The Homans-Miller procedure, first used in 1936, is a modification of the kondolean_procedure using thin skin flaps to cover the resected area of the lymphodemous limb. The Homans-Miller procedure (1936) is a modification using thin skin flaps to cover the resected area. Using particularly thin skin flaps, Miller was able to achieve an aesthetically pleasing result. Miller elevates an anterior and posterior flap from both a medial and lateral incision, raising flaps approximately 1 cm thick. The underlying lymphedematous tissue is excised down to muscle fascia. The skin flaps are trimmed and sutured into position. Good aesthetic and functional results are obtained with this procedure, which is now considered the standard ablative approach used in the treatment of forearm and upper extremity lymphedema. However, occasionally second or even third operations are required to obtain the maximum benefit. See also: * Lymphedema