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Lipedema, a chronic condition characterized by abnormal fat accumulation in the legs and arms, often leads to significant pain, swelling, and mobility issues. Varicose veins and venous insufficiency can exacerbate these symptoms, making effective treatment even more critical. At Lipedema.net, Dr. Thomas Wright provides comprehensive care to ensure safer surgeries and better outcomes for patients in St. Louis and Missouri.

What is Lipedema?

Lipedema is a chronic condition characterized by the abnormal and symmetrical accumulation of subcutaneous adipose tissue  [fat]  in the legs, arms, and sometimes other body parts. Unlike ordinary obesity, the fat deposits in lipedema are painful or tender and do not respond well to conventional diet and exercise, often remaining unchanged even as other body fat decreases. The condition typically progresses through stages, from mild enlargement of the limbs to more severe cases where mobility is significantly affected. Lipedema is also marked by a tendency to bruise easily and may include symptoms such as fibrosis, which is a thickening and hardening of tissue. While it is believed to have a genetic component, lipedema almost exclusively affects women and is often linked to hormonal changes associated with puberty, pregnancy, or menopause. Coexisting conditions such as lymphedema, swelling due to lymph fluid buildup, and venous insufficiency are common.

Understanding the Complications of Varicose Veins and Venous Insufficiency

Varicose veins and venous insufficiency are common issues that can significantly worsen the symptoms of lipedema. These conditions lead to increased pain and swelling, further aggravating the swelling in lipedema-affected legs. Studies have shown a higher prevalence of varicose veins in women with lipedema, often due to vascular leaking as part of the pathology.

Understanding Venous Insufficiency

An individual who presents with venous insufficiency is experiencing a problem related to blood flow. Veins are designed always to carry blood back to the heart, but sometimes, veins experience valve malfunctions. When this happens, blood intended to go in one direction flows the opposite, creating a pooling effect in the veins most often situated within extremities. Severe medical issues can follow as veins dilate with the strain of misdirected blood.  This increased venous pressure in turn increases the interstitial pressure in the subcutaneous tissue, leading to inflammation and, eventually, fibrosis in the subcutaneous tissue. The development of varicose veins is closely linked to venous insufficiency and can be painful and aesthetically displeasing for many people. Varicose veins tend to bulge at the surface, often in shades of blue or purple. Individuals suffering from varicose veins often experience painful symptoms, including swelling, warmth, redness, achiness, and fatigue.

A step beyond varicose veins is the potential for patients to develop deep vein thrombosis (DVT). In this scenario, venous insufficiency leads to the development of blood clots that have the potential to break free and cause a pulmonary embolism. The risk of heart attack and stroke is also increased for those diagnosed with DVT.

Impact on Pain and Swelling

Varicose veins not only increase pain and swelling but also contribute to the progression or worsening of lipedema. Even in cases where lipedema does not worsen, varicose veins and venous insufficiency can lead to increased knee pain, leg pain, heaviness, and swelling. Addressing these issues is essential to improving the quality of life for lipedema patients.

Risk of Deep Vein Thrombosis (DVT)

One critical factor in treating varicose veins in lipedema patients is the risk of Deep Vein Thrombosis (DVT). Women with lipedema have double the risk of developing DVT, with or without venous insufficiency. When venous insufficiency is present, this risk doubles again. This increased risk makes it imperative to manage venous health proactively.

What is Deep Vein Thrombosis?

Deep vein thrombosis is a very serious condition caused when a blood clot forms in a vein that is located deep inside your body. This blood clot is a cluster of solidified blood, similar to the blood you see clotting and beginning to harden when you have a cut or scratch. Clots can be caused by damaged blood vessel walls that narrow and block blood flow and cause clumping, but it can also be the result of damaged vessels from surgery, the lack of body movement for long periods of time, or other personal medical conditions that affect efficient and healthy blood flow. 

Whatever the reason for blood clot formation, it ultimately becomes problematic when it blocks a vein deep in your body and prevents blood from properly circulating. This can cause extremely serious and dangerous medical conditions, such as a pulmonary embolism. In this case, the clot moves from one location, such as the arm or leg, into the lung. The condition can become life-threatening once the clot begins to block lung vessels. 

These blood clots in deep veins are usually seen in the legs, particularly in the thigh or lower leg. However, they can develop in other areas of the body as well. The Centers for Disease Control and Prevention (CDC) notes that about half of those who have DVT will experience symptoms, while the other half will be unaware of their condition. For this reason, many patients who know they have vein issues have become worried about vaccination. Symptoms may be different based on the area of the clot.

Bleeding Risks and Surgical Complications

Varicose veins pose a significant bleeding risk, as they can bleed on their own and cause severe episodes requiring emergency medical attention. During surgery, these veins can lead to increased blood loss and may even necessitate blood transfusions. Dr. Wright’s practice emphasizes the importance of treating venous insufficiency fully before any lipedema surgery, greatly reducing the risk of significant blood loss and ensuring safer surgical outcomes.

