This study is being done to see the long-term results for patients who choose to have surgery for lymphedema (with the vascularized lymph node transfer), compared to patients who choose not to have surgery.

Inclusion Criteria:

• Patients aged 18-80 years
• Primary and secondary lymphedema of the upper or lower extremity
• International Society of Lymphology (ISL) Stage 1, 2, or 3 lymphedema
• Proficiency in English language

Exclusion Criteria:

• Patients with clotting disorders, venous insufficiency, end-stage lymphedema unless they are on the non-surgical arm.
• Additionally, if the patient refuses to complete questionnaires, the patient will be excluded from the study and replaced at the discretion of the principal or co-principal investigator.

Patients who present for consultation of their lymphedema and who meet eligibility criteria will be offered the option of enrolling in this study at the time of their initial consultation.