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了解更多有關術後照顧的重點，患者不再需要穿戴壓力袖套、襪，但建議患者在術後接受3~6個月的復健，需要積極治療。 Post-Operative Care Say Goodbye to Compression Garments after Dr. Cheng's Lymphedema Microsurgery Post-Operative Rehabilitation The A+ Surgery Clinic provides comprehensive and extensive medical services before and after surgery. It is recommended that lymphedema patients receive post-operative rehabilitation for a period of 3- 6 months. It is most noteworthy that patients no longer need to wear compression garments after Dr. Cheng’s Side-to-End Lymphovenous anastomosis and vascularized submental lymph node flap transfer to distal recipient site for post-operative rehabilitation. It is recommended to massage from the proximal limb to the distal site for 15 minutes 3 times a day one month post-operatively for 3 to 6 months to further improve lymphatic drainage. Post-Operative Follow-Up The lymphedema of both upper and lower extremities can cause pain, discomfort, fibrosis, cosmetic problems, and mobility restraints for patients. It is common that lymphedema patients develop various degrees of depression due to physical discomfort, disfiguration, and emotional distress. With an average of a 2-year follow up after undergoing microsurgical microsurgery including Side-to-End Lymphovenous anastomosis and vascularized lymph node flap transfer to distal recipient site, the affected limb become softer overtime. 90% of lymphedema patients have seen size improvement with a mean circumferential difference of 50%. With the physical improvement, patients are subjectively pleased to resume daily activities and life styles they used to have. After vascularized submental lymph node flap transfer, you are asked to comply with the rehabilitation program, which includes progressive lower limb muscle strength training and reverse manual proximal (groin) to distal (ankle) lymphatic drainage. You are encouraged to gradually massage the flap, scar, and control body weight control starting after discharge. Reverse manual lymph drainage and flap massage are performed for 15 minutes/time, 3 times daily. You are advised to return to normal activity gradually as tolerated, and all other physiotherapy and compression wrapping are discontinued. Vascularized submental lymph node flap is placed on the wrist in accordance with the “pump” mechanism and effects of gravity. You do not need to wear a compression garment or bandaging after surgery but are allowed to wear a wrist brace or wrist support to hide the scar on the wrist after the wound complete healed. Another revision surgery to remove the skin paddle and superficial fat of the transferred flap to improve the cosmetic appearance and simultaneous liposuction of the thigh to decrease the production of lymph is recommended after 1 year of vascularized submental lymph node flap transfer. 1. Reverse manual lymph drainage: Time: Performed for 15 minutes/time, 3 times a day, from groin to flap. Method: Medium strength massage that compresses the skin, subcutaneous, fat and muscle in proximal (groin) to distal (flap) direction. This helps encourage drainage of the lymph drainage through the lymph flap and appropriate channels. 2. Flap massage: For increasing the venous drainage of lymph node flap pumping Time: Performed for 15 minutes/time, each 3 times daily. Method: Medium strength massage to pump lymph node flap and the scar around flap. 3. Body weight control: Time: Check body weight every day. Lighten your weight if your Body Mass Index(BMI) over 25. 4. Infection/cellulitis prevention and control: Most healthcare-associated infections are preventable through good hand hygiene. It’s important to identify and treat cellulitis early because the condition can spread rapidly throughout your body. Red area or “New red spots” of skin that tends to extend from distal to proximal Swelling Tenderness Pain Fever over 38.5℃ After the initial postoperative period, you are seen on a monthly basis by sending images. You may use any communication apps, such as Line, WhatsApp, Skype, e-mail or WhatsApp. Surgical outcomes are evaluated by your subjective improvement, circumferential measurements, the frequency of cellulitis, and via patient reported health-related quality of life outcome metrics. We will arrange ultrasonography, CT, and lymphoscintigraphy for checking the number of the lymph node on the flap, lymph node function and volume of the arm after one year.

瞭解更多有關淋巴水腫的成因，淋巴液和淋巴結的差別，淋巴系統的重要性，淋巴循環的流程圖，作為免疫系統的一部分，這些是你必須知道的事。 What is the Lymphatic System? As part of the immune system, the lymphatic system helps the body activate a specific immune response against viruses and bacteria. It retains fluid homeostasis in all different compartments of the body. It is made by channels called lymphatic vessels. These collect lymph from all over the body and deliver lymph to the regional lymph nodes or thoracic ducts and then back to the cardiovascular system. What Causes Lymphedema? Lymphedema occurs when your lymphatic system is unable to properly drain lymph fluid. In addition to primary (congenital) lymphedema, secondary lymphedema is more common and is usually caused by diseases or other treatments. Secondary lymphedema is a common complication after lymph node removal, typically occurring following cancer surgery and radiation therapy. Additionally, lymphedema can result from lymph node damage caused by infections. When the lymphatic system becomes blocked, lymph fluid cannot drain efficiently, leading to fluid buildup in the arms and legs. What is Lymph fluid? Lymph is a colorless protein-rich fluid that physiologically collects waste products and pathogens. It is present in tissue and transported through the lymphatic system to regional lymph-nodes. The venous flow carries 90% of arterial blood back to the heart and the remaining 10% becomes lymph fluid in the interstitial. Peripheral lymph nodes drain approximately 4-8 liters of lymph fluid per day. The lymphocytes (infection-fighting cells) that reside in the lymph nodes activate a specific immune response against infection. What are Lymph Nodes? Lymph nodes are bean-shaped organs of the lymphatic system that are distributed widely throughout the body. They are composed by lymphoid tissue enclosed by a capsule of connective tissue. Lymph nodes are major sites of B cells, T cells, and other immune cells. They serve as filters for the blood and provide specialized tissues where foreign antigens and cancer cells can be trapped and exposed to cells of the immune system for destruction. They are typically found concentrated near junctions of the major lymphatic vessels and most prominently found in the neck, groin, and armpits. Why is the lymphatic system important? The lymphatic system has two important roles: activating the immune response against antigens and transporting lymph fluid. Both functions are important to preserve body homeostasis. When the lymphatic system is compromised by cancer, infections, surgery, trauma, or congenital issues, the affected part of the body is prone to swelling (lymphedema) and recurrent infection due to the faulty surveillance mechanism. The functions of the lymphatic circulation include prevention and resolution of edema, maintenance of interstitial fluid homeostasis, immune trafficking (the regulated transit of antigen-presenting cells to the lymphoid organs), and lipid absorption from the gastrointestinal tract. Recipient Site of Vascularized Lymph Notes Transfer I.Wrist, dorsal or volar II. Elbow III. Axilla IV. Groin V. Posterior proximal leg VI. Ankle, anterior or medial Pathophysiology of Lymphedema i. Lymph accumulation ii. Inflamation iii. Infection iv. Fat proliferation v. Fibrosis Donor Vascularized Lymph Notes 1. Submental 2. Supraclavicular 3. Thoracic 4. Groin 5. Omentum 6. Mesenteric 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。 Lymphatic Circulation Flowchart Explanation of Physiological and Non-Physiological Surgical Approaches for Treating the Lymphatic System English 鄭教授淋巴水腫顯微外科手術學術里程碑

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.

Patient Rights Say Goodbye to Compression Garments after Dr. Cheng's Lymphedema Microsurgery General Consent form A+ Surgery Clinic Patient’s rights and cooperation The cooperation between the patient and the medical team is an important factor for a successful treatment. The patient’s understanding towards patient’s rights and obligations is necessary for a mutual communication in order to promote cooperation and trust. During the patient’s visit to our hospital, we ensure that the following 10 patient’s rights are maintained. Please feel free to provide us with feedback if our services do not meet your expectations, in order for us to improve. It is necessary for the patient and family to provide us with relevant disease information so we can provide you with accurate diagnosis and the most suitable treatment while maximizing the use of limited medical resources to protect our medical environment and the health of everyone. We look forward to building a healthy and harmonious medical environment for all of our patients. Please feel free to approach any of our medical personnel if you have any further inquiries or suggestions about patient’s rights, and it will be our pleasure to assist you in every possible way. Patient’s Rights 【Treatment equality】The patient is entitled to receive treatment regardless of race, religion, nationality, gender, age, disease, sexual preference, location, or social status. 【Healthcare safety】The patient has the right to receive healthcare in a safe medical environment. 【Information and explanation】The patient and primary care provider are entitled to inquire about physician’s or other medical personnel’s names and disease information. 【Informed consent】【Right to refuse】【Alternatives】The patient and the primary family caregiver have the right to participate in the discussion and inquiry of the healthcare process and to decide in the treatment plan, including the rights to refuse treatment and to seek a second opinion. 【Continuous healthcare】The patient has the right to request for pain management, disease management, medication, diet and daily living education, and information and medical services relative to home care services after discharge. 【Palliative Care】According to the hospice and palliative laws and regulations, the patient and the family have the right to decide or alter the decision of “do not resuscitate,” and to renounce the use of life support during cardiac arrest at the risk of termination of life. 【Patient’s privacy】We respect and uphold the patient’s privacy. Disease information and records will be kept confidential. 【Information providing】According to the law, the patient has the right to request for copies of his/her medical record, certificate of diagnosis, and invoice of medical expenses. 【Complain Service】The patient has the right to complain or make suggestions to the hospital, and we will respond accordingly. 【Professional Service】All medical personnel must wear identification cards. The patient can refuse to accept medical service if the medical personnel does not wear an identification card. Patient cooperation To ensure patient safety, the patient and family should provide information such as health condition, medical history, drug history, allergy history, travelling history, contagious disease at present, etc. The patient and family should participate in the discussion of treatment plans and come to a conclusion after understanding the consequences of all possible treatments. All doubts should be clarified with the medical personnel in charge prior to the signing of the consent form. The patient and family should cooperate with physicians in terms of treatment, discharge, or transferal. Please respect our medical resources and the medical facilities of the hospital. Please comply to the hospital’s policies and operating procedures. Never request medical personnel to provide false information or certificate of diagnosis. Please obey the hospital’s curfew and infection policy. Please do not smoke or chew betel nuts in the hospital to prevent affecting the rights of other patients. Please pay the remaining balance after subsidy accordingly. Please approach our social workers or medical personnel in charge if you have any difficulty paying the balance. We provide storage services for the patient and family to secure their personal belongings. We are not responsible for damage or loss of property. Please keep your valuables with you at all times.

瞭解更多安德森整形外科三位專業醫師的門診時間：鄭明輝 院長、杜隆成主任醫師及張豫苓主任醫師，週一至週五皆有門診。 Outpatient clinic hours Tuesday, Thursday and Friday. 1:30 - 4:00 p.m.