Dr. Wright’s Approach to Treating Venous Insufficiency in Lipedema Patients

Dr. Thomas Wright’s expertise in managing venous insufficiency is a cornerstone of his practice. He ensures that all venous insufficiency is treated comprehensively before proceeding with any surgical intervention for lipedema. This proactive approach minimizes the risks associated with surgery, including excessive blood loss and complications related to untreated varicose veins.

Treatment Options

The Importance of Comprehensive Care

Managing lipedema requires a holistic approach that addresses all contributing factors to ensure the best possible outcomes. By treating venous insufficiency first, Dr. Wright reduces the risks associated with surgery and improves overall patient health. His meticulous care has resulted in almost no incidents of significant blood loss in thousands of surgeries performed, demonstrating the effectiveness of his approach.

Conclusion

At Lipedema.net, Dr. Thomas Wright is dedicated to providing comprehensive, minimally invasive treatments for lipedema and related venous issues. He ensures safer procedures and better patient outcomes by addressing varicose veins and venous insufficiency before surgery. If you are struggling with lipedema and its complications, contact Dr. Wright’s St. Louis practice today to explore your treatment options and take the first step towards improved health and well-being.

For more information and to schedule a consultation, visit www.lipedema.net.

Keywords: St. Louis lipo, liposuction near me, St. Louis cosmetic surgery, liposuction treatment, minimally invasive plastic surgery, fat transfers, skin tightening, lipedema reduction surgery.

Lipedema Awareness Month: Raising Awareness and Advocating for Proper Diagnosis and Treatment

June is a significant month for the Lipedema community as it marks Lipedema Awareness Month, with World Lipedema Day celebrated on June 11. This month is dedicated to increasing awareness about lipedema, a chronic condition that affects millions of women worldwide. Despite its prevalence, lipedema remains underdiagnosed and misunderstood. At Lipedema Surgical Solutions, we are committed to spreading awareness, educating the public, and supporting those affected by lipedema.

Understanding Lipedema

Lipedema is a chronic condition characterized by the abnormal and symmetrical accumulation of subcutaneous adipose tissue  [fat]  in the legs, arms, and sometimes other body parts. Unlike ordinary obesity, the fat deposits in lipedema are painful or tender and do not respond well to conventional diet and exercise, often remaining unchanged even as other body fat decreases. The condition typically progresses through stages, from mild enlargement of the limbs to more severe cases where mobility is significantly affected. Lipedema is also marked by a tendency to bruise easily and may include symptoms such as fibrosis, which is a thickening and hardening of tissue. While it is believed to have a genetic component, lipedema almost exclusively affects women and is often linked to hormonal changes associated with puberty, pregnancy, or menopause. Coexisting conditions such as lymphedema, swelling due to lymph fluid buildup, and venous insufficiency are common.

Why Lipedema is Under-diagnosed

Lipedema is often misdiagnosed as obesity or lymphedema due to its similar appearance. This misdiagnosis can delay proper treatment and exacerbate symptoms. The lack of awareness among healthcare professionals and the general public contributes to the underdiagnosis of lipedema. Many women struggle for years without receiving a correct diagnosis, leading to frustration and worsening health outcomes. 

Awareness and recognition of lipedema is poor in the public and among medical professionals, which leads to some women who have lipedema not being diagnosed with lipedema.  The opposite can occur.  Not everyone with large legs and ankle cuffs and who appears to have lipedema disease suffers from it. Several other conditions and diseases can mimic the appearance of lipedema, making accurate diagnosis essential for effective treatment.  Misdiagnosis of lipedema leads to improper treatment, so it is important to be careful and thorough. 

Spreading Awareness and Advocating for Proper Diagnosis

Women with lipedema can take several steps to spread awareness and advocate for themselves:

  1. Educate Yourself and Others: Learn about lipedema and share information with friends, family, and healthcare providers. Utilize resources from reputable organizations such as Lipedema Surgical Solutions and Lipedema UK.
  2. Seek Specialist Care: If you suspect you have lipedema, consult a specialist experienced in diagnosing and treating the condition. In St. Louis, MO, Dr. Wright is a leading expert in lipedema treatment.
  3. Join Support Groups: Connect with others affected by lipedema through support groups and online communities. Sharing experiences can provide emotional support and valuable information.
  4. Participate in Awareness Events: During Lipedema Awareness Month, engage in events to learn more about the condition and support the community.

Attend Dr. Wright’s Speaker Series

Join Dr. Wright this June for informative events to foster a greater understanding of lipedema and its treatment. These events are an excellent opportunity to learn from experts and connect with community members.

Lipedema.net: Your Primary Information Hub

Lipedema.net is a comprehensive resource for anyone seeking detailed information about lipedema. The website features:

Dr. Wright’s YouTube Channel: Visual Learning and Community Engagement

Dr. Wright’s YouTube channel, Lipedema Info, offers:

Lipedema Group – Lipedema.net: A Facebook Community

The Lipedema Group – Lipedema.net on Facebook is a supportive community offering:

Instagram: A Glimpse into Real-life Experiences

Dr. Wright’s Instagram page, @lipedemasurgicalsolutions, provides:

Pinterest: Educational Resources and Inspiration

Dr. Wright’s Pinterest page, Laser Lipo Vein, offers:

Join Our Lipedema Community – You Aren’t Alone!

