Search For:

Travel Visa What is a visa? A visa is a permission certificate or a stamp on a non-citizen applicant’s passport to enter a particular country. To apply for a visa to Taiwan, please visit a Taiwan Representative Office nearest to you. Types of Visas to Taiwan: Visitor, Business Visa: (effective for 7 to 30 days) A U.S citizen doesn't need a visa to visit Taiwan for up to 30 days. Please apply for your visa before your arrival in Taiwan, if you are not a U.S. citizen. For most patients, a visitor visa should offer sufficient time to undergo most kinds of medical checkups, examinations, and treatments. In the event that you are required to stay for longer than one month, we will assist you in applying for a medical visa. A formal certificate of diagnosis will be provided to you for the request of time extension for a medical visa. Landing Visa / Visa Exemption Please complete the immigration card WHILE on board the incoming flight. Citizens of some countries are eligible for a landing visa or visa exemption, which permits individuals to enter Taiwan without prior visa application for a duration of 30 to 90 days. Please click on the link on landing visa for more information. Please click on the link on visa exemption for more information. Entry Permit for Certain Passport Holders For citizens of certain countries, such as Pakistan, Iraq, Myanmar (Burma), Ethiopia, Nigeria, and Afghanistan, a formal medical visa letter signed by our hospital’s doctor will be required to gain entry into Taiwan. Travel Information Say Goodbye to Compression Garments after Dr. Cheng's Lymphedema Microsurgery Once you have confirmed and accepted your treatment plan, we will contact you to double-check and confirm the dates of your previous appointments. We will prepare the necessary travel visa, airport pick-up and hotel accommodation for you, and also make it easy for you to contact us. Travel Destination Known as the “heart of Asia”, Taiwan is packed with exciting things to do, beautiful sights to see, amazing food to try, festivals to enjoy, and friendly people to meet. Taiwan is famous for its landscape, rich heritage, diverse folk traditions, mild climate, magnificent temples, and numerous national museums. It has become a very popular travel destination in Asia because of its convenient and efficient transportation system, safe and secured environment, kind people, and affordable cost of travel. Taiwan’s unique tourism attractions – the combination of traditional Asia and the modern world, the contrast between metropolitan and countryside, the blending cultures of the old and the new, stunning scenery of mountains, coastlines and valleys, and tasty local food and international cuisines – bring tourists back to this beautiful island year after year. Taipei 101 Located in the finest district Taipei has to offer, TAIPEI 101 is the largest engineering project ever in the history of the Taiwan construction business. At 382 meters above the ground the 89F Observation Floor offers visitors a commanding view of the city and Taipei Basin at all directions. Yehliu Geopark Yehliu Geopark is truly a park of natural wonders: rocks carved by wave-cutting and weathering over years and years were formed into shapes resembling figures that are real. The most famous one is of course the Queen’s Head, among other “statues” that are named the Fairy’s Shoe, the Mushroom Rocks, the Tofu Rocks, and the Elephant Rocks, along with many interesting potholes. Do not forget to bring your camera. Sun Moon Lake The Sun Moon Lake National Scenic Area is praised for its five major recreational systems, including the lake, Shueili River, Puli, Jhuoshuei River, and Jiji. The surrounding areas stretch to cover known tourist spots including Taumi, Checheng, Jiji, Shueisheda Mountain, Sangyong Falls, Mingtan Reservoir, and Shueili River. Sun Moon Lake features the only full-range 3D tours (lake, sky and land) in Taiwan. The lake cycling trail has been recognized by CNNGO, CNN as one of the most beautiful cycling trails in the world. *Travel Visa Information : National Immigration Agency www.taiwan.net.tw Taroko National Park Taroko is famous for its spectacular mountains and marble canyons. Cliffs and canyons stretch along Liwu River. The waterfalls characterized Taroko National Park and the most famous ones are Baiyang Waterfall, Yindai Waterfall, Changchun Waterfall, and Lushui Waterfall. Swallow Grotto (Yanzikou) and Tunnel of Nine Turns (Jiuqudong) are the most impressive natural scenes in Taroko and the canyons here are the narrowest.