鄭明輝教授發表66篇淋巴水腫論文和兩本教科書篇章，與國際學術醫界連結，為顯微重建整型外科及淋巴水腫世界權威 Publications Dr. Cheng's Publications in Lymphedema Microsurgery Dr. Cheng's Book and Chapter 1. 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. doi: 10.1097/PRS.0b013e31819e6529. https://www.ncbi.nlm.nih.gov/pubmed/19337095 2. A novel approach to the treatment of lower extremity lymphedema by transferring a vascularized submental lymph node flap to the ankle. Cheng MH, Huang JJ, Nguyen DH, Saint-Cyr M, Zenn MR, Tan BK, Lee CL. Gynecol Oncol. 2012 Jul;126(1):93-8. doi: 10.1016/j.ygyno.2012.04.017. Epub 2012 Apr 17. https://www.ncbi.nlm.nih.gov/pubmed/22516659 3. 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. doi:10.1097/PRS.0b013e31828bd3b3 https://www.ncbi.nlm.nih.gov/pubmed/23714790 4. Preplanning Vascularized Lymph Node Transfer with Duplex Ultrasonography: An Evaluation of 3 Donor Sites. Patel KM, Chu SY, Huang JJ, Wu CW, Lin CY, Cheng MH. Plast Reconstr Surg Glob Open. 2014 Sep 8;2(8):e193. doi: 10.1097/GOX.0000000000000105. eCollection 2014 Aug. https://www.ncbi.nlm.nih.gov/pubmed/25426376 5. The use of magnetic resonance angiography in vascularized groin lymph node transfer: an anatomic study. Dayan JH, Dayan E, Kagen A, Cheng MH, Sultan M, Samson W, Smith ML. J Reconstr Microsurg. 2014 Jan;30(1):41-5. doi: 10.1055/s-0033-1351668. Epub 2013 Sep 9. https://www.ncbi.nlm.nih.gov/pubmed/24019175 6. The mechanism of vascularized lymph node transfer for lymphedema: natural lymphaticovenous drainage. Cheng MH, Huang JJ, Wu CW, Yang CY, Lin CY, Henry SL, Kolios L. Plast Reconstr Surg. 2014 Feb;133(2):192e-8e. doi: 10.1097/01.prs.0000437257.78327.5b. https://www.ncbi.nlm.nih.gov/pubmed/24469190 7. Developing a Lower Limb Lymphedema Animal Model with Combined Lymphadenectomy and Low-dose Radiation. Yang CY, Nguyen DH, Wu CW, Fang YH, Chao KT, Patel KM, Cheng MH. Plast Reconstr Surg Glob Open. 2014 Apr 7;2(3):e121. doi: 10.1097/GOX.0000000000000064.eCollection 2014 Mar. https://www.ncbi.nlm.nih.gov/pubmed/25289315 8. 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. doi: 10.1097/GOX.0000000000000099. eCollection 2014 Jun. https://www.ncbi.nlm.nih.gov/pubmed/25289360 9. From theory to evidence: long-term evaluation of the mechanism of action and flap integration of distal vascularized lymph node transfers. Patel KM, Lin CY, Cheng MH. J Reconstr Microsurg. 2015 Jan;31(1):26-30. doi: 10.1055/s-0034-1381957. Epub 2014 Aug 19. https://www.ncbi.nlm.nih.gov/pubmed/25137504 10. Quantity of lymph nodes correlates with improvement in lymphatic drainage in treatment of hind limb lymphedema with lymph node flap transfer in rats. Nguyen DH, Chou PY, Hsieh YH, Momeni A, Fang YH, Patel KM, Yang CY, Cheng MH. Microsurgery. 2016 Mar;36(3):239-45. doi: 10.1002/micr.22388. Epub 2015 Feb 25. https://www.ncbi.nlm.nih.gov/pubmed/25715830 11. Simultaneous Bilateral Submental Lymph Node Flaps for Lower Limb Lymphedema Post Leg Charles Procedure. Ito R, Lin MC, Cheng MH. Plast Reconstr Surg Glob Open. 2015 Sep 15;3(9):e513. doi: 10.1097/GOX.0000000000000489. eCollection 2015 Sep. https://www.ncbi.nlm.nih.gov/pubmed/26495226 12. Successful treatment of early-stage lower extremity lymphedema with side-to-end lymphovenous anastomosis with indocyanine green lymphography assisted. Ito R, Wu CT, Lin MC, Cheng MH. Microsurgery. 2016 May;36(4):310-5. doi: 10.1002/micr.30010. Epub 2015 Dec 15. https://www.ncbi.nlm.nih.gov/pubmed/26666982 13. Lymphedema surgery: Patient selection and an overview of surgical techniques. Allen RJ Jr, Cheng MH. J Surg Oncol. 2016 Jun;113(8):923-31. doi: 10.1002/jso.24170. Epub 2016 Feb 5. Review. https://www.ncbi.nlm.nih.gov/pubmed/26846615 14. Surgical anatomy of the vascularized submental lymph node flap: Anatomic study of correlation of submental artery perforators and quantity of submental lymph node. Tzou CH, Meng S, Ines T, Reissig L, Pichler U, Steinbacher J, Pona I, Roka-Palkovits J, Rath T, Weninger WJ, Cheng MH. J Surg Oncol. 2017 Jan;115(1):54-59. doi: 10.1002/jso.24336. Epub 2016 Jun 23. https://www.ncbi.nlm.nih.gov/pubmed/27338566 15. The 5th world symposium for lymphedema surgery-Recent updates in lymphedema surgery and setting up of a global knowledge exchange platform. Loh CY, Wu JC, Nguyen A, Dayan J, Smith M, Masia J, Chang D, Koshima I, Cheng MH. J Surg Oncol. 2017 Jan;115(1):6-12. doi: 10.1002/jso.24341. Epub 2016 Jun 28. Review. https://www.ncbi.nlm.nih.gov/pubmed/27353481 16. The surgical anatomy of the supraclavicular lymph node flap: A basis for the free vascularized lymph node transfer. Steinbacher J, Tinhofer IE, Meng S, Reissig LF, Placheta E, Roka-Palkovits J, Rath T, Cheng MH, Weninger WJ, Tzou CH. J Surg Oncol. 2017 Jan;115(1):60-62. doi: 10.1002/jso.24346. Epub 2016 Jun 28. https://www.ncbi.nlm.nih.gov/pubmed/27353521 17. The 5th World Symposium for Lymphedema Surgery. Cheng MH, Koshima I, Chang DW, Masia J. J Surg Oncol. 2017 Jan;115(1):5. doi: 10.1002/jso.24383. Epub 2016 Jul 29. No abstract available. https://www.ncbi.nlm.nih.gov/pubmed/27473624 18. Platysma-sparing vascularized submental lymph node flap transfer for extremity lymphedema. Poccia I, Lin CY, Cheng MH. J Surg Oncol. 2017 Jan;115(1):48-53. doi: 10.1002/jso.24350. Epub 2017 Jan 6. https://www.ncbi.nlm.nih.gov/pubmed/28058777 19. A prospective clinical assessment of anatomic variability of the submental vascularized lymph node flap. Cheng MH, Lin CY, Patel KM. J Surg Oncol. 2017 Jan;115(1):43-47. doi: 10.1002/jso.24487. Epub 2017 Jan 13. https://www.ncbi.nlm.nih.gov/pubmed/28083889 20. 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. doi: 10.1097/GOX.0000000000001288. eCollection 2017 Apr. https://www.ncbi.nlm.nih.gov/pubmed/28507857 21. The surgical anatomy of the vascularized lateral thoracic artery lymph node flap-A cadaver study. Tinhofer IE, Meng S, Steinbacher J, Roka-Palkovits J, Györi E, Reissig LF, Cheng MH, Weninger WJ, Tzou CH. J Surg Oncol. 2017 Dec;116(8):1062-1068. doi: 10.1002/jso.24783. Epub 2017 Aug 7. 22. Visualization of Skin Perfusion by Indocyanine Green Fluorescence Angiography-A Feasibility Study. Steinbacher J, Yoshimatsu H, Meng S, Hamscha UM, Chan CS, Weninger WJ, Wu CT, Cheng MH, Tzou CH. Plast Reconstr Surg Glob Open. 2017 Sep 25;5(9):e1455. doi: 10.1097/GOX.0000000000001455. eCollection 2017 Sep. https://www.ncbi.nlm.nih.gov/pubmed/29062637 23. Vascularized lymph node transfer for treatment of extremity lymphedema: An overview of current controversies regarding donor sites, recipient sites and outcomes. Pappalardo M, Patel K, Cheng MH. J Surg Oncol. 2018 Jun;117(7):1420-1431. doi: 10.1002/jso.25034. Epub 2018 Mar 24. Review. https://www.ncbi.nlm.nih.gov/pubmed/29572824 24. Vascularized Lymph Node Transfer for Lymphedema. Schaverien MV, Badash I, Patel KM, Selber JC, Cheng MH. Semin Plast Surg. 2018 Feb;32(1):28-35. doi: 10.1055/s-0038-1632401. Epub 2018 Apr 9.Review. https://www.ncbi.nlm.nih.gov/pubmed/29636651 25. Accurate Prediction of Submental Lymph Nodes Using Magnetic Resonance Imaging for Lymphedema Surgery. Asuncion MO, Chu SY, Huang YL, Lin CY, Cheng MH. Plast Reconstr Surg Glob Open. 2018 Mar 23;6(3):e1691. doi: 10.1097/GOX.0000000000001691. eCollection 2018 Mar. https://www.ncbi.nlm.nih.gov/pubmed/29707451 26. Critical Ischemia Time, Perfusion and Drainage Function of Vascularized Lymph Nodes. Yang CY, HO OA, Cheng MH, Hsiao HY. Plast Reconstr Surg. 2018 Jun 12. doi: 10.1097/PRS.0000000000004673. [Epub ahead of print] https://www.ncbi.nlm.nih.gov/pubmed/29927833 27. Correlation between Quantity of Transferred Lymph Nodes and Outcome in Vascularized Submental Lymph Node Flap Transfer for Lower Limb Lymphedema. Gustafsson J, Chu SY, Chan WH, Cheng MH. Plast Reconstr Surg. 2018 Jul 10. doi: 10.1097/PRS.0000000000004793. [Epub ahead of print] https://www.ncbi.nlm.nih.gov/pubmed/30020232 28. Acoustic Radiation Force Impulse Elastography: Tissue Stiffness Measurement in Limb Lymphedema. Chan WH, Huang YL, Lin C, Lin CY, Cheng MH, Chu SY. Radiology. 2018 Aug 14:172869. doi: 10.1148/radiol.2018172869. [Epub ahead of print] https://www.ncbi.nlm.nih.gov/pubmed/30106341 29. Lymph node transplantation for the treatment of lymphedema. Gould DJ, Mehrara BJ, Neligan P, Cheng MH, Patel KM. J Surg Oncol. 2018 Aug 21. doi: 10.1002/jso.25180. [Epub ahead of print] Review. https://www.ncbi.nlm.nih.gov/pubmed/30129675 30. Effectiveness of Vascularized Lymph Node Transfer for Extremity Lymphedema Using Volumetric and Circumferential Differences Gustafsson J, Chu SY, Chan WH, Cheng MH. Plast Reconstr Surg. 2018 Jul 10. doi: 10.1097/PRS.0000000000004793. [Epub ahead of print] https://www.ncbi.nlm.nih.gov/pubmed/30020232 31. Lymphedema and concomitant venous comorbidity in the extremity: Comprehensive evaluation, management strategy, and outcomes. Sachanandani N S, Chu SY, Ho O A., Cheong CF, Lin CY, Cheng MH*. J Surg Oncol. 2018 Nov;118(6):941-952. doi: 10.1002/jso.25237. https://www.ncbi.nlm.nih.gov/pubmed/ ? term=Lymphedema+and+concomitant+venous+comorbidity+in+the+extremity%3A+Comprehensive+evaluation%2C+management+strategy%2C+and+outcomes 32. Outcomes of Vascularized Lymph Node Transfer and Lymphovenous Anastomosis for Treatmentof Primary Lymphedema. Cheng MH, Loh CYY, Lin CY. Plats Reconstr Surg Glob Open. 2018 Dec 20;6(12):e2056. https://journals.lww.com/prsgo/Fulltext/2018/12000/Outcomes_of_Vascularized_Lymph Node_Transfer_and.15.aspx 33. Comparisons of Submental and Groin Vascularized Lymph Node Flaps Transfer for BreastCancer-Related Lymphedema. Ho OA, Lin CY, Pappalardo M, Cheng MH. Plats Reconstr Surg Glob Open. 2018 Dec 13;6(12):e1923. https://journals.lww.com/prsgo/Fulltext/2018/12000/Comparisons_of_Submental_and_Groin_Vascularized.13.aspx 34. A Prospective Evaluation of Lymphedema-Specific Quality-of-Life Outcomes Following Vascularized Lymph Node Transfer. Sachanandani N S, Chu SY, Ho O A., Cheong CF, Lin CY, Cheng MH*. J Surg Oncol. 2018 Nov;118(6):941-952. doi: 10.1002/jso.25237. https://www.ncbi.nlm.nih.gov/pubmed/ ? term=Lymphedema+and+concomitant+venous+comorbidity+in+the+extremity%3A+Comprehensive+evaluation%2C+management+strategy%2C+and+outcomes 35. 