Facial lymphedema (FL) is a potential complication following head-and-neck tumor (HNT) therapy. Conservative management is often difficult, and there is limited literature on surgical treatments for FL. This report presents three cases of FL treated with lymphaticovenular anastomosis (LVA). All three patients were male with ISL stage 2 FL following treatment for oral squamous cell carcinoma, aged 59, 45, and 55 years. In each case, double end-to-end LVAs were performed in the preauricular region (right side in cases 1 and 3, left side in case 2). Follow-up was 12 months for cases 1 and 2 and 9 months in case 3, with no post-operative complications. Case 1 showed a 4% reduction in two of three anthropometric parameters, case 2 demonstrated an 8% reduction in all the parameters along with quality-of-life improvement, and case 3 had a 6% reduction in all parameters with improvement in both pinch test and quality-of-life. LVA supermicrosurgery appears to be an effective treatment for FL, improving quality of life with minimal complications and no need for further surgical interventions.
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