Dr. Cheng, a world authority in micro-reconstructive plastic surgery and lymphedema treatment, provides surgical services such as lymphedema treatment, breast reconstruction, breast augmentation, double eyelids, eye bags, liposuction, wrinkle removal and lift. Contact A+ Surgery Clinic for more information. 25 Years of Surgical Experience An Authority in Lymphedema, Breast Reconstruction, and Aesthetic Medicine - lymphedema - microsurgery - Taiwan - breast reconstruction - A+ Surgery Clinic Dr. Cheng is Affiliated With About Lymphedema Microsurgery Dr. Cheng has been practicing Lymphedema microsurgery since 2000. He has invented some of the most advanced and effective surgical techniques to treat lymphedema. His ground-breaking innovation of vascularized submental lymph node (VSLN) and vascularized groin lymph node (VGLN) flap transfer to distal recipient site creates a physiologic drainage conduit to alter excess lymphatic fluid buildup and minimize the lymphedema associated side effects of tissue fibrosis and cellulitis. Dr. Cheng's lymphedema microsurgery outcomes show statistically significant circumferential reduction rates of affected limb circumference and impressive decreases in the episodes of cellulitis on the lymphedematous limb. His practice is the first in the world to immediately release patients from wearing compression garments postoperatively. Meet Dr. Cheng Ming-Huei Cheng MD, MBA, FACS, is a board certified plastic surgeon specialized in reconstructive microsurgery. Dr. Ming-Huei Cheng is listed among the most sought-after surgeons in the reconstructive microsurgery field. He has performed more than 2,000 microsurgical cases, including arm and leg reconstructions, head and neck reconstructions, breast reconstructions, extracranial-intracranial arterial bypasses, lymphovenous anastomosis and vascularized lymph node flap transfers. He finished a combined microsurgical and research fellow at Department of Plastic Surgery, MD Anderson Cancer Center, Houston, Texas in 1999. He is a member of the American Society for Reconstructive Microsurgery since 2003, a fellow of the American College of Surgeons since 2009, an international member of the American Society of Plastic Surgeons since 2012 and became an Adjunct Professor of the Department of Plastic Surgery at University of Michigan, USA in 2017. Learn more Coming to Anderson feels as comforting as home. Patient Testimonials Patient Testimonials Play Video Share Whole Channel This Video Facebook Twitter Pinterest Tumblr Copy Link Link Copied Search video... Now Playing Lymphedema Treatment Testimony: Canadian Patient at A+ Surgery Clinic, Taipei, Taiwan"Video Content: 09:51 Play Video Now Playing Lymphedema Treatment Testimony:In addition to excellent medical care, also enjoys Taiwanese cuisine 04:27 Play Video Now Playing Mr. William from Australia 05:50 Play Video A+ Surgery Clinic offers treatment for: Primary lymphedema Upper limb lymphedema following breast cancer treatment Lower limb lymphedema following gynecological cancer treatment Lower lymphedema presented after trauma or other surgeries lymphedema, microsurgery, Taiwan, breast reconstruction, A+ Surgery Clinic Outpatient clinic hours Tuesday, Thursday and Friday. 1:30 - 4:00 p.m.

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 aplussurgery@gmail.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 ！

Lymphedema FAQ for patients outside of Taiwan. Feel free to contact us if you have any other questions Prepare vascularized submental lymph node flap transfer surgery Q1 How long is the stay, to comfortably prepare for surgery and complete postoperative care? One week. Q2 At which hospital or facility would the surgery actually be performed? A+ Surgery Clinic has the state of art 42X Mitaka microscope, 3 operation rooms, and professional anesthesiologists, full-time RNs, and 7 private rooms for admission. Q3 Will you and your office coordinate all aspects of care? Yes. All of our patients are well cared for. Q4 Who will be the point person before, during, and after the surgery? Miffy Lin, Ph.D., chiayumiffy@gmail.com Q5 Do you have any logistical leaflet you could share that is aimed at international patients like us? No. You may check our website: www.lymphedemamicrosurgery.com Surgical procedure, from planning to post-operative care Q1 Do you need MRI, lymphoscintigraphy, and ICG, OR are one or two of those sufficient? If so, which is/are preferable in terms of balancing accuracy of diagnosis /surgical course vs radiation or other risks? Lymphoscintigraphy and ICG are required to make an accurate diagnosis and staging for the treatment, either LVA or VLNT. MRI does not help for the treatment. Q2.1 Before travel to Taiwan, are other tests (beyond imaging) needed to determine the appropriate surgical procedure? Please