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. doi: 10.1016/j.ygyno.2016.01.007. Epub 2016 Jan 7. https://www.ncbi.nlm.nih.gov/pubmed/26773469 36. Outcomes of Lymphedema Microsurgery for Breast Cancer-related Lymphedema With or Without Microvascular Breast Reconstruction. Ho OA, Lin CY, Pappalardo M, Cheng MH. Ann Surg. 2017 Jun 7. doi: 10.1097/SLA.0000000000002322. [Epub ahead of print] https://www.ncbi.nlm.nih.gov/pubmed/28594742 37. 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. doi: 10.1097/SLA.0000000000002917. https://www.ncbi.nlm.nih.gov/pubmed/30004927 38. Dorsal Wrist Placement for Vascularized Submental Lymph Node Transfer Significantly Improves Breast Cancer-Related Lymphedema. Hattan A, Fries Charles Anton, BChir, FRCS, Cheng Ming-Huei. Plastic and Reconstructive Surgery - Global Open: 2019 Feb, 7(2): e2149. https://journals.lww.com/prsgo/Fulltext/2019/02000/Dorsal_Wrist Placement_for_Vascularized_Submental.14.aspx 39. Comparison of Outcomes between Side-to-End and End-to-End Lymphovenous Anastomoses for Early-Grade Extremity Lymphedema. Fahad K. Al-Jindan, Lin CY, Cheng MH. Plast Reconstr Surg. 2019 May 10. [Epub ahead of print] https://www.ncbi.nlm.nih.gov/pubmed/31188305 40. Factors associated with professional healthcare advice seeking in breast cancer-related lymphedema. Lin CY, Cheng MH et al. J Surg Oncol. 2020 Jan;121(1):67-74. doi: 10.1002/jso.25523. Epub 2019 Jun 18. https://www.ncbi.nlm.nih.gov/pubmed/31209885 41. Lymphoscintigraphy for the Diagnosis of Extremity Lymphedema: Current Controversies Regarding Protocol, Interpretation and Clinical Application. Pappalardo M, Cheng MH. J Surg Oncol. 2020 Jan;121(1):37-47. doi: 10.1002/jso.25526. Epub 2019 Jun 18. https://www.ncbi.nlm.nih.gov/pubmed/31209893 42. Intra-abdominal Chylovenous Bypass Treats Retroperitoneal Lymphangiomatosis. Chen C, Cheng MH et al. J Surg Oncol. 2020 Jan;121(1):75-84. doi: 10.1002/jso.25514. Epub 2019 Jul 4. https://www.ncbi.nlm.nih.gov/pubmed/31273800 43. Lymphedema Microsurgery Reduces the Rate of Implant Removal for Patients Who Have Pre-existing Lymphedema and Total Knee Arthroplasty for Knee Osteoarthritis. Voravitvet TY, Cheng MH et al. J Surg Oncol. 2020 Jan;121(1):57-66. doi: 10.1002/jso.25517. Epub 2019 Jun 13. https://www.ncbi.nlm.nih.gov/pubmed/31197837 44. Clinical Features, Microbiological Epidemiology and Recommendations of Management for Cellulitis in Extremity Lymphedema. Rodriguez JR, Cheng MH et al. J Surg Oncol. 2020 Jan;121(1):25-36. doi: 10.1002/jso.25525. Epub 2019 Jul 2. https://www.ncbi.nlm.nih.gov/pubmed/31264724 45. Delayed Primary Retention Suture: A new technique to inset Vascularized Submental Lymph Node Transfer. Koide S, Cheng MH et al. J Surg Oncol. 2020 Jan;121(1):138-143. doi: 10.1002/jso.25520. Epub 2019 Jul 5. https://www.ncbi.nlm.nih.gov/pubmed/31276208 46. Long-Term Outcome of Lower Extremity Lymphedema Treated with Vascularized Lymph Node Flaps with Venous Complications. Koide S, Cheng MH et al. J Surg Oncol. 2020 Jan;121(1):129-137. doi: 10.1002/jso.25602. Epub 2019 Jun 27. https://www.ncbi.nlm.nih.gov/pubmed/31246288 47. Summary of hands-on supermicrosurgery course and live surgeries at 8th world symposium for lymphedema surgery. Pappalardo M, Cheng MH et al. J Surg Oncol. 2020 Jan;121(1):8-19. doi: 10.1002/jso.25619. Epub 2019 Jul 16. https://www.ncbi.nlm.nih.gov/pubmed/31309553 48. Introduction of the 8th World Symposium for Lymphedema Surgery. Cheng MH, Chang DW, Masia J, Koshima I. J Surg Oncol. 2020 Jan;121(1):7. doi: 10.1002/jso.25620. Epub 2019 Jul 9. https://www.ncbi.nlm.nih.gov/pubmed/31290156 49. Impacts of Arterial Ischemia or Venous Occ.usion on Vascularized Groin Lymph Nodes in a Rat Model. Tinhofer I. E., Yang CY, Chen C, Cheng MH. J Surg Oncol. 2020 Jan;121(1):153-162. doi: 10.1002/jso.25518. Epub 2019 May 31. https://www.ncbi.nlm.nih.gov/pubmed/31152457 50. Volumetric Differences in the Superficial and Deep Compartments of Patients with Secondary Unilateral Lower Limb Lymphedema. Chu SY, Cheng MH et al. Plast Reconstr Surg. (paper in press) 51. Efficacy validation of a lymphatic drainage device for lymphedema drainage in a rat model. Cheng MH, Yang CY, Tee R, Hong YT, Lu CC. J Surg Oncol. 2019 Dec;120(7):1162-1168. https://www.ncbi.nlm.nih.gov/pubmed/?term=Efficacy+validation+of+a+lymphatic+drainage+device+for+lymphedema+drainage+in+a+rat+model 52. Institutionalization of Reconstructive Lymphedema Surgery in Austria - Single Center Experience. Tzou CHJ, Cheng MH et al. J Surg Oncol. 2020 Jan; 121(1):91-99. https://www.ncbi.nlm.nih.gov/pubmed/?term=Institutionalization+of+Reconstructive+Lymphedema+Surgery+in+Austria+%E2%80%93+Single+Center+Experience 53. Comparisons of Manual Tape Measurement and Morphomics Measurement of Patients with Upper Extremity Lymphedema. Horbal SR, Chu SY, Cheng MH* et al. Plast Reconstr Surg Global Open. 2019 Oct 29;7(10): e2431 https://www.ncbi.nlm.nih.gov/pubmed/ ? 54. Characterization of limb lymphedema using the statistical analysis of ultrasound backscattering. Lee YL, Cheng MH et al. Quant Imaging Med Surg. 2020;10(1):48-56. 55. Simultaneous Ipsilateral Vascularized Lymph Node Transplantation and Contralateral Lymphovenous Anastomosis in Bilateral Different-Severities Extremity Lymphedema. Cheng MH*, Tee R, Chen C, Lin CY, Pappalardo M. Ann Surg Oncol. 2020 Jun 18. doi: 10.1245 56. ASO Author Reflection: Simultaneous Ipsilateral Vascularized Lymph Node Transplantation and Contralateral Lymphovenous Anastomosis in Bilateral Different-Severities Extremity Lymphedema. Horbal SR, Chu SY, Cheng MH* et al. Ann Surg Oncol. 2020 Jul 10. 57. Lymphedema microsurgery improved outcomes of pediatric primary extremity lymphedema. Cheng MH*, Liu TTF. Microsurgery, 2020 Jul 11. 58. Chylovenous bypass for mesenteric lymphangiomatosis: A case report. Chen C,Cheng MH*. J Surg Oncol. 2020 Jul 15. 59. Staging and clinical correlations of lymphoscintigraphy for unilateral gynecological cancerrelated lymphedema. Pappalardo M, Lin C, Ho OA, Kuo CF, Lin CY, Cheng MH". J Surg Oncol. 2020 Mar;121(3):422-434. 60. Morbidity of Marginal Mandibular Nerve Post Vascularized Submental Lymph Node Flap Transplantation. Chang Tommy NJ, Lee CH, Lin Jennifer AJ, Cheng MH*. J Surg Oncol. 2020 Dec;122(8):1747-1754 https://pubmed.ncbi.nlm.nih.gov/32869304/ 61. Simultaneous Ipsilateral Vascularized Lymph Node Transplantation and Contralateral Lymphovenous Anastomosis in Bilateral Different-Severities Extremity Lymphedema. Cheng MH*, Tee R, Chen C, Lin CY, Pappalardo M. Ann Surg Oncol. 2020 Jun 18. https://pubmed.ncbi.nlm.nih.gov/32556869/ 62. ASO Author Reflections: Simultaneous Ipsilateral Vascularized Lymph Node Transplantation and Contralateral Lymphovenous Anastomosis in Bilateral Different-Severities Extremity Lymphedema. Cheng MH*. Ann Surg Oncol. 2020 Dec;27(13):5277-5278. https://pubmed.ncbi.nlm.nih.gov/32651692/ 63. Response to letter to the editor: Evidence of Lymph Flow Amelioration on Indocyanine Green Lymphography after Vascularized Lymph Node Transfer. Cheng MH". Ann Surg Oncol. 2021 Jun;123(7):1641. https://pubmed.ncbi.nlm.nih.gov/33825195/ 64. Retrograde Manual Lymphatic Drainage following Vascularized Lymph Node Transfer to Distal Recipient Sites for Extremity Lymphedema: A Retrospective Study and Literature Review. Roka-Palkovits J, Lin CY, Tzou CH J, Tinhofer, Cheng MH*. Plast Reconstr Surg. 2021 Sep 1;148(3):425e-436e. https://pubmed.ncbi.nlm.nih.gov/34432699/ 65. Immediate Lymphovenous Bypass Treated Donor Site Lymphedema during Phalloplasty for Gender Dysphoria. Lin W, Safa B, Chen M, Cheng MH*. Plast Reconstr Surg Glob Open. 2021 Sep 17;9(9):e3822. https://pubmed.ncbi.nlm.nih.gov/34549009/ 66. Heparin-induced thrombocytopenia and thrombosis in primary lymphedema patients who underwent vascularized lymph node transplantations. Hsu SY, Lin CY, Cheng MH*. J Surg Oncol. 2022 Feb 2. https://pubmed.ncbi.nlm.nih.gov/35107827 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. Principles and Practice of Lymphedema Surgery 2nd Edition - January 7, 2021 Ming-Huei Cheng, David Chang, Ketan Patel. Paperback ISBN: 9780323694186 Book chapters: 16 1. Cheng MH, Nguyen DH, Huang JJ. Chapter 77: Vascularized Groin Lymph Node Flap for Treatment of Lymphedema. In: Perforator Flaps: Anatomy, Technique, & Clinical Applications. 2nd Edition. Blondeel PN, Morris SF, Hallock GG, and Neligan PC (Editors). Quality Medical Publishing, Inc. St. Louis, Missouri. 2013:1317-1328. 2. Cheng MH, Nguyen DH. Chapter 54: Lymph Node Transfer for Lymphedema. In: Operative Microsurgery. Boyd JB and Jones NF (Editors). McGraw-Hill, New York. 2015:672-682. 3. Tobbia D, Cheng MH. Vascularized Groin Lymph Node Flap Transfer for Post mastectomy Upper Limb Lymphedema. In Grabb's Encyclopedia of Flaps, 4th edition. Strauch B, Vasconez LO, Lee BT, and Herman CK (Editors). Wolters Kluwer, Philadelphia, PA, USA. 2015. 4. Tzou CHJ, Cheng MH. Transfer of lymph node tissue - my approach. In Oncoplastic and Reconstructive Management of the Breast: A Multidisciplinary Approach. CRC Press, Boca Raton, FL, 2015. 5. Cheng MH, Chang DW, Patel KM. Chapter 1: An introduction to principles and practice of lymphedema surgery. In Principles and Practice of Lymphedema Surgery. Cheng MH, Chang DW, Patel KM (Editors). Elsevier Inc, Oxford, United Kingdom. 2015 6. Nguyen DH, Cheng MH. Chapter 5: Laboratory study of lymphoma. In Principles and Practice of Lymphedema Surgery. Cheng MH, Chang DW, Patel KM (Editors). Elsevier Inc, Oxford, United Kingdom. 2015

