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PubMed record Kaeser HE

Chronic elevation can impair fat loss, disrupt sleep, and suppress immune function Elevated prolactin

Phase 4: Beyond Week 16 This is maintenance and optimization

The cornerstone of management is decongestive lymphatic therapy (DLT) , which comprises four main components: Manual lymphatic drainage (MLD) : A specialised massage technique that stimulates lymphatic flow and redirects fluid to functioning lymphatic pathways Compression therapy : Multi-layer bandaging during intensive treatment phases, followed by compression garments for long-term maintenance Skin care : Meticulous hygiene, emollient use, and prompt treatment of skin breaks to prevent cellulitis Exercise : Tailored physical activity programmes that promote lymphatic drainage through muscle pump action whilst wearing compression Patients should be educated about self-management strategies , including daily skin inspection, appropriate exercise, limb elevation when resting, and recognition of cellulitis symptoms (increased warmth, redness, pain, or systemic features such as fever)