Living with lipedema can be challenging, but with the right resources and support, managing the condition becomes significantly easier. From comprehensive information hubs like Lipedema.net to engaging social media platforms, numerous avenues exist for education, support, and community. Dr. Wright’s dedication to providing resources highlights the growing awareness and support for those battling lipedema.

Remember, while online resources are invaluable, they should complement, not replace, professional medical advice. Always consult with healthcare professionals for personalized medical guidance and treatment plans.

Contact Lipedema Surgical Solutions

If you or someone you know is struggling with symptoms of lipedema, don’t hesitate to seek help. Contact Lipedema Surgical Solutions online for guidance on understanding lipedema, obtaining a proper diagnosis, and exploring treatment options. Our team, led by Dr. Wright, is dedicated to providing comprehensive care and support for women with lipedema.

Keywords: Lipedema, Lipedema Treatment, St. Louis MO Lipedema Specialists, Dr. Wright St. Louis, Lipedema Awareness Month, World Lipedema Day

By spreading awareness and advocating for proper diagnosis and treatment, we can improve the lives of those affected by lipedema. Let’s work together to make a difference this Lipedema Awareness Month and beyond.

  

Misdiagnosis of  Lipedema: Diseases That Look Like Lipedema

Lipedema is a complex and often misunderstood condition characterized by the abnormal accumulation of fat in the legs and arms.  Awareness and recognition of lipedema is poor in the public and among medical professionals which leads to some women who have lipedema not being diagnosed with lipedema.  The opposite can occur.  Not everyone who has large legs and ankle cuffs and appears to have lipedema disease actually suffers from it. There are several other conditions and diseases that can mimic the appearance of lipedema, making accurate diagnosis essential for effective treatment.  Mis-diagnosis of lipedema leads to improper treatment so it is important to be careful and thorough. 

What is Lipedema?

Lipedema is a chronic condition characterized by the abnormal and symmetrical accumulation of subcutaneous adipose tissue  [fat]  in the legs, arms, and sometimes other body parts. Unlike ordinary obesity, the fat deposits in lipedema are painful or tender and do not respond well to conventional diet and exercise, often remaining unchanged even as other body fat decreases. The condition typically progresses through stages, from mild enlargement of the limbs to more severe cases where mobility is significantly affected. Lipedema is also marked by a tendency to bruise easily and may include symptoms such as fibrosis, which is a thickening and hardening of tissue. While it is believed to have a genetic component, lipedema almost exclusively affects women and is often linked to hormonal changes associated with puberty, pregnancy, or menopause. Coexisting conditions such as lymphedema, which involves swelling due to lymph fluid buildup, and venous insufficiency are common. 

The Challenge of Diagnosis

Diagnosing lipedema is not straightforward. It cannot be done solely by looking at photos or observing symptoms, as several other conditions look similar. Accurate diagnosis requires a comprehensive medical history, thorough physical examination, and often, diagnostic testing. Unlike other medical conditions, no blood or objective laboratory test can definitively diagnose lipedema.


Getting a diagnosis for lipedema involves several steps, primarily because it’s often misunderstood and can be confused with other conditions like obesity or lymphedema. Here’s a typical process for obtaining a lipedema diagnosis:

  1. Medical History Review: The first step is a thorough review of the patient’s medical history. This includes discussing symptoms, family history of similar issues, and any changes in the condition related to life events such as puberty, pregnancy, or menopause since lipedema is known to be hormonally influenced.
  2. Physical Examination: A healthcare provider, often a specialist in lymphatic disorders, will perform a physical examination. They look for the typical pattern of fat accumulation (symmetrical and sparing the feet and hands), skin texture changes, such as subcutaneous spheroids, and signs of pain or bruising. Part of the exam must include a test for nonpitting and pitting edema. This includes The Bjork or Bow Tie test, testing the texture of the skin with light pressure, and a Stemmers test on the feet and hands. 
  3. Symptom Assessment: The provider will assess symptoms like pain, tenderness, and easy bruising in the fatty areas, which are characteristic of lipedema.
  4. Ruling Out Other Conditions: Since no specific test can definitively diagnose lipedema, part of the diagnosis process involves ruling out other conditions. This may include tests for lymphedema (such as lymphoscintigraphy), venous insufficiency (using Doppler ultrasound), and sometimes heart or kidney conditions that can also cause limb swelling.
  5. Specialist Consultations: Patients might be referred to various specialists, including those skilled in vascular medicine, dermatology, or bariatric specialists, to further analyze symptoms and eliminate other potential causes.
  6. Imaging Tests: In some cases, imaging tests such as MRI, ultrasound, or CT scans can be used to observe the distribution of fat and check for other abnormalities.
  7. Lipedema Staging: If lipedema is diagnosed, the doctor may stage the disease based on its severity and progression. Staging helps in planning appropriate treatment and management.
  8. Educational Resources and Support: Patients are often provided with information about the condition and directed towards support groups and resources to help manage the emotional and physical impacts of lipedema.