鄭明輝教授是經過國際專業認可的整形外科專科醫師，同時也是美國重建顯微外科學會2006年Godina獎得主，是第一位亞洲整形外科醫師得獎者。截至目前為止，鄭教授已經完成了2100多例顯微手術，包括頭頸部重建、乳房重建、顱內外動脈血管吻合手術、淋巴管靜脈吻合術和顯微淋巴結皮瓣移植手術。 The Journey of Dr. Cheng Say Goodbye to Compression Garments after Dr. Cheng's Lymphedema Microsurgery 1988 1991 1997 1998-1999 2001 2002 2003 2004 2006 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2019 2020 2021 2022 2024 自中山醫學大學醫學系畢業 進入林口長庚醫院接受六年的整形外科住院醫師訓練 獲得台灣整形重建外科專科醫師資格 在美國知名的休士頓安德森癌症中心(MD Anderson Cancer Center) 完成顯微乳房重建及基礎研究的專業訓練(Fellowship) 創立網站台灣乳房重建協會(www.nicebreast.com.tw ),將乳房重建的知識傳播到全台灣,到目前為止已有超過29萬人次造訪 創辦了台灣乳房重建協會 成為美國整形外科醫學會國際會員 在林口長庚醫院舉辦了第一次亞洲乳房整形重建醫學會(Asian Symposium for Breast Plastic and Reconstructive Surgery) 創立乳房重建補助專款,補助全台乳房重建病患 身為顯微重建外科主任以「技冠全球:重建生命的奇蹟」申請生策會國家品質獎,並且獲得醫療院所類金獎 晉升為林口長庚醫院專任教授 被任命為林口長庚副院長,負責開刀房的整頓與提升,之後開刀房績效每年提升10%,積極推動各科第三代達文西手術,一年後達文西手術數量領先全台灣 在台灣舉辦世界淋巴水腫手術醫學會(World Symposium for Lymphedema Surgery)榮獲長庚大學的傑出校友 創立了林口長庚的組織工程中心 成立台灣第一個淋巴水腫治療中心 八仙塵炸事件共有65位病人送到林口長庚醫院治療。鄭副院長被任命為指揮官,全權負責這些平均43%的燙傷面積的病人,在三個月後都順利出院,是全世界治療燙傷最好的成績之一 接受美國顯微外科醫學會遴選為Zamboni訪問教授 在台灣舉辦世界淋巴水腫手術醫學會 (World Symposium for Lymphedema Surgery)由董事會提升為林口長庚醫院總院院長。他以創辦人的“人本濟世”為中心 思想,提升服務品質及效率,推動肺臟移植團隊整合,批准五個手移植臨床試驗案例,繼續推動國際醫療,並且積極提升林口長庚的學術研究和國際知名度,和密西根大學簽下合作協議,共同舉辦學術會議 被聘為密西根大學 (University of Michigan) 整形外科的兼任教授,成為二十多年來第三位獲得該職位的外國醫師 創立網站淋巴水腫顯微手術(www.lymphedemamicrosurgery.com ) ,將淋巴水腫顯微手術的知識傳播到全世界 帶領的淋巴水腫顯微手術團隊,以「顯微下頜淋巴結移植手術治療淋巴水腫」獲得生策會第十六屆國家新創獎新創醫療技術獎的臨床新創組第一名 在台灣舉辦世界淋巴水腫手術醫學會 (World Symposium for Lymphedema Surgery) 他的淋巴水腫顯微手術治療團隊,以「建立世界級淋巴水腫診斷、治療、研 究與教育標竿」獲生策會國家品質獎-醫療院所類(SNQ)銀獎 入選美國史丹佛大學公佈之:從全球800萬名科學家中遴選出世界排名前2%的 科學家 被世界顯微外科醫學會任命為秘書長,繼續在顯微外科領域做出貢獻 榮獲臺南ㄧ中100週年校慶第十五屆學術教育類校友傑出成就獎 入選美國史丹佛大學公佈之:從全球800萬名科學家中遴選出世界排名前2%的 科學家 從林口長庚醫院退休,並創立安德森整形外科診所,開始自行執業 出版第二本中文書「乳癌奇蹟治癒」,是博客來網路書店及誠品書店中文醫 療書籍的暢銷排行榜前3名 入選美國史丹佛大學公佈之: 從全球800萬名科學家中遴選出世界排名前2%的 科學家 在台灣舉辦世界淋巴水腫手術醫學會 (World Symposium for Lymphedema Surgery) 入選美國史丹佛大學公佈之: 從全球800萬名科學家中遴選出世界排名前2%的 科學家 Ming-Huei Cheng, M.D., M.B.A., F.A.C.S. November 27, 2024 Degree, Position, and Societies Dr. Ming-Huei Cheng completed his General Surgery and Plastic Surgery residency training at Chang Gung Memorial Hospital, Taipei, Taiwan, in 1997 and finished a combined microsurgical and research fellowship at the Department of Plastic Surgery, MD Anderson Cancer Center, Houston, Texas, in 1999. He has been a member of the American Society for Reconstructive Microsurgery since 2003 and an international member of the American Society of Plastic Surgeons since 2009. He was promoted to a Full Professor at the Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, in 2011. He has been an adjunct professor at the Division of Plastic Surgery at the University of Michigan, Ann Arbor, MI., since 2017. He retired from Chang Gung Memorial Hospital and established his private clinic, A+ Surgery Clinic, specializing in lymphedema microsurgery and microsurgical breast reconstruction in Taipei in April 2023 (www.aplussurgery.com ). He was appointed Vice President of the World Society for Reconstructive Microsurgery in August 2023. Clinical Works Dr. Cheng initiated his distinguished career in reconstructive microsurgery, specializing initially in extremity and head and neck reconstruction, later expanding to breast reconstruction and lymphedema microsurgery. Globally recognized, he is a highly sought-after figure in reconstructive microsurgery. With a portfolio exceeding 2,600 microsurgical cases, Dr. Cheng has demonstrated unparalleled expertise in head and neck reconstructions, right hepatic artery anastomoses for living-donor liver transplantation, breast reconstructions, extracranial-intracranial bypasses, and lymphovenous bypasses (98.5% patency rate). His proficiency in vascularized lymph node transfer also boasts an impressive 98% success rate. Since 2000, Dr. Cheng has pioneered innovative techniques, such as distal recipient site utilization for vascularized lymph node flap transfer and the groundbreaking vascularized submental lymph node flap transfer for extremity lymphedema. His clinical research on the mechanisms of vascularized lymph node transfer has led to the development of a new severity classification for Lymphedema Grading in Annals Surgical Oncology (2015) and a novel Taiwan Lymphoscintigraphy Staging system in Annals of Surgery (2018). Dr. Cheng's unique and innovative techniques stand as some of the most effective treatments for lymphedema. Research, Publications, and Patents Dr. Cheng's impactful research career includes 22 projects from the Ministry of Science and Technology, 39 projects from Chang Gung Memorial Hospital, and leadership at the Center for Tissue Engineering since 2014. His extensive publications comprise 270 peer-reviewed papers and 42 book chapters, including the chapter "Lymphedema: Diagnosis and Treatment" in "Grabb and Smith’s Plastic Surgery 8th edition" (Wolters Kluwer, 2020). He is one of the Editors-in-Chief of the textbook “Principles and Practice of Lymphedema Surgery”, first, second, and Spanish editions. Dr. Cheng's scholarly impact is reflected in 12,467 citations, an h-index of 59, and an i10-index of 195 on Google Scholar as of November 27, 2024 (https://scholar.google.com/citations?user=KtfcDvcAAAAJ&hl=en). His inventive contributions extend to 17 intellectual patents in Taiwan and three in the United States. Teaching, Visiting Professorships, and Editor of Peer-Review Journals Dr. Cheng, a preeminent expert in international reconstructive microsurgery, is frequently invited to prestigious conferences for lectures and panels. Hosting annual microsurgery courses since 2010 and the super microsurgery course since 2017, he has trained 107 residents and 126 international fellows, receiving 1026 international visitors in the past 26 years. Noteworthy successes include mentees who, under his guidance, have become professors, employing advanced techniques like vascularized lymph node transfer for breast cancer-related lymphedema. Dr. Cheng's influence extends globally through 32 visiting professorships at renowned institutes, including Harvard Medical School and Mayo Clinic. He plays pivotal roles as Reconstruction Section Editor at the Annals of Surgical Oncology and co-Section (Reconstruction) Editor at the Journal of Surgical Oncology. Additionally, he has served as an editor for journals like Plastic and Reconstructive Surgery, Plastic and Reconstructive Surgery Global Open, Microsurgery, and Annals of Plastic Surgery. Dr. Cheng's ongoing contributions actively shape and disseminate knowledge in reconstructive surgery. Host International Conferences Dr. Cheng has been a driving force in fostering collaboration between the Taiwan Society of Plastic Surgery (TSPS) and the American Society of Plastic Surgeons (ASPS). His visionary approach aims to provide learning opportunities for junior doctors and surgeons in Taiwan while connecting them with the global medical society through an alliance with ASPS. In 2009, he initiated and hosted the inaugural Asian Symposium for Breast Plastic and Reconstructive Surgery, advocating for breast reconstruction and facilitating the exchange of advanced surgical techniques and knowledge for treating breast cancer patients in Asian countries. This impactful conference has been held consecutively for 11 years. Additionally, Dr. Cheng hosted and co-chaired the World Symposium on Lymphedema Surgery in 2013, 2016, 2019 and 2024. This annual gathering brings together the world's foremost lymphedema experts, providing a platform to present their expertise and discuss various surgical procedures and challenges in treating lymphedema. Websites and Patient Support Group In 2001, Dr. Cheng initiated the breast reconstruction website http://www.nicebreast.com.tw , dedicated to educating the public on breast cancer and reconstruction. The following year, he founded the inaugural Taiwan Breast Reconstruction Patient Support Group, contributing to breast cancer awareness in Taiwan and neighboring Asian countries. Collaborating with Avon Company, he organized annual fundraising events, offering financial aid to over 450 patients undergoing breast reconstruction. In 2019, Dr. Cheng launched the lymphedema website https://lymphedemamicrosurgery.com/, attracting over 300,000 visits and sharing the latest microsurgical techniques, results, and research on lymphedema diagnosis and treatments. His continued commitment to patient support expanded in 2023 with the launch of the Plastic and Recontructive Surgery website www.aplussurgery.com for the A+ Surgery Clinic’s official website. Awards and Honors Dr. Cheng's notable recognitions include the 2006 Godina Travel Fellow of the American Society for Reconstructive Microsurgery and the 2008 Outstanding Alumnus of Chung Shun Medical University. He received the Distinguished Alumni Award from Chang Gung University in 2013 and was named the Zamboni Visiting Professor by the American Society for Reconstructive Microsurgery in 2016. Notable awards include the First Place Award at the National Innovation Competition 2019 and a Silver Medal at the Symbol of National Quality Competition in 2020 for his Center of Lymphedema team. Dr. Cheng's global impact is highlighted by his consistent top 2% ranking among 8 million scientists continuous for 5 years, from 2020 to 2024, as recognized by Stanford University, Elsevier, and SciTech Strategies. In 2022, he received the 15th Annual (100th Anniversary) Distinguished Alumni Award from Tainan First High School. International Invited Lectures Invited Panelist and Moderator Instructional Courses Vascularized groin lymph node transfer using the wrist as a recipient site for the management of postmastectomy upper extremity lymphedema. The third conference, Group for Advance Breast Reconstruction surgeons. Beijing, China, October 12, 2008. The osteomyocutaneous peroneal artery combined flap for reconstruction of composite and en bloc mandibular defects. First combined meeting of American Society for Reconstructive Microsurgery and Chinese Society of Microsurgery, Shanghai, China. Vascularized groin lymph node transfer using the wrist as a recipient site for the management of postmastectomy upper extremity lymphedema. Institute of Reconstructive Plastic Surgery, New York University Langone Medical Center, New York, October 28, 2008. The osteomyocutaneous peroneal artery combined flap for reconstruction of composite and en bloc mandibular defects. Division of Plastic Surgery, Mayo Clinic, Rochester, Minnesota, October 30, 2008. Vascularized groin lymph node transfer using the wrist as a recipient site for the management of postmastectomy upper extremity lymphedema. Division of Plastic Surgery, Mayo Clinic, Rochester, Minnesota, October 31, 2008. The osteomyocutaneous peroneal artery combined flap for reconstruction of composite and en bloc mandibular defects. Cross-Strait symposium of new advancement in oral cancer management and reconstruction. Xiamen, China, December 13-14, 2008. Recent Advances for breast reconstruction in Taiwan. The Cross Strait Conference on Breast Cancer Treatment Consensus, Xiamen, China, May 16, 2009. Salvage strategy for venous compromised DIEP flaps. First Asian Symposium for Breast Plastic and Reconstructive Surgery in Taoyuan, Taiwan, May 30-31, 2009. Nipple reconstruction with modified top hat flap and cartilage graft. First Asian Symposium for Breast Plastic and Reconstructive Surgery in Taoyuan, Taiwan, May 30-31, 2009. Vascular Groin Lymph node transfer for postmastectomy upper extremity lymphedema. First Asian Symposium for Breast Plastic and Reconstructive Surgery in Taoyuan, Taiwan, May 30-31, 2009. One flap does many things in head and neck reconstruction. 