check platelet count, since the heparin-induced thrombocytopenia and thrombosis is the most common complications post VLNT, specially for those patients with heparin exposure such as the Port-A insertion for chemotherapy. Q2.2 Before travel to Taiwan, are there any medical records that we should be sending you? Surgical record, pathology reports, Lymphoscintigraphy and ICG. Q3 Upon arrival in Taiwan: what are the salient pre-operative steps? CBC/DC, Chest X-ray, EKG, Lymphoscintigraphy and ICG. Q4 Would you personally be performing the surgery, irrespective of the surgical path you deem best? I personally perform the surgery through the entire procedure. Q5 What other specialists, if any, would be part of my medical team? I personally perform the surgery through the entire procedure. Q6 How long does the surgical procedure itself last? LVA: 2 hours, VLNT 4-5 hours. Q7 How long is the hospital stay? LVA: 2 days, VLNT 5-7 days. Q8 How much pain should my reasonably expect and for how long? Not much pain immediate postoperatively, most patients do not need intravenous pain killer. Q9 What are the salient risks of undergoing the surgery itself? How likely are they? The heparin-induced thrombocytopenia and thrombosis (HITT) is the most common complication post VLNT, about 15 %, especially for those patients with heparin exposure such as the Port-A insertion for chemotherapy. HITT will develop the local pedicle artery or vein thrombosis, which will affect the survival and function of the VLNT. Infection is rare. Q10 What are the post-operative risks or adverse effects of the procedure? How likely are they? See above answer. Q11 Can you briefly describe anew (our notes are a bit confusing) the salient difference between your approach and the "main US alternative" we discussed (Cleveland Clinic)? The side-to-end lymphovenous anastomosis is the better drainage for extremity lymphedema without wearing compression postoperatively. The lymphatic vessels require contraction to push the lymph from distal to proximal, from dependent site to axilla. If the lymphatic vessels are divided and lost its continuity during end-to-end anastomosis, all the segments of lymphatic vessels will lose their continuity and contraction function, which lost the drainage function eventually. Q12.1 What are the key benefits of your approach compared to the main US alternative? Is your approach substantially less invasive than the main US alternative? Yes, one side-to-end LVA at the distal forearm is less invasive, no trauma to other healthy lymphatic vessels. No compression garments are required postoperatively. Q12.2 What are the key benefits of your approach compared to the main US alternative? Is your approach substantially lower risk? Yes. Q12.3 What are the key benefits of your approach compared to the main US alternative? Is the reduction in lifetime risk of infection/cellulitis substantially greater? Yes. Once the lymph has been adequately drained into venous system through side-to-end LVA daily, estimated 500 cc per day, the infection and cellulitis has significantly decreased. Q12.4 What are the key benefits of your approach compared to the main US alternative? Is the reduction in other lymphedema-related risks/co-morbidities substantially greater? Yes, mainly the infection, swelling, and appearance. Q12.5 What are the key benefits of your approach compared to the main US alternative? Is reduction in arm circumference substantially greater? Yes. Q12.6 What are the key benefits of your approach compared to the main US alternative? Is the absence of need for post-surgical compression unique to your approach? Yes. Q13 Taking into account the unique benefits of your approach, are there any countervailing potential risks or disadvantages that we should consider, relative to the main US alternative? No countervailing potential risks in side-to-end LVA. The temporary cosmesis in the distal recipient site, the potential HITT in VLNT. Q14 You indicated a 98% success rate for the procedure, which is remarkable and very comforting. Are there clinical indicators that can determine if my is at high risk of being in the 2%? If the ICG demonstrating the lymphatic vessels are available at the forearm. Q15 About post-operative care, what does the post-operative care in Taiwan involve? You may visit the testimonials of our patients via Youtube at https://www.youtube.com/watch?v=IINbv0xZdWQ , and https://www.youtube.com/watch?v=NwCw_SQnAPI . Q16 About post-operative care, once we are back home, is there someone you trust in NYC to collaborate with, so as to ensure any follow up care is performed to your standards of excellence? Dr. Joseph Dayan at Memorial Sloan Kettering Cancer Center. Q17 About post-operative care, how likely is it that we would need to travel to Taiwan anew for