，較傳統型拉皮手術有更多好處，如傷口小更容易照護，且減少疤痕形成並可加速復原時間。 7.Thermage FLX 鳳凰電波 屬於非侵入性治療，不會有任何傷口，是利用每秒678萬次的高頻率電流，在深層皮膚產生55~65度的熱能，以刺激膠原蛋白新生，達到撫平細紋、提升膚質、緊緻肌膚及重塑輪廓的效果，治療方式中包含脈衝技術，以環繞式施打來提升舒適度，及AccuREP技術使每一療程區域有完整且一致的能量，大幅優化療程效能。 鳳凰電波不僅臉部可施打，也適合眼周、四肢皺褶或身體橘皮部位皆可做此治療，且療程的後續照顧簡單，僅需正常保濕及防曬，視情況能維持1~2年。 我不知道怎麼選擇治療方式，該如何諮詢? 皺紋治療的方法種類繁多，歡迎至安德森整形外科診所諮詢，您可藉由整形外科醫師的專業評估，經與個案管理師諮詢溝通後，審慎的選擇出對您最適合的治療方案。

美體除毛療程 Beauty treatments 體毛太多易悶熱、出汗、毛囊炎，經常要刮毛好麻煩!!! 不再毛手毛腳(~別再叫我毛怪~)雷射永久性除毛 幾乎無痛感、免上麻、療程舒適 恢復光滑肌膚一勞永逸，大方舉手露腿不怕尷尬~~ 皮膚光滑不再「毛」躁：除毛5大重點部位 1. 手腳四肢增生的體毛 2. 臉部汗毛與眉雜毛 3. 腋下、胸毛、腹部等體毛 4. 鬍鬚、落腮鬍 5. 比基尼線、私密處、乳暈部位體毛 去除體毛的方式有哪些? 1.雷射除毛 此方式獲得醫學認證，可有效破壞毛囊根部、抑制毛髮生長，省時方便，且可避免傷害皮膚表層。因毛囊有生長週期，在進行雷射時有些毛囊可能正處於休眠期，所以通常雷射需要5~8次 才能除乾淨。 ​ 2.刮毛刀 只能刮除表面毛髮，很快會再長出刺刺的「小黑頭」，且刮毛刀容易傷害到皮膚，可能造成黑色素沉澱和毛囊炎。 ​ 3.除毛膏 雖然可簡單、快速、無痛去除毛髮根部，但化學成分製品會刺激皮膚，容易造成過敏，不適合用在皮膚細緻的部位。 ​ 4.蜜臘除毛 能暫時去除毛髮的根部，平均維持3週時間，無法有效達到永久除毛的效果。 永久性除毛的治療原理 毛囊生長毛髮有一定的週期循環，稱為毛囊生長週期，分為3個階段：生長期、衰退期、和休止期。 雷射除毛是針對處於生長期的毛囊，破壞其毛囊幹細胞，達到抑制毛髮生長的效果。醫學上認定的「永久除毛」，是指以雷射連續進行6~8次的療程，可達到抑制80~90%毛髮生長，經過每次療程後，毛髮生長會變得越來越慢、越細！ 配合毛髮生長週期，原則上建議每3~4週規律的施打一次雷射。過程中會根據每個人體質狀況不同而有所調整。 雷射除毛術前須知 1.不可「拔毛」以免導致黑色素不足，影響效果或引發毛囊炎而無法進行雷射。 2.治療區域1週內避免塗抹刺激性藥品、磨砂膏、去角質霜。 3.皮膚正在過敏發炎或皮膚乾癢粗糙，應暫時避免治療。 4.治療時應於前一天將治療區域毛髮刮乾淨。 5.治療當日應著寬鬆衣物，以減少術後治療部位摩擦。 雷射除毛療程需要除毛幾次? 根據每個人的除毛部位及毛量多寡，治療次數也會有所不同。這又回到上面提到的，毛囊分為成長期、衰退期及休止期3個階段，每次雷射只對當時正在成長期階段的毛髮有作用。 雷射除毛治療一次約可減少 5~10% 生長期的毛髮，由於毛髮有週期性，每次雷射間隔的時間不宜太密集，這樣才能打到不同生長週期的毛囊，發揮較佳的除毛效果。 一般來說，配合醫師評估你的毛髮週期，約每 6~8 週做一次治療，通常雷射治療 6 次以上，毛髮會逐次逐量慢慢減少或變細，最終達到視覺上乾淨的效果，獲得治療者普遍滿意的程度。當然每個人狀況不一，建議以門診現場諮詢評估為準。 什麼樣的情況不適合雷射除毛？ 1.懷孕和哺乳 基於醫學倫理考量，由於尚未有針對孕婦及哺乳媽媽進行雷射除毛的人體實驗，因此不建議懷孕及哺乳期間進行雷射除毛。 ​ 2.正在使用某些藥物 除毛雷射前 6 個月有口服 A 酸，或正在服用光敏感藥物，或是光敏感者，需主動告知醫師，與醫師充分討論自己進行中的療程狀況後，再評估是否可以雷射除毛。 ​ 3.患特定疾病 現存癌症或有癌症病史、患有免疫抑制疾病（例如 AIDS 或 HIV），或使用免疫抑制藥物導致免疫系統受損、因病態或藥物引起的多毛症，建議優先處理病症。 ​ 4.毛髮顏色淺 白色、顏色較淺的毛髮，雷射作用效果可能較差。這也是為什麼在歐美地區，蜜蠟除毛較雷射除毛盛行的原因。 ​ 5.欲雷射部位感染中 雷射區域有任何現症感染，例如：濕疹、牛皮癬、瘡、毛囊發炎、開放性撕裂或擦傷等，不適合進行雷射除毛。 ​ 6.未受控的內分泌失調 例如：患有糖尿病、甲狀腺功能紊亂、多囊卵巢症、賀爾蒙雄性化者。 雷射除毛術後護理事項 1.治療區域1週內避免使用到各式果酸、各式美白類、各式香精類、去角質和酒精類的成分產品。 2.可使用沐浴乳或香皂洗澡，水溫宜稍低。 3.治療後不會有傷口，但偶有輕微泛紅現象，配合使用冰敷和保濕乳液，數小時到數天 內就會消退。 4.治療後患部若有黑頭毛根，約 1 週後脫落。 5.術後需加強保濕和防曬，且1週內避免高溫場所蒸汽浴、三溫暖和泳池。