1st Mayo Clinic/Chang Gung University Medical College Symposium in Reconstructive Microsurgery in Rochester, Minnesota, June 4-7, 2009. Solutions for Inadequate Venous outflow in Free Flap Breast Reconstruction. 1st Mayo Clinic/Chang Gung University Medical College Symposium in Reconstructive Microsurgery in Rochester, Minnesota, June 4-7, 2009. Management of Post-Mastectomy Upper Extremity Edema. 1st Mayo Clinic/Chang Gung University Medical College Symposium in Reconstructive Microsurgery in Rochester, Minnesota, June 4-7, 2009. The Osteomyocutaneous Peroneal Artery Combined Flap. Techniques in Flap Dissection with Cadaver Workshop Program in Dallas, Texas, July 11-12, 2009. Vascularized Groin Lymph Node Transfers for Treatment of Upper Extremity Lymphedema. Techniques in Flap Dissection with Cadaver Workshop Program in Dallas, Texas, July 11-12, 2009. Vascularized Groin Lymph Node Transfers for Treatment of Upper Extremity Lymphedema. The University of Texas MD Anderson Cancer, Houston, Texas, July 13-14, 2009. Vascularized Groin Lymph Node Transfers for Treatment of Upper Extremity Lymphedema. University of South California, Los Angeles, California, July 16-17, 2009. The Osteomyocutaneous Peroneal Artery Combined Flap. University of South California, Los Angeles, California, July 16-17, 2009. Recent advances in breast reconstruction in Taiwan. The third Shenzhen conference of breast cancer in Shenzhen, China, August 27-30, 2009. Vascularized groin lymph node transfer for postmastectomy upper extremity lymphedema. The third Shenzhen Conference of Breast Cancer in Shenzhen, China, August 27-30, 2009. Vascularized groin lymph node transfer for postmastectomy upper extremity lymphedema. 2009 Taipei International Breast Cancer Symposium, Taipei, Taiwan, September 12-13, 2009. Clinical research guiding the state of art in reconstructive microsurgery. 2nd European Plastic Surgery Research Council in Hamburg, Germany, August 26-29, 2010. Vascularized Groin Lymph Node Transfer for Postmastectomy Upper Limb Lymphedema. Asia Breast Cancer Collaborative Group Meeting 2010, Guangzhou International Breast Cancer Symposium in Guangzhou, China, September 3-5, 2010. The Advantage and Disadvantage of Instant and Delayed Breast Reconstruction with DIEP Flap. Asia Breast Cancer Collaborative Group Meeting 2010, Guangzhou International Breast Cancer Symposium in Guangzhou, China, September 3-5, 2010. Recent Advances of Breast Reconstruction at Chang Gung Memorial Hospital. 2nd World Association of Plastic Surgeons of Chinese Descent, Taoyuan, Taiwan, October 31, 2010. Vascular Groin Lymph Node Transfer for Post Mastectomy Lymphedema. The 16th World Congress of the International Confederation for Plastic, Reconstructive and Aesthetic Surgery, Vancouver, Canada, May 21-27, 2011. Recent advances in mandibular reconstruction at the 3rd World Congress of the International Academy of Oral Oncology (IAOO), Singapore, Singapore, July 15-17, 2011. A Strategic Approach for Tongue Reconstruction to Achieve Predictable and Improved Functional and Aesthetic Outcomes at the 3rd World Congress of the International Academy of Oral Oncology (IAOO), Singapore, Singapore, July 15-17, 2011. Vascularized LN Transfer for Lymphedema Treatment. The 4th CCH International Breast Cancer Conference, Taichung, Taiwan, August 13, 2011. Microsurgery: Tips and Tricks. 3rd European Plastic Surgery Research Council in Hamburg, Germany, August 25-28, 2011. Unilateral breast reconstruction with a DIEP flap and simultaneous contralateral breast augmentation. The 3rd Asian Symposium of Breast Plastic and Reconstructive Surgery, Seoul, Korea, October 7-9, 2011. New Classification of Mandibular Defect and Reconstruction. The Korean Society of Plastic and Reconstructive Surgeons: The 2nd Research & Reconstructive Forum, Gwangju, Korea, June 1-2, 2012. New Classification of Mandibular Defects and Reconstructions. 2012 Annual Meeting and International Conference of Taiwan Head and Neck Society, Changhua, Taiwan, June 9-10, 2012. Oro-maxillary reconstruction with a microsurgical free flap. AOCMF Advances Symposium on Reconstruction, Trauma, and Tumor, Taoyuan, Taiwan, June 16-17, 2012. Simultaneous Scarless Contralateral Breast Augmentation During Unilateral Breast Reconstruction Using Bilateral Differentially Split DIEP Flaps. 2012 Taipei International Breast Cancer Symposium & International Oncoplastic Breast Surgery Symposium with the 4th Cross Strait Conference on Breast Cancer Treatment Consensus, Taipei, Taiwan, September 22, 2013. Simultaneous Scarless Contralateral Breast Augmentation During Unilateral Breast Reconstruction Using Bilateral Differentially Split DIEP Flaps. The 4th Asian Symposium of Breast Plastic and Reconstructive Surgery, Xi’an, China, October 12, 2013. Lower Limb Lymphedema Treatment with Vascularized Submental Lymph Nodes Flap Transfer. APAGE 2013 Laparoscopic Gynecologic Oncology Surgery & Hands-on Animal Workshop, Shanghai, China, March 21-23, 2013. Evaluation of the Effect of Vascularized Lymph Nodes Transfer on Lymphatic Drainage and Local Immune Function in an Experimental Rat Lymphedema Model. 2013 International Symposium on Surgical Treatment of Lymphedema, Taoyuan, Taiwan, April 10-20, 2013. Vascularized Groin Lymph Node Flap Transfer for Postmastectomy Upper Limb Lymphedema: The Flap Anatomy, Recipient Sites, and Outcomes. 2013 International Symposium on Surgical Treatment of Lymphedema, Taoyuan, Taiwan, April 10-20, 2013. Vascularized Submental Lymph Node Flap Transfer for the Treatment of Lower Extremity Lymphedema: Anatomical Study and Clinical Applications. 2013 International Symposium on Surgical Treatment of Lymphedema, Taoyuan, Taiwan, April 10-20, 2013. Vascularized lymph node flap transfer. Department of Plastic Surgery, MedStar Georgetown University Hospital, Washington, DC, USA. February 6, 2014. Simultaneous Contralateral augmentation during unilateral breast reconstruction with differentially split DIEP Flaps. Department of Plastic Surgery, MedStar Georgetown University Hospital, Washington, DC, USA. February 6, 2014. Tricks, Tips, and Pearls for head and neck reconstruction. Department of Plastic Surgery, MedStar Georgetown University Hospital, Washington, DC, USA. February 6, 2014. Submental lymph node transplantation for lymphedema. Research and Surgical Perspectives in Lymphedema, Brussel, Belgium, March 3, 2014. Vascularized lymph nodes flaps for lymphedema - Taiwan style. 3rd International Symposium on Lymphedema Surgical Treatment, Barcelona, Spin. March 5, 2014. Vascularized lymph node transfer for upper and lower limbs lymphedema - recipient site selection and mechanism. The 2nd Meeting of Asian Pacific Federation of Societies for Reconstructive Microsurgery (APFSRM) 2014, Buyeo, Korea. July 4, 2014. Salvage of venous congested DIEP Flap. The 5th International Oncoplastic Breast Surgery Symposium, Guangzhou, China, September 19, 2014. Simultaneous contralateral breast augmentation with unilateral breast reconstruction with a DIEP flap. The 5th International Oncoplastic Breast Surgery Symposium, Guangzhou, China, September 20, 2014. Vascularized Lymph Node Flap for Breast Cancer-related Lymphedema a. The 5th International Oncoplastic Breast Surgery Symposium, Guangzhou, China, September 20, 2014. Redefining the Future of ASBPRS. The 6th Asian Symposium for Breast Reconstructive Surgery, Bali, Indonesia, October 20, 2014. Vascularized Lymph Node Transfer for Upper and Lower Limbs Lymphedema—Recipient Site Selection and Mechanism. The 6th Asian Symposium for Breast Reconstructive Surgery, Bali, Indonesia, October 21, 2014. The Aesthetic Refinement of Breast Reconstructive. The 6th Asian Symposium for Breast Reconstructive Surgery, Bali, Indonesia, October 21, 2014. Vascularized lymph node flap transfer for treatment of lymphedema. The 4th Congress of the World Association for Plastic Surgeons of Chinese Descent, November 7, 2014. Superficial inferior epigastric artery perforator flap (SIEA) with Superficial circumflex iliac artery perforator flap (SCIA), Duke Breast Perforator FLAP Course, February 28 to March 1, 2015. Vascularize Lymph Node Flap Transfer for Upper and Lower Limb Lymphedema. The 58th Annual Meeting of Japan Society of Plastic and Reconstructive Surgery, Kyoto, Japan. April 8 to 10, 2015. Master Course: Breast Reconstruction. 2015 Mevos International Congress of Aesthetic Surgery, Dalian, China, July 25 – 26, 2015 Patient Safety, SNQ, and International Medical Services. 