Getting a correct diagnosis of lipedema can be challenging due to a general lack of awareness about the condition even among medical professionals. Patients might need to consult with multiple healthcare providers before receiving an accurate diagnosis.

Common Lipedema Disease Lookalikes

Here are some conditions that can be confused with lipedema:

Other Lipomatosis and Fat Disorders:

Vascular and Lymphatic Conditions:

Endocrine Diseases:

Importance of Differential Diagnosis

The need to differentiate lipedema from these lookalikes is crucial. Misdiagnosis can lead to inappropriate treatments, which may not only fail to help but could potentially cause harm. For instance, treatments beneficial for lipedema, like certain types of massage or compression, may not be appropriate for conditions like Dercum’s disease.

Diagnostic Steps and Testing

To rule out other conditions, healthcare providers might recommend various tests such as:

Patients and healthcare providers must be thorough in the diagnostic process to ensure that the treatment plan is appropriate for the actual condition.

Conclusion

Recognizing that not every case of apparent lipedema is indeed a critical step in getting correct care. Patients who are misdiagnosed often experience frustration due to ineffective treatments and poor outcomes. By understanding and identifying lipedema lookalikes, patients can be directed toward the proper care and management they truly need.

For more visual understanding, watch this informative video that discusses the complexities of diagnosing conditions that mimic lipedema.

Through careful examination and consideration of all possible conditions, healthcare providers can ensure accurate diagnoses and effective treatment plans, ultimately leading to better patient health outcomes.

Lipedema, a chronic condition marked by the disproportionate accumulation of fat in the legs and arms, has perplexed and challenged the medical community for decades. Originating from the pioneering observations of Drs. Allen and Hines in 1940, the journey of lipedema treatment has evolved dramatically, from rudimentary recommendations of diet and compression stockings to groundbreaking surgical interventions. Dr. Wright’s upcoming talk with the Fat Disorders Resource Society (FDRS) from April 19-21 promises to shed light on this transformative journey and highlights the innovative strides in treating this often misunderstood disease.

Understanding Lipedema and Its Challenges

Lipedema, characterized by pain, swelling, and an increased susceptibility to bruising, has long posed significant challenges in diagnosis and management. Traditional management strategies, while providing relief, often fell short of addressing the progressive nature of lipedema, leading many to live with unresolved pain and mobility issues. The condition’s overlap with lymphedema further complicated treatment approaches, necessitating a nuanced understanding of the lymphatic system’s involvement.

The Tumultuous Road to Surgical Innovation

The 1990s marked a pivotal era in lipedema treatment. The introduction of the tumescent liposuction technique by Dr. Jeff Klein, which minimized blood loss and reduced surgical risks, set the stage for a new therapeutic approach. Dr Gerhard Sattler spent time with Dr Klein, bringing the new techniques to Germany. Dr. Gerhard Sattler’s pioneering efforts, alongside his colleagues, Drs. Stefan Rapprich and Manuel Cornely demonstrated the potential of liposuction in providing significant relief for lipedema patients. Despite early successes, concerns regarding potential lymphatic damage loomed, sparking heated debates within the medical community. The first abstract publication of the surgical reduction of lipedema was in 2002 from the Paris Dermatology Conference. 

Navigating Through Controversy Towards Acceptance

Lymphologists who focus on diagnosing and treating lymphedema were concerned with surgery for lipedema-causing lymphedema. Surgery, Trauma, and Radiation therapy can cause lymphedema. Lipedema women have an increased risk of developing lymphedema. The lymphologists who were treating lymphedema patients caused by liposuction and related surgeries were up in arms about the potential for lipedema surgery to cause more lymphedema. The controversy surrounding liposuction for lipedema underscored the need for meticulous technique and a deeper understanding of lymphatic anatomy. Studies conducted in the late 1990s and early 2000s meticulously examined the effects of liposuction on the lymphatic system, eventually paving the way for techniques that preserved lymphatic integrity while effectively reducing lipedema symptoms.

FDRS: Advocates for Lipedema Awareness and Treatment

The Fat Disorders Resource Society (FDRS) has been instrumental in advancing the cause of individuals suffering from lipedema and related conditions. By fostering education, research, and advocacy, FDRS plays a critical role in raising awareness, improving patient outcomes, and supporting the development of effective treatments. Dr. Wright’s collaboration with FDRS underscores a shared commitment to enhancing the quality of life for those affected by fat disorders through education and innovative care.

Lipedema Liposuction: A New Dawn

The evolution of lipedema treatment through liposuction, particularly lymph-sparing techniques, represents a significant leap forward. Early adopters of these methods demonstrated remarkable improvements in symptoms, reduced need for ongoing conservative treatments, and a marked enhancement in patients’ quality of life. These findings, bolstered by subsequent studies, underscore liposuction’s role as a viable, long-term solution for managing lipedema.