follow up care or procedures? One year post-operatively. Q18 Is there a risk that the two long flights from /to NYC might defeat the benefits of the surgery itself? No. I have quite a few international patients from US, Canada, Rusia, Sweden, Dubai, Saudi Arabic, India, and Iraq. Q19 I am on Anastrozole, Verzenio, Minoxidil. Are any of those of concern as it relates to surgery? No. Q20 Considering the most promising current /known avenues of research for an actual cure over the next 5 to 10 years, is the surgery likely to foreclose applicability of such potential cures? In my opinion, the side-to-end LVA can cure the early grade lymphedema, and VLNT can cure the late grade lymphedema without wearing compression garments. I think there may be some innovation for the treatment of lymphedema in the next 5-10 years. Managing symptoms & caring for my lymphatic system today Q1 How long is the stay, to comfortably prepare for surgery and complete postoperative care? We followed your advice not to bandage. Can you briefly provide anew the key rationale for your recommendation? (Please forgive our anxiety; bandaging seems to be the standard of care in the US.) Bandage and compression garments are not helping the drainage of lymph in the extremity daily. 10% of arterial blood become the lymph(estimated 500 cc /day in the upper limb) in the interstitial, then the lymph accumulates through the lymphatic vessels to axillary lymph nodes, which continuously drains to thoracic ducts, and to venous system. Bandage and compression garments will affect the contraction of the lymphatic vessels. Although the lymphedematous limb seems not swelling, but the lymphatic vessels will be fibrotic changed quickly. Q2 Are there demonstrably helpful non-surgical treatments or routines that I can start now to manage symptoms or protect her lymphatic system (e.g.: exercises, lymphatic massage by certified therapist, acupuncture, diet, arm elevation)? Exercises including yugo, biking, swimming and golfing within 3 hours each time are helpful for circulations. Lymphatic massage is helpful too. Please remember the lymph production is 10% of the arterial flow. Diet control is good. Arm elevation with one pillow during sleep is good. Financial aspects Q1 What is the all-in cost of the procedure? Please ask Miffy for the details of the cost of possible procedures. Q2 Is this cost fixed /guaranteed? Please ask Miffy for the details of the cost of possible procedures. Q3 Are you amenable to working with our insurance (BUPA in the United Kingdom) to ensure they provide us with pre-authorization, so that we can be reimbursed. We regret to inform you that we are unable to accept BUPA insurance policies at this time. However, we would be happy to discuss alternative payment options Get in Touch FAQS About Lymphatic System & Lymphedema

瞭解更多鄭明輝院長首創的淋巴水腫分級評分系統，透過客觀測量和先進的影像技術來分析症狀，能夠精準盤段及確保術後最好的結果。 Cheng Lymphedema Grading Systems Say Goodbye to Compression Garments after Dr. Cheng's Lymphedema Microsurgery Lymphedema Grading Systems Using physical exam findings, history of disease and imaging modalities, several classification schemes have been proposed to stage lymphedema. Perhaps the most widely used is the International Society of Lymphology staging system. But this staging system is based only the clinical symptoms, but no objective measurement or imaging assessment. As our understanding of lymphedema has evolved and technologies improved, other staging systems based on clinical presentation, circumferential measurements, objective measurements, lymphatic imaging or a combination thereof have been proposed. Effective and precise treatment A system adopted by the world At our center, we use the Cheng Lymphedema Grading system based on symptom severity, circumferential difference, and lymphoscintigraphy imaging to determine appropriate treatment, which was published on the Annals of Surgical Oncology, a renowned journal: A Prospective Evaluation of Lymphedema-Specific Quality-of-Life Outcomes Following Vascularized Lymph Node Transfer. (Patel KM, Lin CY, Cheng MH.) and book: Principles and Practice of Lymphedema Surgery. Cheng MH, Chang DW, Patel KM (Editors). Elsevier Inc, Oxford, United Kingdom. ISBN: 978-0-323-29897-1. July 2015. Cheng Lymphedema Grading English Chinese Upper English Chinese 資料來源： Principles and Practice of Lymphedema Surgery. Cheng MH, Chang DW, Patel KM (Editors). Elsevier Inc, Oxford, United Kingdom. ISBN: 978-0-323-29897-1. July 2015, page 204. Lower English Chinese 資料來源： Principles and Practice of Lymphedema Surgery. Cheng MH, Chang DW, Patel KM (Editors). Elsevier Inc, Oxford, United Kingdom. ISBN: 978-0-323-29897-1. July 2015, page 204. Novel Taiwan Lymphoscintigraphy Staging System Dr. Cheng is the author of the Cheng Lymphedema Grading System with integration