2015 Mevos International Congress of Aesthetic Surgery, Dalian, China, July 25 – 26, 2015 Taiwan-Style Breast Reconstruction. The 18th Reach to Recovery International Breast Cancer Support Conference, September 6 – 9, 2015. Submental Lymph Node Transfer. The Chicago Breast & Lymphedema Symposium, Chicago, Illinois, September 19 – 20, 2015 The Mechanism of Vascularized Lymph Node Transfer for Lymphedema – Natural Lymphatico-Venous Drainage. The 5th World Symposium for Lymphedema Surgery, Chang Gung Linkou Medical Center, Taoyuan, April 27 – 29, 2016. Recent advances in Asian breast reconstruction. The Asian Society for Breast Plastic and Reconstructive Surgery, Inaugural Meeting and Instructional Course, Taiwan, Chang Gung Linkou Medical Center, Taoyuan, April 30, 2016. Recent Advances in Lower Limb Lymphedema, The 17th Asia-Pacific Association for Gynecologic Endoscopy and Minimally Invasive Therapy (APAGE) Annual Congress 2016, Taipei International Convention Center, Taiwan, November 4 – 6, 2016. Vascularized lymph nodes flap transfers for upper and lower limbs lymphedema, the Orange County Society of Plastic Surgeons meeting, Los Angles, USA, November 7, 2016. LYMPH NODE TRANSPLANT- Groin/Submental, The first annual Lymphedema Symposium at BIDMC/Harvard Medical School, Boston, USA, November 3, 2017. Breast Cancer-related Lymphedema and Surgical Treatment. Hefei, Anhui, China, December 30, 2017. Submental LNT, WSRM/ASLS Joint Symposium on Lymphatic Surgery, January 12, 2018. Lymphedema Grading and Treatment, Hangzhou, Zheijian, China, March 17, 2018. Quality of life improvement by breast reconstruction, Guangzhou, Guangdong, China, May 19, 2018. Breast Cancer-related Lymphedema Grading and Surgical Treatment, Changsha, Hunan, China, May 25, 2018. Recent trends in Asian breast reconstruction using free tissue transfer, The 2018 annual meeting of Asian Society for Breast Plastic and Reconstructive Surgery, Taiwan, Chang Gung Linkou Medical Center, Taoyuan, June 2, 2018. TAPA breast augmentation, The 2018 annual meeting of Asian Society for Breast Plastic and Reconstructive Surgery, Taiwan, Chang Gung Linkou Medical Center, Taoyuan, June 2, 2018. Vascularized Lymph Node Transfer for Treatment of Lymphedema, 1st Annual USC Multi-Disciplinary Approach to Lymphedema and Related Disorders Symposium, June 9, 2018. Vascularized lymph node flap transfer for extremity lymphedema, Suzhou, Zhejiang, China, August 18, 2018. Patient selection and indication for lymphedema microsurgery, International Istanbul Breast Cancer Conference - BREASTANBUL 2018, Istanbul, Turkey, October 11, 2018. Outcome of lymphedema microsurgery, International Istanbul Breast Cancer Conference - BREASTANBUL 2018, Istanbul, Turkey, October 11, 2018. Taiwan Lymphoscintigraphy Staging. 2nd Annual Lymphedema Symposium in Boston hosted by BIDMC/Harvard Medical School, November 2, 2018. Outcomes of Lymphedema Microsurgery for Breast Cancer-Related Lymphedema. The sixth Breast Cancer Symposium-USC, LA, USA, January 26, 2019. ASRM/ASLS: Innovations in Lymphatic Surgery. 2019 American Society for Reconstructive Microsurgery, Palm spring, USA. February 2, 2019. Patient selection and indication of lymphedema surgery. Lymphedema Surgery and the Clinical Application of Supermicrosurgery, Hong Kong, February 15, 2019. Mechanism of vascularized lymph node transfer. Lymphedema Surgery and the Clinical Application of Supermicrosurgery, Hong Kong, February 15, 2019. The outcome of lymphedema surgery. Lymphedema Surgery and the Clinical Application of Supermicrosurgery, Hong Kong, February 15, 2019. DIEP Flap for Breast Reconstruction in Thin Patients. Lymphedema Surgery and the Clinical Application of Supermicrosurgery, Hong Kong, February 16, 2019. Lipofilling. Pre-conference Workshops, the Second International Multidisciplinary Breast Conference, Dubai, UAE, February 21, 2019. One-stage direct-to-implant immediate breast reconstruction. Pre-conference Workshops, the Second International Multidisciplinary Breast Conference, Dubai, UAE, February 21, 2019. DIEP flap for breast reconstruction. Pre-conference Workshops, the Second International Multidisciplinary Breast Conference, Dubai, UAE, February 21, 2019. Management Lymphedema. The Second International Multidisciplinary Breast Conference, Dubai, UAE, February 23, 2019. Breast reconstruction. The Second International Multidisciplinary Breast Conference, Dubai, UAE, February 23, 2019. Vascularized Lymph Node Transfer: Techniques and Outcomes. 2nd Annual USC Multi-Disciplinary Approach to Lymphedema and Related Disorders Symposium, Santa Monica, USA, June 8, 2019. Patient Selection and Outcome of Lymphedema Microsurgery. The 49th Annual Meeting of the Portuguese Plastic and Reconstructive Society (SPCPRE), Porto, Portugal, November 8, 2019. Extracranial-Intracranial Arterial Bypass. The 49th Annual Meeting of the Portuguese Plastic and Reconstructive Society (SPCPRE), Porto, Portugal, November 8, 2019. Tricks, Tips and Pearls of Head and Neck Reconstruction, Buncke Clinic Virtual Visiting Professor, Webinar, May 9, 2020. Recent Advances in Lymphedema Microsurgery at Chang Gung Memorial Hospital, Buncke Clinic Virtual Visiting Professor, Webinar, May 30, 2020. Simultaneous Unilateral Breast Reconstruction and Contralateral Augmentation Mammoplasty, IMC Webinar lecture, July 18, 2020. Lymph node transfer. 2020 Duke Virtual Flap Course Track 1, Webinar, August 1, 2020. Lymphedema Microsurgery, UCLA Resident Lecture, Webinar, August 11, 2020. Video session of Surgery: Submental VLNT. Chicago Breast & World Lymphedema Surgery Symposium, Webinar, April 24, 2021. Vascularized lymph node flap transfer for Lymphedema- mechanism and outcome, The 5th Congress of Asian Pacific Federation of Societies for Reconstructive Microsurgery, Webinar, Dec 01, 2021. Innovations in Lymphedema Treatment, 3rd Annual USC Multi-Disciplinary Approach to Lymphedema and Related Disorders Symposium, Webinar, Jun 26, 2022. Outcome and Mechanism of Vascularized Lymph Node Transfer, 9th World Congress of Biomechanics, Webinar, Jul 12, 2022. Reconstructions in oral cancer, The AAO-HNSF Global Grand Rounds-Contemporary Management of Oral Cancer, Webinar, July 30, 2022. Outcomes and Mechanism of Vascularized Lymph Node Flap Transfer, LYMPHOCON 2022, Webinar, Sep 23, 2022. Outcomes and Updates on Lymphedema microsurgery, 2022 NLN-Cleveland Clinic Conference, Cleveland, USA, Nov 18, 2022. Submental Lymph Node Transfer, 2022 NLN-Cleveland Clinic Conference, Cleveland, USA, Nov 19, 2022. Keynote lecture: Recent Advances in Lymphedema Treatment, The 10th World Symposium for Lymphedema surgery, Taiwan, A+ Surgery Clinic, Taipei, April 24, 2024. Vascularized groin lymph node transfer for postmastectomy lymphedema. Panel: Surgical options, techniques and outcomes for postoperative extremity lymphedema, with David Chang, and Isao Koshima. 2010 Annual Scientific Meeting, American Society for Reconstructive Microsurgery, Boca Raton, Florida, January 11, 2010. Penalist, Scientific session: Head & Neck. 2nd European Plastic Surgery Research Council, Hamburg, Germany, August 27, 2010. Penalist, Post mastectomy lymphedema – does anything work? American Society of Plastic Surgeons, Toronto, Canada, October 5, 2010. Penalist, Symposium: Head and Neck. 2nd World Association of Plastic Surgeons of Chinese Descent, Taoyuan, Taiwan, Oct 30, 2010. Moderator, Symposium: Flap Related. 2nd World Association of Plastic Surgeons of Chinese Descent, Taoyuan, Taiwan, Oct 31, 2010. Penalist, Lymphedema treatment. American Society for Reconstructive Microsurgery in Cancun, Mexico, January 17, 2011. Penalist. Lymphedema. The 16th World Congress of the International Confederation for Plastic, Reconstructive and Aesthetic Surgery, Vancouver, Canada, May 21-27, 2011. Moderator, The application of the ALT flap in the head and neck reconstruction. 2011 Annual Meeting & International Conference of Taiwan Head and Neck Society, July 9-10, 2011. Penalist, Scientific Session: Reconstruction I. 3rd European Plastic Suregery Research Council, Hamburg, Germany, August 26, 2011. Moderator, Breast. 2011 Chang Gung Mayo Clinic Symposium in Reconstructive Surgery, the W Hotel and Chang Gung Linkou Medical Center, Taipei, Taiwan, October 27-30, 2011. Moderator, Oncoplastic Strategies and Techniques. 2012 Taipei International Breast Cancer Symposium & International Oncoplastic Breast Surgery Symposium with the 4th Cross Strait Conference on Breast Cancer Treatment Consensus, Taipei, Taiwan, September 22, 2013. Moderator, The Evolving Partnership of Breast Reconstruction and Radiation: Does it Work? 2012 Taipei International Breast Cancer Symposium & International Oncoplastic Breast Surgery Symposium with the 4th Cross Strait Conference on Breast Cancer Treatment Consensus, Taipei, Taiwan, September 22, 2013. Moderator, Breast Reconstruction. The 4th Asian Symposium of Breast Plastic and Reconstructive Surgery, Xi’an, China, October 12, 2013. Panelist, DIEP Flap Complications. The 3rd World Congress for Plastic Surgeons of Chinese Descent, Xi’an, China, October 13, 2013. Moderator, Breast Reconstruction (II). The 3rd World Congress for Plastic Surgeons of Chinese Descent, Xi’an, China, October 13, 2013. Panelist, Vascularized Lymph Node Transfer for the Treatment of Lymphedema: Controversies in Safety and Efficacy. American Society for Reconstructive Microsurgery, Naples, Florida. January 12-15, 2013. Moderator, Mandible resection and reconstruction in oral cancer surgery, 2013 Annual meeting & international conference of Taiwan head and neck society, Tainan, Taiwan. May 4-5, 2013. Moderator, Vascular Lymph Node Transfer – I. 2013 International Symposium on Surgical Treatment of Lymphedema, Taoyuan, Taiwan, April 10-20, 2013. Moderator, Oral Presentation Section 4. 2013 International Symposium on Surgical Treatment of Lymphedema, Taoyuan, Taiwan, April 10-20, 2013. Moderator, Breast IV Section. 2013 World Society for Reconstructive Microsurgery, Chicago, Illinois. July 11-13, 2013. Panelist, Brest V Section. 2013 World Society for Reconstructive Microsurgery, Chicago, Illinois. July 11-13, 2013. Panelist, Head & Neck V Section. New Classification of Mandibular Defects and Related Reconstruction. 2013 World Society for Reconstructive Microsurgery, Chicago, Illinois. July 11-13, 2013. Panelist, Lymphedema Section. Lymph Node Transfer: Taiwan Style. 2013 World Society for Reconstructive Microsurgery, Chicago, Illinois. July 11-13, 2013. Panelist, New Technologies in Lymphedema 2013 American Society of Plastic Surgeons, San Diego, California, October 11-15, 2013. Panelist, Vascularized Lymph Node Transfer: Taiwan Style. American Society for Reconstructive Microsurgery, Kauai, Hawaii. January 11-14, 2014. Panelist, Midface Panel - Breakout Panel. Maxilla reconstruction. American Society for Reconstructive Microsurgery, Kauai, Hawaii. January 11-14, 2014. Moderator, Pathophysiology of Lymphedema: current evidence. 