The Legacy of Dr. Wright and FDRS in Lipedema Care

Dr. Wright’s upcoming talk with FDRS is more than a historical overview of lipedema treatment; it’s a testament to the relentless pursuit of better outcomes for lipedema patients. By highlighting the journey from conservative management to surgical innovation, Dr. Wright emphasizes the importance of continued research, patient education, and multidisciplinary collaboration in tackling lipedema.

Through this dialogue, Dr. Wright and FDRS aim to empower patients and healthcare professionals alike, offering hope and direction in the ongoing battle against lipedema. The discussion will not only explore the milestones in lipedema treatment but also illuminate the path forward, emphasizing the necessity of accessibility to effective treatments and the ongoing need for advocacy and support.

A Call to Action for Continued Progress

As we anticipate Dr. Wright’s insightful presentation, it is crucial to recognize that the journey of lipedema care is far from complete. The collaboration between healthcare professionals and organizations like FDRS highlights the dynamic nature of lipedema research and treatment, underscoring the need for continued vigilance, innovation, and compassion in addressing this condition.

Armed with knowledge and support, Lipedema patients can navigate their treatment options with greater confidence, advocating for care that not only alleviates symptoms but also enhances their overall well-being. The dialogue between Dr. Wright and FDRS serves as a beacon of hope, driving home the message that significant strides in lipedema care are possible and within reach with perseverance and collaboration.

Conclusion

The history of treating lipedema is a narrative of challenge, innovation, and hope. Dr. Wright’s forthcoming talk with FDRS promises to be a profound exploration of this journey, shedding light on the milestones that have shaped lipedema care and the promising horizon of treatments. As we look forward to this event, let us rally behind the ongoing efforts to improve the lives of those affected by lipedema, inspired by the knowledge that together, we can make a difference. Through education, research, and advocacy, we can continue to push the boundaries of what is possible in lipedema treatment, ensuring that every individual has access to the care and support they deserve.

Navigating the healthcare system can be a daunting task, especially when seeking treatment for conditions like lipedema. Recognized for its complexity and often misdiagnosed, lipedema is a chronic condition characterized by an abnormal accumulation of fat cells in the legs and arms, leading to pain, swelling, and mobility issues. As we observe World Lymphedema Day in March, it’s an opportune time to shed light on the importance of understanding and managing lipedema, including the critical aspect of securing insurance coverage for its treatments.

Understanding Lipedema and Its Treatment

Lipedema is often misunderstood and can be mistaken for obesity or lymphedema, but it’s a distinct condition requiring specific treatment approaches. Key treatments include conservative methods like manual lymphatic drainage, compression therapy, and carefully tailored exercise programs. In more advanced cases, liposuction and lymph-sparing procedures are recommended to remove the diseased fat cells and alleviate symptoms.

The Challenge of Insurance Coverage

One of the most significant hurdles for patients with lipedema is getting insurance companies to cover the cost of surgeries. Many insurers classify lipedema surgery as cosmetic rather than medically necessary, leaving patients to bear the financial burden. However, with persistence, the right approach, and armed with evidence, it’s possible to secure coverage for these essential procedures.

Step-by-Step Guide to Getting Insurance to Cover Lipedema Surgeries

1. Understand Your Insurance Policy

Begin by thoroughly reviewing your insurance policy to understand what treatments and surgeries it covers.  You will need to look at your insurance plan’s summary of plan benefits. You can obtain a copy of the plan summary through your insurance portal or your employer’s HR [ Human Resource ] representative. Look for exclusion for cosmetic surgeries as they often lump lipedema surgery in with cosmetic surgery.  Look for any clauses related to chronic conditions, obesity-related treatments, and reconstructive surgeries. Also, look for exclusion for special services. Knowing the ins and outs of your policy will help you build a strong case for coverage.

2. Understand Medical Necessity Criteria

If you have coverage, each insurance company has different medical necessity criteria that must be met for the company to even consider approving prior authorization.  Often, these requirements include a certain BMI (or previous bariatric surgery with weight loss or medically supervised weight loss program) and trial of conservative measures, including the medial grade compression use, exercise, and manual lymph drainage.  Some also include functional assessment of disability, intermittent pneumatic compression pumps, and secondary diagnosing physicians.  

3. Rule Out Other Conditions

Getting a proper diagnosis is crucial. Several other diseases need to be excluded, including other lipomatosis [fat diseases such as Dercum’s and Madelung’s disease], lymphedema, and venous diseases such as pelvic venous compression. Several of the venous diseases that can look like lipedema should be excluded with a venous Doppler ultrasound and another test if indicated.  Sometimes lipedema can coexist with obesity and/or lymphedema and/or venous disease. Each disease needs a different treatment. Failure to recognize the associated diseases can cause ineffective treatment and frustrated patients. 