of Taiwan Lymphoscintigraphy Staging which was published in Annals of Surgery (the top Surgery Journal) in July 2018. The Cheng Lymphedema Grading System with integration of Taiwan Lymphoscintigraphy Staging, a comprehensive objective assessment tool that analyzes lymphedema symptoms with quantitative measurements and advanced imaging technology, can effectively help physicians evaluate the severity of lymphatic obstructions, determine the accurate diagnosis, select the most appropriate procedures to treat lymphedema, and ultimately ensure the favorable functional outcome and finest quality of life for lymphedema patients. Taiwan Lymphoscintigraphy Staging English Chinese 資料來源： Cheng MH, Pappalardo M, Lin C, Kuo CF, Lin CY, Chung KC. Validity of the Novel Taiwan Lymphoscintigraphy Staging and Correlation of Cheng LymphedemaGrading for Unilateral Extremity Lymphedema. Ann Surg. 2018 Sep;268(3):513-525 Partial obstruction Total obstruction Recommended reading journal 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 https://www.ncbi.nlm.nih.gov/pubmed/25515196 Validity of the Novel Taiwan Lymphoscintigraphy Staging and Correlation of Cheng LymphedemaGrading for Unilateral Extremity Lymphedema. Cheng MH, Pappalardo M, Lin C, Kuo CF, Lin CY, Chung KC. Ann Surg. 2018 Sep;268(3):513-525. https://www.ncbi.nlm.nih.gov/pubmed/30004927

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

鄭明輝教授時常受邀至世界各地的教育和醫療機構演講，分享有關淋巴水腫和乳房重建的專業手術技術及研究結果。 Presentations Say Goodbye to Compression Garments after Dr. Cheng's Lymphedema Microsurgery We appreciate the recognition and affirmation from our patients in the United States. Every word of encouragement is our driving force! Dec 17, 2024 Professor Cheng was invited to attend the 49th Global Plastic Surgery Conference held in Porto, Portugal. Dec 10, 2024 Gratitude from Canada — A Patient's Kindness Warms Our Hearts Sep 26, 2024

瞭解更多安德森整形外科近期的新消息，包括活動資訊、各式療程的知識分享、醫師資訊及其他有關診所的重要資訊 We appreciate the recognition and affirmation from our patients in the United States. Every word of encouragement is our driving force! We are delighted to see Ms. Henry successfully overcome post-breast cancer lymphedema and completely free from compression garments! 💪... Patient testimonials Ming-huei Cheng Dec 17, 2024 0 Post not marked as liked Professor Cheng was invited to attend the 49th Global Plastic Surgery Conference held in Porto, Portugal. It was a great honor to be invited by Dr. Manuel Caneiro and Dr. Alvaro Silva to attend the 49th Global Plastic Surgery Conference held... Presentations Ming-huei Cheng Dec 10, 2024 1 Post not marked as liked Gratitude from Canada — A Patient's Kindness Warms Our Hearts This week, Anderson received a thank-you card that warmed the hearts of all our medical staff. This card was not just a simple greeting... Ming-huei Cheng Sep 26, 2024 0 Post not marked as liked Congratulations to Dr. Cheng for being recognized among the top 2% of scientists worldwide! I'm thrilled to share that Stanford University has released its 2024 list of the 'Top 2% Scientists in the World,' recognizing the top 2%... Ming-huei Cheng Sep 25, 2024 0 Post not marked as liked The 10th World Symposium for Lymphedema Surgery (WSLS) was successfully concluded The 10th World Lymphedema Symposium was held at Taipei Garden Hotel on April 22-24. The Anderson team, led by Dean Zheng Minghui, spent... Lymphedema Ming-huei Cheng Apr 24, 2024 0 Post not marked as liked Congratulation! The Spanish version of Lymphedema Surgery textbook has been published It is my privilege to announce the Spanish version of our Lymphedema Surgery textbook has been published. I would like to give special... Lymphedema Ming-huei Cheng Apr 30, 2022 0 Post not marked as liked Dr.Cheng gave A Virtual Visiting Professor Lecture at The University of California, Los Angeles (UCLA) I have appreciated the opportunity to give a virtual visiting professor lecture for UCLA today. It brought back memories of the training... Presentations Ming-huei Cheng Aug 12, 2020 0 Post not marked as liked Dr.Cheng Presented at The 2020 Virtual Duke Flap Course Feel so privileged to be part of the renowned training program with many amazing and talented surgical experts at the 2020 Virtual Duke... Presentations Ming-huei Cheng Aug 2, 2020 0 Post not marked as liked Dr. Cheng Presented at 2020 American Society of Reconstructive Microsurgery (ASRM) Annual Meeting Very happy to have managed to attend the 2020 American Society of Reconstructive Microsurgery (ASRM) Annual Meeting at Marriott Harbor... Presentations Ming-huei Cheng Jan 12, 2020 0 Post not marked as liked Congratulation! Papers Published in the Journal Surgical Oncology I want to express my sincere appreciation to the Editor-in-Chief Dr. Stephen Sener of Journal Surgical Oncology, and the co-guest editors... Ming-huei Cheng Dec 19, 2019 0 0 comments 0 Post not marked as liked Congratulation! Two Papers Published in Plastic Reconstructive Surgery I feel so happy and humbled to share the great news that two research papers were recently published in the October Issue at Plastic... Ming-huei Cheng Nov 15, 2019 0 Post not marked as liked Raises Breast Reconstruction Awareness in October It was a great pleasure and honor to share my journey as a surgeon of breast constructions at the grand round of our Department at CGMH... Ming-huei Cheng Oct 16, 2019 0 Post not marked as liked