3rd International Symposium on Lymphedema Surgical Treatment, Barcelona, Spin. March 5, 2014. Moderator, Plenary Lecture. The 2nd Meeting of Asian Pacific Federation of Societies for Reconstructive Microsurgery (APFSRM), Buyeo, Korea, July 4, 2014. Panelist, The Versatility of the Workhorse ALT Flap in Plastic Surgery. 2014 The Plastic Surgery Meeting, Chicago, Illinois, October 11, 2014. Panelist, Lymph node Transfer in the Breast Cancer Patient. 2014 The Plastic Surgery Meeting, Chicago, Illinois, October 14, 2014. Moderator, Best Practice of Breast Conserving Surgery and Reconstruction. The 6th Asian Symposium for Breast Reconstructive Surgery, Bali, Indonesia, October 21, 2014. Panelist, Decision Making in Lymphatic Surgery. 2015 American Society for Reconstructive Microsurgery, Atlantis, Paradise Island, Bahamas. January 24, 2015. Panelist, American Society of Lymphatic Surgery Scientific Session. 2015 American Society for Reconstructive Microsurgery, Atlantis, Paradise Island, Bahamas. January 26, 2015. Panelist, Master Class: Lymphedema. 2015 World Society for Reconstructive Microsurgery, Mumbai, India. March 19 – 22, 2015. Panelist, PDA9 Outcomes in Breast Reconstruction: - Aesthetics & Efficiency. 2015 World Society for Reconstructive Microsurgery, Mumbai, India. March 19 – 22, 2015. Panelist, Training in Microsurgery Part 2 (International Fellowships), World Society for Reconstructive Microsurgery, Mumbai, India. March 19 – 22, 2015. Panelist, Taiwan section. The 30th anniversary of the Korean Society for Aesthetic Plastic Surgery (KSAPS), Seoul, Korea. March 28 – 29, 2015. Panelist, Aesthetic and Reconstructive Surgery of the Breast in Asians: Present and Future. 2015 Mevos International Congress of Aesthetic Surgery, Dalian, China, July 25 – 26, 2015 Panelist, Breast Reconstruction. 2015 Mevos International Congress of Aesthetic Surgery, Dalian, China, July 25 – 26, 2015 Moderator, Breast Reconstruction. 2015 Mevos International Congress of Aesthetic Surgery, Dalian, China, July 25 – 26, 2015 Panelist, Breast Reduction and Mastopexy. 2015 Mevos International Congress of Aesthetic Surgery, Dalian, China, July 25 – 26, 2015 Moderator, Surgical Treatment of Lymphedema. The Chicago Breast & Lymphedema Symposium, Chicago, Illinois, September 19 – 20, 2015 Panelist, Lymph Node Transfer: How & Why I Do It This Way. The Chicago Breast & Lymphedema Symposium, Chicago, Illinois, September 19 – 20, 2015. Panelist, Perineal Reconstruction, Hear from the experts on pelvic and perineal reconstruction. Learn what complications to anticipate and clinical pearls; what works best in their hands. 2015 The Plastic Surgery Meeting, Boston, Massachusetts, October 15 – 20, 2015. Panelist, Decision Making in Lymphatic Surgery. 2016 American Society for Reconstructive Microsurgery, Scottsdale, Arizona, USA. January 16, 2016. Panelist, Lymphatic Surgery: Which Operation for Whom? 2016 American Society for Reconstructive Microsurgery, Scottsdale, Arizona, USA. January 19, 2016. Panelist, Lymphedema: Everything You Ever Wanted To Know? American Association of Plastic Surgeons and Plastic Surgery Research Council Joint Meeting, New York, USA, May 19 – 22, 2016 Panelist, What’s New in Lymphatic Surgery. The Chicago Breast & Lymphedema Symposium, Chicago, Illinois, September 16-17, 2016 Panelist, Lymphedema 1: Knowns and unknowns in lymphatic surgery: Masters' perspectives, 9th Congress of World Society for Reconstructive Microsurgery, Seoul, Korea, June 16, 2017. Panelist, Education in Microsurgery, 9th Congress of World Society for Reconstructive Microsurgery, Seoul, Korea, June 17, 2017. Panelist, Contralateral Breast and Oncoplastic Surgery, Combined Meeting of the 14th Asan Plastic Surgery Symposium and Korean Academic Association of Breast Plastic and Reconstructive Surgery, Seoul, Korea, June 18, 2017. Panelist, Imaging – How I Do It, The first annual Lymphedema Symposium at BIDMC/Harvard Medical School, Boston, USA, November 4, 2017. Panelist, An Algorithmic Approach to Deciding which Lymphedema Surgery a Patient Needs, 2018 American Society for Reconstructive Microsurgery, Phoenix, Arizona, USA. January 14, 2018. Moderator, Pre & Postop Care for Lymphedema Surgery, The Chicago Breast Symposium and 7th World Symposium on Lymphedema Surgery, Chicago, Illinois, April 26, 2018. Panelist, Lymphedema Surgery II, The Chicago Breast Symposium and 7th World Symposium on Lymphedema Surgery, Chicago, Illinois, April 27, 2018. Panelist, Changes in Lymphedema Surgery Over Time, The Chicago Breast Symposium and 7th World Symposium on Lymphedema Surgery, Chicago, Illinois, April 27, 2018. Moderator, Best salvage and best case, The 2018 annual meeting of Asian Society for Breast Plastic and Reconstructive Surgery, Taiwan, Chang Gung Linkou Medical Center, Taoyuan, June 2, 2018. Panelist, Lymphedema Management, International Istanbul Breast Cancer Conference - BREASTANBUL 2018, Istanbul, Turkey, October 13, 2018. Panelist, Reconstruction: Flap Reconstructions, International Istanbul Breast Cancer Conference - BREASTANBUL 2018, Istanbul, Turkey, October 13, 2018 Moderator, Master Class 4: Kotaro Yoshimura. International Annual Meeting of Taiwan Society of Aesthetic Plastic Surgery, Kaoshiung, Taiwan. October 27, 2018. Moderator, Microsurgery (I). 6th WAPSCD & 2018 APPRS & Annual Meeting of Taiwan Society of Plastic Surgery, Taipei, Taiwan. November 29, 2018. Moderator, Lymphedema Updates, Annual Meeting of the Taiwan Society for Reconstructive Microsurgery, Taipei, Taiwan. January 12, 2019. Moderator, Lymphedema Surgery and the Clinical Application of Supermicrosurgery, Hong Kong, February 15, 2019. Panelist, Case Presentations and Panel Discussions-Expert Panel. Lymphedema Surgery and the Clinical Application of Supermicrosurgery, Hong Kong, February 15, 2019. Moderator, Lymphedema Surgery and the Clinical Application of Supermicrosurgery, Hong Kong, February 16, 2019. Moderator, Annual Meeting of the Taiwan Surgical Association, Taipei, Taiwan, March 17, 2019. Panelist, Surgical Technique and Outcomes of Variable Donor Lymph Node Flaps, the 8th World Symposium for Lymphedema surgery, Taiwan, Chang Gung Linkou Medical Center, Taoyuan, April 25, 2019. Moderator, Keynote Lecture, the 8th World Symposium for Lymphedema surgery, Taiwan, Chang Gung Linkou Medical Center, Taoyuan, April 25, 2019. Moderator, Annual Meeting of the Asian Society of Breast Plastic and Reconstructive Surgery, Taiwan, Chang Gung Linkou Medical Center, Taoyuan, April 28, 2019. Moderator. 2nd Annual USC Multi-Disciplinary Approach to Lymphedema and Related Disorders Symposium, Santa Monica, USA, June 8, 2019. Panelist, Lymphoedema, 10th Congress of World Society for Reconstructive Microsurgery, Bologna, Italy, June 13, 2019. Panelist, Current trends in head & neck soft tissue reconstruction, 10th Congress of World Society for Reconstructive Microsurgery, Bologna, Italy, June 13, 2019. Panelist, New technology Head & neck reconstruction in the next decennium: innovation, arts, and controversies. 10th Congress of World Society for Reconstructive Microsurgery, Bologna, Italy, June 15, 2019. Panelist, “What’s New in Lymphedema Surgery”: My Current Approach & Why. 2020 American Society for Reconstructive Microsurgery Annual Meeting, Ft. Lauderdale, Florida, USA. January 10, 2020. Moderator. Extracranial– Intracranial Bypass. 2020 American Society for Reconstructive Microsurgery Annual Meeting, Ft. Lauderdale, Florida, USA. January 12, 2020. Moderator: Breakout panel, Lymphedema Q & A, 2020 Duke Virtual Flap Course Track 1, Webinar, August 1, 2020. Panelist, “EDUCATIONAL SESSION: Improving the current surgical techniques”: Vascularized lymph node flap: How and when? Submental, the 9th World Symposium on Lymphedema Surgery (9th WSLS, HYBERWSLS), online, October 6, 2020. Panelist, “CONTROVERSY SESSION: Postoperative management”: What is my protocol, the 9th World Symposium on Lymphedema Surgery (9th WSLS, HYBERWSLS), online, October 6, 2020. Moderator, Patient Selection and Outcomes in Lymphedema Surgery, Virtual Plastic Surgery The Meeting, Live Stream, October 16, 2020. Panelist, “ASLS/ASRM LYMPHATIC SURGERY UPDATE”, ASRM Virtual Symposium, Live Stream, January 15, 2021. Moderator: Pre and Postop management, Chicago Breast & World Lymphedema Surgery Symposium, Webinar, April 23, 2021. Panelist, “Reconstructive Surgery”, The International Federation of Head and Neck Oncologic Societies Virtual World Tour,I, Zone 4 (East Asia & Oceania), Webinar, July 31, 2021. Panelist, “How to read an ICG lymphangiography”, London Breast Meeting, Parallel Session 1B: Imaging for Microsurgeons, Webinar, Sep 01, 2021. Panelist, “Summary of the 9th World Symposium on Lymphoedema Surgery” London Breast Meeting, What is New in Lymphoedema? Webinar, Sep 02, 2021. Moderator: Mammaplasty Forum 2 , 2021 Taiwan Society of Aesthetic Plastic Surgery International Annual Meeting, Taipei Taiwan, Oct 03, 2021. Panelist, “Recent Advanced in Breast Reconstruction and lymphedema,” 8th Global Chinese Breast Cancer Organizations Alliance Conference, Webinar, Oct 09, 2021. Demand Panel: What is the Ideal Reconstructed Breast? An International Perspective, 2021 The American Society of Plastic Surgeons (ASPS) On, Webinar, Oct 22, 2021 BLS panel: Lymph Node Transplants: How do they work? Boston Lymphatic Symposium, Webinar, Nov 06, 2021 Panelist, “Lymphedema Surgery”, World Association for Plastic Surgeons of Chinese Descent, Webinar, Nov 18, 2021 Moderator: Video and Lecture:講師術前講解術式設計, Taiwan Society of Aesthetic Plastic Surgery, Kaohsiung, Taiwan, Jan 16, 2022. Moderator: Unedited Video Demo:包含術前設計、術中技術示範與講解, Taiwan Society of Aesthetic Plastic Surgery, Kaohsiung, Taiwan, Jan 16, 2022. Panelist, “Enhancing Lymphatic Drainage by Nanofibrillar Collagen Scaffold”, Lymphedema Summit held by the Department of Plastic Surgery, Stanford University, Webinar, Jan 23, 2022. 