4. Consult With Specialists

Consult with specialists, who are experienced and knowledgeable about lipedema. These professionals can provide detailed assessments, treatment plans, and supporting letters that emphasize the medical necessity of the surgery. Their expert opinions can be influential in convincing insurance companies of the need for coverage.  Generally, these are vascular/venous and lymphatic specialists who focus on lipedema and lymphedema.

5. Prepare a Detailed Treatment Plan

Detailed documentation of treatment is essential, including conservative treatments attempted, their outcomes, and the rationale for surgery. This plan should illustrate the comprehensive approach to managing your lipedema and why surgery is recommended.

Work with your healthcare provider to gather medical records, diagnostic tests, and letters of necessity. These documents clearly state that the surgery is essential for your health and not merely for cosmetic purposes.

6. Submit to insurance

If you are planning to use insurance, your surgeon should submit all of your documentation to your health insurance for “ prior authorization” ahead of your surgery. 

7. Appeal Denials

If your initial claim is denied, don’t lose hope. Many patients succeed upon appeal. Carefully review the insurance company’s reason for denial and address these points in your appeal letter. Include additional documentation and expert opinions if necessary. Persistence is key, as several rounds of appeals may be required.  Your surgeon can appeal the ruling.  

You may consider using an additional resource such as an ERISA attorney, insurance advocate or a patient advocate.  If you decide to use a patient advocate – be careful! 

In the United States, there is an unregulated space where people describe themselves as patient advocates.

While some of these self-appointed patient advocates are helpful and ethical, other self-appointed advocates are duplicitous and attack patients and providers who do not recommend or refer for their costly services.  

Reach Out For Help Today!

Securing insurance coverage for lipedema surgery is a challenging but not insurmountable task. It requires patience, thorough preparation, and a proactive approach. As we recognize World Lymphedema Day, let’s also acknowledge the importance of advocating for comprehensive care and support for those living with lipedema. By following the steps outlined above and leveraging available resources, you can increase your chances of getting insurance to cover your lipedema surgeries, paving the way for a healthier and more comfortable life.

Remember, your health is worth fighting for. With the right strategy, persistence, and support, you can navigate the complexities of insurance coverage for lipedema treatment and take a significant step toward managing your condition effectively.

 

In the ongoing battle against lipedema, a condition that affects millions of women worldwide, patients and specialists alike are in constant search for effective treatments. Lipedema, characterized by the abnormal accumulation of fat cells in the legs, arms, and other body parts, can lead to pain, swelling, and mobility issues. Dr. Wright, a leading lipedema surgeon based in St. Louis, is at the forefront of exploring innovative treatments to help those suffering from this challenging condition. One such promising treatment is Ozempic, a medication primarily known for its benefits in weight management. While not specifically studied for lipedema, emerging evidence and patient reports suggest it might relieve some individuals struggling with this condition.

Understanding Ozempic

Ozempic, a brand name for the drug semaglutide, is an injectable medication originally approved for the treatment of type 2 diabetes. It works by mimicking a hormone that regulates blood sugar, satiety, and the slowing down of gastric emptying. In recent years, its weight loss benefits have gained significant attention, leading to its use in managing obesity and related conditions.

The Connection to Lipedema

Lipedema is a complex condition; effective management often requires a multifaceted approach. The condition is not just about excess fat but also inflammation and pain. Here’s where Ozempic steps into the picture. While primarily used for weight loss, Ozempic also has properties that reduce adipose inflammation. These two effects – weight management and the reduction of inflammation – are crucial in lipedema.

Weight Management

Many individuals with lipedema struggle with weight control despite maintaining a healthy lifestyle. The stubborn fat associated with lipedema does not respond well to conventional weight loss methods, including diet and exercise. Ozempic’s ability to aid in weight loss presents a glimmer of hope for those who have found little success with traditional methods. By reducing the volume of lipedema fat, Ozempic could alleviate some of the pressure and discomfort in the affected limbs.

Reduction of Adipose Inflammation

Lipedema is not just a cosmetic issue; it’s a painful condition often accompanied by significant inflammation. This inflammation can exacerbate the pain and swelling associated with lipedema. Ozempic’s anti-inflammatory properties might help reduce this condition, relieving many sufferers.

Dr. Wright’s Perspective on Ozempic and Lipedema

Dr. Wright, a renowned lipedema surgeon in St. Louis, has observed the potential benefits of Ozempic in managing lipedema. According to Dr. Wright, while Ozempic has not been studied explicitly for lipedema, there are encouraging reports from patients who have experienced improvements in their symptoms. These improvements include weight reduction in lipedema areas, decreased inflammation, reduced pain, and better mobility.

Patient Reports and Observations

Most of the prescriptions for Ozempic in lipedema come from primary care physicians, not directly from lipedema specialists. Patients have reported a decrease in the size of lipedema fat deposits and improvements in related habits such as smoking, drinking, and nail-biting. This suggests that Ozempic’s benefits extend beyond the direct treatment of lipedema, potentially improving overall health and well-being.