瞭解更多顯微淋巴結皮瓣移植的適合對象、手術結果、術前及術後的對比和分析，全部來自於鄭明輝教授的多年經驗。 Vascularized Lymph Node Flap Transfer (VLNT) Say Goodbye to Compression Garments after Dr. Cheng's Lymphedema Microsurgery About VLNT Lymphedema can cause painful and unsightly swelling in the arms and/or legs. Though there are varying degrees of lymphedema, Dr. Cheng’s expert microsurgery techniques provide several possible solutions. For patients with Cheng’s Lymphedema late Grade II to Grade IV, and no clear functioning lymphatics shown on indocyanine green (ICG) lymphography images, a vascularized lymph node (VLN) flap transfer is recommended. For patients with more severe cases of lymphedema, such as lymphedema Grade IV, there may be a need for a liposuction or a partial wedge excision one year after the VLN flap transfer. 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. Candidates for VLN Flap Transfer Lymphedema patients who aggressively received rehabilitation for more than 6 months without making any improvement. Patients that develop episodes of cellulitis. Patients with total lymphatic obstruction present in diagnostic imaging (lymphoscintigraphy). Patients with no patent lymphatic (collecting) ducts available for the procedure of lymphovenous anastomosis (LVA). (See LVA section) Patitents with Cheng’s Grading Ⅱ, Ⅲ and Ⅳ lymphedema 淋巴結移植治療乳癌術後淋巴水腫 術前 術後 6 個月 術後 8 年 水腫2年 丹毒/蜂窩性組織炎2次 上臂改善：82％ 下臂改善：35％ 上臂改善：82％ 下臂改善：50％ 淋巴結移植治療乳癌術後淋巴水腫 術前 術後 3 個月 術後 8 年 水腫10年 丹毒/蜂窩性組織炎30次 體重60 kg 上臂改善：5 ％ 下臂改善：5 ％ 體重 59 kg ( 減少1kg ) 上臂改善：60 ％ 下臂改善：10 ％ 體重56 kg ( 減少4 kg ) 淋巴結移植治療二期乳癌術後淋巴水腫 術前 術後 24 個月 水腫2年 丹毒/蜂窩性組織炎3次 體重67kg 上臂改善：80 ％ 下臂改善：56 ％ 體重64 kg(減少3 kg) 淋巴結移植治療乳癌術後淋巴水腫 術前 術後 3 個月 術後 42 個月 水腫2年 丹毒/蜂窩性組織炎3次 上臂改善：25 ％ 下臂改善：15 ％ 上臂改善：90 ％ 下臂改善：90 ％ How Does It Work? The choice of the donor site for the VLN flap surgery is based on patient preference, and the availability of sizable lymph nodes at the preferred site. Before the donor site is chosen, Dr. Cheng uses ultrasound images to determine the viability of the lymph nodes. Given these factors, the vascularized submental lymph node (VSLN) flap is the most commonly preferred VLN flap by Dr. Cheng’s patients. Usually, the VSLN flap is transferred to the back of the wrist or to the ankle in accordance with the “pump” mechanism, catchment effect, and natural gravity effect to achieve maximal functional recovery. Though this surgery can provide great relief for painful swelling, the unsightly skin on the wrist may be bothersome to the patient. Fortunately, one-year after VSLN flap transfer surgery it can be removed, leaving a more subtle, linear scar. At this point, the limb previously affected by the lymphedema should be softer and smaller as well. Intrinsic lymphovenous connections exist within the lymph node flap. These connections are responsible for shunting the lymphatic fluid into the venous system, creating local decompression at the site of vascularized lymph node flap transfer. 資料來源： 淋巴水腫手術的原則和實踐。 Cheng MH，Chang DW，Patel KM（編輯）。 Elsevier Inc，英國牛津。 ISBN：978-0-323-29897-1。 2015年7月，第65頁。 此圖右側肢體正常，左側為上肢及下肢淋巴水腫。 可使用的治療方法如：淋巴管靜脈吻合術或顯微淋巴結皮瓣移植。 資料來源： 淋巴水腫手術的原則與實踐。 Cheng MH，Chang DW，Patel KM（編輯）。 Elsevier Inc，英國牛津。 ISBN：978-0-323-29897-1。 2015年7月，第219頁。 淋巴結供體區 1. 下領部 2. 鎖骨下 3. 胸椎 4. 腹股溝 5. 大網膜 6. 腸系膜 淋巴水腫的病理生理 a. 淋巴積聚 b. 炎症發炎 c. 脂肪增生 d.纖維化 淋巴結皮瓣接受區 I. 手腕（背部或手掌） II. 手肘 III. 腋下 IV. 腹股溝 V. 後腿近端 VI. 足踝（前側或内側） What to Expect After Flap Transfer Surgery Dr. Cheng’s unique surgical technique can greatly improve the quality of life of patients suffering from lymphedema. By transferring the vascularized lymph node flap to the recipient site, for example to the wrist, Dr. Cheng improves the functionality of the lymphatic system. As a result, the tissue becomes softer, the affected arms and/or legs become smaller and lighter and the patient experiences less cellulitis. This in turn gives the patient an improved cosmetic appearance. In addition, it is important to note that with Dr. Cheng’s superior technique and skills, patients no longer need to wear compression garments post-surgery. Although after VLN flap surgery the initial transferred flap on the wrist is not aesthetically pleasing, one year after the surgery the transferred skin may be removed. Typically done under local