104. Moderator, Conference VIP Lecture, 2022 Annual Meeting of Taiwan Surgical Association, Taipei, Taiwan, Mar 13, 2022 105. Panelist, “Outcomes of vascularized lymph node transfer in primary and secondary Lymphedema”, Techniques & outcomes of VLNT: when and how?, Update Symposium on Lymphedema Surgery, Webinar, Apr 25, 2022. 106. Panel, “How My Surgical Approach/ Technique have Been Changed Over Time?”, The World Society for Reconstructive Microsurgery, Webinar, Jun 4, 2022. 107. Panel, Approach and Outcomes for Vascularized Lymph Node Transplant”, 8th International Breast Surgery workshop & 4th World Consensus Conference on BIA-ALCL, Webinar, Sep 30, 2022. 108. Panel, “Delayed Lymphatic Reconstruction-LNT”, Plastic Surgery The Meeting, On-Demand, Webinar, Oct 22, 2022. 109. Panel, “Outcome and mechanism of vascularized lymph node transfer”, Surgical treatment in lymphology, 3rd Vienna Lymphology Symposium, Vinna Austria, Nov 26, 2022. 110. Moderator, Invited Speech, 2022 Annual Meeting of Taiwan Society of Plastic Surgery（TSPS）, Taipei, Taiwan, Dec 17, 2022. 111. Moderator, Keynote Lecture I, The 10th World Symposium for Lymphedema surgery, Taiwan, A+ Surgery Clinic, Taipei, April 23, 2024. 112. Moderator, Keynote Lecture II, The 10th World Symposium for Lymphedema surgery, Taiwan, A+ Surgery Clinic, Taipei, April 23, 2024. 113. Debate Panel I, “Single Malt Whisky Versus Cocktail”, Staged Procedures, The 10th World Symposium for Lymphedema surgery, Taiwan, A+ Surgery Clinic, Taipei, April 24, 2024. 114. Panel, “Long-term Outcomes: What is the Best?”, The 10th World Symposium for Lymphedema surgery, Taiwan, A+ Surgery Clinic, Taipei, April 24, 2024. 115. Debate Panel II, “LVA Versus VLNT”, The 10th World Symposium for Lymphedema surgery, Taiwan, A+ Surgery Clinic, Taipei, April 24, 2024. 116. Moderator, LE&RN Testimony, The 10th World Symposium for Lymphedema surgery, Taiwan, A+ Surgery Clinic, Taipei, April 24, 2024. NEW! Vascularized Lymph Node Flap Transfer for Upper and Lower Limb Lymphedema. 2013 American Society of Plastic Surgeons, San Diego, California, October 11-15, 2013. Monitoring Patient-Centered Outcomes Through the Progression of Breast Reconstruction: A Multi-Centered Prospective Longitudinal Evaluation. 2013 American Society of Plastic Surgeons, San Diego, California, October 11-15, 2013. Lymph node transfer Chang Gung Style. 2013 American Society of Plastic Surgeons, San Diego, California, October 11-15, 2013. Lymph node Transfer - Breast Applications. 2014 The Plastic Surgery Meeting, Chicago, Illinois, October 14, 2014. Vascularized Lymph Node Flap Transfer for Upper and Lower Limb Lymphedema. 2014 The Plastic Surgery Meeting, Chicago, Illinois, October 14, 2014. Vascularized Lymph Node Flap Transfer for Upper and Lower Limb Lymphedema. 2015 The Plastic Surgery Meeting, Boston, Massachusetts, October 16, 2015. Lymph node Transfer - Breast Applications. 2015 The Plastic Surgery Meeting, Boston, Massachusetts, October 17, 2015. Advanced lymphatic surgery: How I do it. 9th Congress of World Society for Reconstructive Microsurgery, Seoul, Korea, June 16, 2017. Supermicrosurgery hands-on course, the Department of Plastic Reconstructive Surgery, Chang Gung Memorial Hospital, Linkou, Taiwan, May 5, 2018. Supermicrosurgery hands-on course, the Department of Plastic Reconstructive Surgery, Chang Gung Memorial Hospital, Linkou, Taiwan, November 17, 2018. Supermicrosurgery hands-on course, the Department of Plastic Reconstructive Surgery, Chang Gung Memorial Hospital, Linkou, Taiwan, November 24, 2018. Planning 3D reconstruction in craniofacial surgery, (lecture topic: 3D Planning for EC-IC Arterial Bypass), 10th Congress of World Society for Reconstructive Microsurgery, Bologna, Italy, June 13, 2019. Current Surgical Approach for Upper Extremity Lymphedema, 2020 American Association for Hand Surgery Annual Meeting, Ft. Lauderdale, Florida, USA. January 10, 2020. Workshop: Sewing with the masters, 3rd Vienna Lymphology Symposium, Vinna Austria, Nov 25, 2022. Workshop: Sewing with the masters, 3rd Vienna Lymphology Symposium, Vinna Austria, Nov 26, 2022. Co-chairman, 8th World Symposium for Lymphedema surgery International Workshop or Live Surgery (Live Surgery) Vascularized Submental Lymph Node Transfer, the 8th World Symposium for Lymphedema surgery, Taiwan, Chang Gung Linkou Medical Center, Taoyuan, April 25

Lower Extremity Lymphedema 下肢淋巴水腫：成因與症狀、淋巴水腫診斷、治療方式 Lower Extremity Lymphedema Say Goodbye to Compression Garments after Dr. Cheng's Lymphedema Microsurgery What is lower extremity lymphedema? The lower extremity lymphedema has a 10-49% occurrence in patients who suffer from gynecological cancers with pelvic lymph node dissection and radiation. Higher body mass index, a greater number of pelvic lymph node removal, and radiation are the top risk factors for lower extremity lymphedema caused by parasite infection (Filariasis). Primary lymphedema patients with unknown etiology for symptoms and signs are categorized by their ages of onset as congenital (less than 2 years), lymphedema praecox (2- 35 years), and lymphedema tadar (older than 35 years). The incidence is higher after cancer resection and lymph node dissection in vulva cancer followed by cervical and ovarian cancer. Recently, sentinel lymph node biopsy was selectively applied in gynecological cancer surgery to reduce the lower limb lymphedema. Symptoms of Leg Lymphedema Lymphedema then presents as chronic changes and swelling of the tissue and is often associated with adipogenesis or fibrotic changes in the lower limb as well. 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. It is common for lymphedema patients to experience depression, due to the physical discomfort, emotional distress and lowered quality of life. Diagnosis of Leg Lymphedema Dr. Ming-Huei Cheng developed a Cheng’s Lymphedema Grading tool to assess the severity of extremity lymphedema. Cheng Lymphedema Grading System is currently the most common used measurement, it is based on not only subjective criteria and clear objective findings that could facilitate discussions and meaningful comparison of the treatment proposed. The circumferential measurement is an objective analysis tool to assess the severity of lymphedema commonly by comparing the circumferential differences between the lymphedematous limb and the normal limb. Lymphoscintigraphy, computed tomography (CT), indocyanine green (ICG) lymphography, and magnetic resonance imaging (MRI) are other key diagnostic devices to determine the severity of lymphedema. The lymphoscintigraphy has been reported as the most effective indicator with 96% sensitive and 100% specific conclusion for diagnosing extremity lymphedema. The Taiwan Lymphoscintigraphy Staging systems was published in 2018 at Annals of Surgery. Lymphoscintigraphy computed tomography (CT) magnetic resonance imaging (MRI) indocyanine green (ICG) lymphography Treatment of Lower Extremity Treatments of lymphedema are aimed to control infection, to reduce the swelling of the extremity and to improve the quality of life. Basic treatments of lymphedema start with conservative physical therapy, including manual lymphatic drainage and compression bandage-centered decongestive lymphatic therapy. The efficacy of conservative physical therapy presents only when the patients are compliant with the treatment program. However, it also carries risks of intravascular cancer metastasis and thrombosis formation. Surgical treatments are indicated when first line conservative measures fail and when patients present with late stage disease. There are two main categories of surgical treatment: excisional and physiologic procedures. Excisional procedures are essentially a surgical reduction of excess fibro-adipose tissue in the affected limb while physiologic procedures reconstruct the lymphatic system to improve physiologic drainage. Surgical treatments are also “be cure and control”, the goals of treatment are similarly preventing progression of disease and reducing morbidities. Debulky surgery and circumferential suction-assisted lipectomy can be performed to reduce the severely, non-pitting lymphedematous extremity. More technical demanding surgeries, such as lymphaticovenous anastomosis and Free vascularized lymph node transfer The basic physiologic mechanism of the vascularized lymph node flap is that lymph is absorbed by the transferred lymph nodes and drained into a donor vein through natural lymphaticovenous connections inside a flap. The arterial flow from the recipient artery to the vascularized lymph node flap provides the driving force for venous return and hence, continuous lymph drainage. We report the transfer of a vascularized submental lymph node flap to the ankle is a novel approach for the effective treatment of lower extremity lymphedema. There was no donor site morbidity. At a mean follow-up of 8.7 ± 4.2 months, the mean reduction of the leg circumfer- ence was 64±11.5% above the knee, 63.7±34.3% below the knee and 67.3±19.2% above the ankle. 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 A novel approach to the treatment of lower extremity lymphedema by transferring a vascularized submental lymph node flap to the ankle. Cheng MH, Huang JJ, Nguyen DH, Saint-Cyr M, Zenn MR, Tan BK, Lee CL. Gynecol Oncol. 2012 Jul;126(1):93-8. https://www.ncbi.nlm.nih.gov/pubmed/22516659 Simultaneous Bilateral Submental Lymph Node Flaps for Lower Limb Lymphedema Post Leg Charles Procedure. Ito R, Lin MC, Cheng MH. Plast Reconstr Surg Glob Open. 2015 Sep 15;3(9):e513. https://www.ncbi.nlm.nih.gov/pubmed/26495226 Vascularized lymph node transfer for treatment of extremity lymphedema: An overview of current controversies regarding donor sites, recipient sites and outcomes. Pappalardo M, Patel K, Cheng MH. J Surg Oncol. 2018 Jun;117(7):1420-1431. https://www.ncbi.nlm.nih.gov/pubmed/29572824 Correlation between Quantity of Transferred Lymph Nodes and Outcome in Vascularized Submental Lymph Node Flap Transfer for Lower Limb Lymphedema. Gustafsson J, Chu SY, Chan WH, Cheng MH. Plast Reconstr Surg. 2018 Jul 10. https://www.ncbi.nlm.nih.gov/pubmed/30020232 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

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