Considerations and Side Effects

As with any medication, Ozempic comes with potential side effects. Some patients may experience nausea, muscle loss, constipation, and other discomforts. It’s crucial for individuals considering Ozempic for lipedema to consult with a healthcare provider, preferably one familiar with lipedema, to weigh the benefits against the possible risks. Dr. Wright emphasizes the importance of a tailored approach, taking into account each patient’s specific circumstances and health profile.

The Future of Ozempic in Lipedema Treatment

The exploration of Ozempic as a treatment for lipedema is still in its early stages. More research and clinical studies are needed to understand its efficacy and safety fully. However, the anecdotal evidence and preliminary observations by specialists like Dr. Wright offer a hopeful outlook for many who have struggled to find relief from lipedema’s debilitating effects.

A Holistic Approach to Lipedema Care

Dr. Wright advocates for a comprehensive approach to managing lipedema, incorporating lifestyle modifications, specialized treatments, and, when appropriate, medications like Ozempic. The goal is to address the physical symptoms of lipedema and the psychological and emotional challenges that often accompany the condition.

Conclusion

For women suffering from lipedema, the journey to finding effective treatment can be long and fraught with frustration. The potential of Ozempic to aid in weight management and reduce inflammation presents a promising avenue for research and treatment. Dr. Wright, a leading figure in St. Louis lipedema treatment, continues to monitor and evaluate the benefits of Ozempic and other emerging treatments for lipedema. While Ozempic may not be a cure-all, it could be a valuable component of a comprehensive treatment plan for some individuals with lipedema. As with any medical treatment, it’s essential to consult with a healthcare provider to determine the best course of action for your specific needs.

In the quest to improve the quality of life for those with lipedema, Ozempic represents a potential tool in the arsenal against this challenging condition. With ongoing research and patient feedback, we hope treatments like Ozempic will bring us one step closer to effective management and relief for those affected by lipedema.

Lipedema is a chronic condition predominantly affecting women, characterized by abnormal fat accumulation in the legs and arms. It can be a confusing and often misdiagnosed condition, leading many to feel lost in their search for information and support. However, the internet has become a haven for resources, offering extensive information and a sense of community for those affected by lipedema. This blog will explore the wealth of resources available to women with lipedema, including the website lipedema.net, Dr. Wright’s YouTube channel, Facebook group, Instagram, and Pinterest pages, each offering unique insights and support for this condition.

Lipedema.net: Your Primary Information Hub

Lipedema.net is an excellent starting point for anyone seeking comprehensive information about lipedema. This website is an extensive resource, providing detailed insights into the nature of the disease, symptoms, diagnosis, and treatment options. It offers:

Dr. Wright’s YouTube Channel: Visual Learning and Community Engagement

For those who prefer video content, Dr. Wright’s YouTube channel, Lipedema Info, is a treasure trove of information. The channel features:

Lipedema Group – Lipedema.net: A Facebook Community

The Lipedema Group – Lipedema.net on Facebook is a vibrant community where members can find support and share experiences. This group offers:

Instagram: A Glimpse into Real-life Experiences

Dr. Wright’s Instagram page, @lipedemasurgicalsolutions, is a visually engaging platform providing insights into the treatment and management of lipedema. Here, you can find:

Pinterest: Educational Resources and Inspiration

Lastly, Dr. Wright’s Pinterest page, Laser Lipo Vein, is an excellent resource for educational material and inspiration. This platform offers:

Join Our Lipedema Community – You Aren’t Alone!

Living with lipedema can be challenging, but with the right resources and support, managing the condition becomes significantly easier. From comprehensive information hubs like lipedema.net to engaging social media platforms like YouTube and Instagram, numerous avenues exist to explore for education, support, and community. Dr. Wright’s dedication to providing a wealth of resources across these platforms highlights the growing awareness and support for those battling lipedema. By leveraging these resources, women with lipedema can empower themselves with knowledge, find comfort in shared experiences, and remain updated on the latest in lipedema care and research.

Remember, while online resources are invaluable, they should complement, not replace, professional medical advice. Always consult with healthcare professionals for personalized medical guidance and treatment plans.

If you or someone you know is dealing with lipedema, we encourage you to explore these resources. Visit lipedema.net, subscribe to Dr. Wright’s YouTube channel, join the Facebook group, follow the Instagram page, and check out the Pinterest boards. Each platform offers unique perspectives and support, providing a comprehensive toolkit to understand and manage lipedema effectively. Join this growing community today and take a step forward in your journey toward wellness and empowerment.

Lipedema is a chronic and progressive disease that primarily affects women. It is often misdiagnosed as obesity or primary lymphedema, leading to a lack of understanding and appropriate treatment options. Lipedema’s physical and psychological consequences significantly impact the quality of life of those who suffer from it. This comprehensive guide will delve into women’s experiences with lipedema, highlighting their challenges and the importance of providing adequate care and support.

What is Lipedema?