anesthesia, this procedure will leave the wrist with a subtle, linear scar instead. In Cheng’s experience, the success rate of the vascularized lymph node flap is 98%. With an average 18 months of follow-up after VLNT surgery, 90% of BCRL patients show substantial improvement, with an average circumferential difference improvement of 40%. Though patient results vary, in general, post-surgery the affected limb becomes much softer over time; and restriction of daily activities is minimized. After VLN flap surgery patients resume their normal life styles with a boost in self-confidence. A VLN Flap transfer with Dr. Cheng can alleviate lymphedema symptoms, greatly increasing patients’ quality of life. Evidences of Mechanism of Vascularized Lymph Node Transfer 1. Tc-99m Lymphoscintigraphy Increased Clearance on Static Images Static views of the same edematous upper limb on posterior view. Images of the upper extremity was taken at 30, 60 and 120 minutes after injection of radio-labelled tracer. Preoperative images (upper row: A-C) and postoperative images (lower row: D-F).In the pre-op images, there is prominent diffuse accumulation of activity shown in the skin of the affected forearm over time. Post-operatively, dermal backflow is less marked in the forearm (D-F) and the radio-labelled tracer has migrated more rapidly to the distal arm (arrow in F). Data source: 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. 2. Vascularized Groin Lymph Node Transfer to Elbow of Post-op Lymphoscintigraphy A 68-year-old female patient who was a victim of right upper limb lymphedema underwent vascularized groin lymph node flap transfer to right elbow (A). Preoperative lymphoscintigraphy showed accumulation of Tc-99 in the forearm and absence of right axilla lymph node (B). At a follow-up of 56 months, the patient was satisfied with the softening of left upper limb with a circumferential reduction of 58% above elbow and 40% below elbow (C). Post-op lymphoscintigraphy revealed increased uptake of Tc-99 by the transferred vascularized lymph nodes at the elbow level and less accumulation of Tc-99 in right upper arm (D). Data source: Principles and Practice of Lymphedema Surgery. Cheng MH, Chang DW, Patel KM (Editors). Elsevier Inc, Oxford, United Kingdom. ISBN: 978-0-323-29897-1. July 2015, page 204-5. 3. Vascularized Submental Lymph Node Transfer to wrist of Post-op Lymphoscintigraphy A 52-year-old female patient who was a right upper limb lymphedema underwent vascularized submental lymph node flap transfer to right wrist. Pre-op lymphoscintigraphy showed accumulation of Tc-99 in the forearm and absence of right axilla lymph node. Post-op lymphoscintigraphy revealed increased uptake of Tc-99 by the transferred two vascularized lymph nodes at the wrist level and less accumulation of Tc-99 in right upper arm. Data source: Principles and Practice of Lymphedema Surgery. Cheng MH, Chang DW, Patel KM (Editors). Elsevier Inc, Oxford, United Kingdom. ISBN: 978-0-323-29897-1. July 2015, page 204-5. 4. Intra-op Image Evidences of Mechanism of Vascularized Lymph Node Transfer ICG Injection on Lymph Node Directly Native Lymph Drainage through VSLN Flap Data source: Proposed pathway and mechanism of vascularized lymph node flaps. Ito R, Zelken J, Yang CY, Lin CY, Cheng MH. Gynecol Oncol. 2016 Apr;141(1):182-8. Q1 How can VLN surgery improve lymphedema? Lymphedema is caused by a blockage in the lymphatic system. If the lymph fluid is unable to circulate through the body, it builds-up and causes minor to severe swelling. Typically, lymphedema swelling is seen in the arms and/or the legs, though it can occur is other parts of the body. There are different degrees of lymphedema and some cases can be treated non-surgically. However, for certain types, such as Cheng's Grade II, III and IV lymphedema, surgery may be the only option to alleviate symptoms and reduce swelling. The VLN flap transfer unblocks the lymphatic system in order to allow the lymph fluid to circulate better, reducing swelling in the affected limb over time. Dr. Cheng has been extremely successful in using this technique to treat moderate to severe cases of lymphedema. Q2 Are follow-up appointments post-surgery required? VLN flap surgery with renowned surgeon Dr. Cheng has an excellent success rate. However, the VLN flap surgery is a delicate procedure that requires several follow up appointments after the surgery. These appointments allow Dr. Cheng to carefully measure the circumference of the affected limb or limbs to ensure optimal results. Dr. Cheng will discuss symptom relief with patients, which helps to determine the success of the transferred lymph nodes. Although no compression garments are needed, it is important to attend all follow-up appointments in order to assess progress anddetermine if any addition physical therapy is necessary. Q3 Why choose Dr. Cheng for VLN flap surgery? As an internationally renowned surgeon, Dr. Cheng is an expert in several microsurgery techniques that address lymphedema, including VLN flap surgery. With over a 98% success rate, Dr. Cheng can properly asses your condition and determine what is the best treatment plan. Depending on the grade of lymphedema, Dr. Cheng will recommend the best solution. As a plastic surgeon that specializes in reconstructive microsurgery, Dr. Cheng holds the world record for successfully treating the largest number of lymphedema patients with vascularized lymph node transfers. His unique technique and expert skill enable him to not only diagnose the cause and grade of lymphedema but also propose the best treatment to reduce patients' symptoms and improve their quality of life. 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

Visiting Professorships Say Goodbye to Compression Garments after Dr. Cheng's Lymphedema Microsurgery Godina Traveling Professor, Aesthetic & Plastic Surgery Institute University of California, Irvine, Orange, California, June 10, 2006. 2006 Godina Traveling Fellow and Flap Course Faculty, Duke University. Visiting Professor, Duke University Medical Center, Durham, Nort Carolina, August 4, 2006. Visiting Lecturer, M.D. Anderson Cancer Center Department of Plastic Surgery, Houston, Texas, November 13-15, 2006. Visiting Professor in Plastic Surgery, University of Pennsylvania Medical Center, Philadelphia, Pennsylvania, November 16-19, 2006. Visiting Professor in Plastic Surgery, Southern Illinois University School of Medicine, Springfield, Illinois, November 20-22, 2006. Visiting Professor in Institute of Reconstructive Plastic Surgery, New York University Lang one Medical Center, New York, October 25-29, 2008. Visiting Professor in Division of Plastic Surgery, Mayo Clinic, Rochester, Minnesota, October 29-31, 2008. Visiting Professor in Department of Plastic Surgery, The University of Texas MD Anderson Cancer, Houston, Texas, July 13-14, 2009 Visiting Professor in Division of Plastic Surgery, University of South California, Los Angeles, California, July 16-17, 2009. Visiting Professor in Division of Plastic Surgery, Mayo Clinic Phoenix, Arizona, October 27-29, 2009. Visiting Professor in Division of Plastic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, July 17-21,2010. Visiting Professor in Division of Plastic Surgery, Singapore General Hospital, Singapore, Singapore, July 13-17, 2011. Visiting Professor in Division of Plastic Surgery, the Ohio State University, July 10-14, 2012. Visiting Professor in Department of Plastic Surgery, MedStar Georgetown University Hospital, February 5, 2014. Visiting Professor in Department of Plastic Surgery, Brussels University Hospital, March 2-4, 2014. Visiting Professor in Department of Plastic Surgery, NYU Langone Medical Center, October 7-8, 2014. Visiting Professor in Department of Plastic Surgery, Asan Medical Center, University of Ulsan, March 26, 2015. Visiting Professor in Department of Plastic Surgery, Samsung Medical Center, Sungkyunkwan University, March 27, 2015. Visiting Professor in Department of Plastic Surgery, University of Michigan, September 22-25, 2015. Visiting Professor in Department of Plastic Surgery, the Keck School of Medicine of the University of Southern California, January 14 - 15. 2016 Visiting Professor in Department of Plastic Surgery, Duke University Medical Center, Durham, North Carolina, February 22, 2016. ASRM William A. Zamboni Visiting Professor in Department of Plastic Surgery, University of California, San Diego, May 16-17, 2016. ASRM William A. Zamboni Visiting Professor in Department of Plastic Surgery, The University of Chicago Medicine & Biological Sciences,Chicago, September 18-19, 2016. ASRM William A. Zamboni Visiting Professor in Department of Plastic Surgery, University of California, Irvine, November 7-8, 2016. Visiting Professor in Department of Plastic Surgery, Memorial Sloan Kettering Cancer Center, New York, August 21, 2017. Visiting Professor in Department of Plastic Surgery, University of Michigan, Detroit, August 28 to 30, 2017. Visiting Professor in Department of Plastic Surgery, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, November 3 to 4,2017. International Visiting Professor in Plastics Division, Stanford University, February 16-21, 2018. Visiting Professor in Department of Plastic Surgery, University of Michigan, Detroit, July 29 to August 1, 2018. Visiting Professor in the Department of Plastic Surgery, University of Michigan, Ann Arbor, Michigan, August 8 to 10, 2019. Buncke Clinic Virtual Visiting Professor, Webinar, May 9, 2020. Visiting Professor in the Department of Plastic Surgery, University of Michigan, Ann Arbor, Michigan, May 2 to 6, 2022.