Lipedema is characterized by the abnormal deposition of subcutaneous adipose tissue, primarily in the lower body parts, such as the buttocks and legs. This adipose disease is of unknown etiology and tends to manifest during or after puberty, although it can also occur in connection with pregnancy or menopause. The accumulation of fat and fibrous tissue leads to bilateral swelling and enlargement, causing discomfort, bruising, severe pain, and limited mobility. Unfortunately, the progression of lipedema varies greatly, making it challenging to predict and control.

Conservative therapy, which focuses on patient education, weight control, manual lymphatic drainage therapy, and compression therapy, is commonly used to manage lipedema. Surgical interventions, such as liposuction, may be necessary in some cases. However, there are no easy solutions for treating lipedema, and further research is needed to develop more effective interventions.

The Impact on Quality of Life: Physical and Psychological Morbidity

Living with lipedema has a profound effect on the quality of life of women. The physical symptoms, including pain, fatigue, and limited mobility, significantly hinder their daily activities and overall well-being. Women with lipedema often describe their bodies as burdensome, feeling controlled and hindered by the swelling and pain they experience. The constant pain and discomfort can lead to exhaustion and a sense of helplessness.

Furthermore, the psychological impact of lipedema should not be overlooked. Women with lipedema often face fat-shaming and negative judgments from others, which affects their self-esteem and body image. They may feel unattractive and struggle with intimacy and sexual activity. The changes in their bodies, such as the appearance of loose and bumpy skin, pose additional challenges regarding hygiene and self-care. The lack of understanding and support from healthcare professionals further exacerbates their emotional distress.

Seeking Professional Care: Challenges and Unsatisfactory Advice

Women with lipedema frequently seek medical help to address the changes in their bodies and the increasing pain they experience. However, obtaining an accurate diagnosis can be a lengthy and frustrating process. Many women have encountered healthcare professionals who lack knowledge about lipedema, leading to misdiagnosis or dismissive attitudes. Instead of receiving appropriate care, they are often advised to engage in weight loss exercises or visit physiotherapists and dietitians without addressing the underlying lipedema.

Women with lipedema often take matters into their own hands, researching and gathering information to understand their condition better. Some find the diagnosis themselves and present it to their doctors, only to face skepticism and hurtful comments. The lack of awareness and understanding among healthcare professionals contributes to feelings of isolation and a lack of support for women with lipedema.

The Need for Adequate Care and Support: Treatment Options and Decision-Making

Receiving a diagnosis of lipedema should be a turning point towards appropriate care and treatment. However, many women find themselves at a dead end. Despite having a confirmed diagnosis, they struggle to access the care they need. The limited knowledge about lipedema among healthcare professionals hinders the development of effective treatment strategies. Women with lipedema often have to fight for liposuction surgery, which can be crucial in managing the disease. They may also seek treatment abroad, incurring additional financial burdens.

The lack of guidance and support in medical decision-making further compounds the challenges faced by women with lipedema. They often feel alone, left to navigate their treatment options without sufficient professional advice. Some women have found supportive doctors who listen to their concerns and collaborate with them to develop appropriate treatment plans. However, these rare instances highlight the urgent need for increased awareness and knowledge among healthcare professionals.

The Physical and Emotional Burden: Pain and Fatigue

Pain and fatigue are two significant symptoms that women with lipedema experience daily. The pain associated with lipedema is often described as aching, heavy, and unpredictable. It can worsen with movement and become stabbing in nature. Women with lipedema express feelings of exhaustion and describe the constant pain as debilitating. The invisible nature of their symptoms makes it challenging for others to understand and empathize with their experiences.

Fatigue, another common symptom of lipedema, further adds to the physical and emotional burden. Women with lipedema describe feeling constantly tired, which affects their ability to engage in daily activities. The lack of understanding and validation of their pain and fatigue by others, including healthcare professionals, leads to feelings of neglect and frustration.

Dignity and Respect in Healthcare Encounters: The Importance of Understanding

Encounters with healthcare professionals play a crucial role in the lives of women with lipedema. Unfortunately, many women feel that their experiences are not taken seriously, resulting in a lack of dignity and respect. Healthcare professionals’ skepticism and dismissive attitudes toward their pain and symptoms contribute to feelings of violation and humiliation. Women with lipedema emphasize the need for healthcare professionals to listen, understand, and acknowledge their experiences.

Creating a supportive healthcare environment requires healthcare professionals to educate themselves about lipedema and its impact on patients’ lives. By validating women’s experiences and providing appropriate care, healthcare professionals can alleviate the emotional distress associated with lipedema. Collaborative decision-making and the involvement of specialists can also contribute to better treatment outcomes and improved quality of life.

The Journey Towards Self-Acceptance: Body Image and Self-Esteem

Living with lipedema often leads to negative body image and decreased self-esteem. Women with lipedema may feel unattractive and struggle with self-acceptance. The changes in their bodies, such as the irregular distribution of fat and the appearance of cellulite, contribute to dissatisfaction and insecurity. The societal pressure to conform to narrow beauty standards exacerbates these negative feelings.

However, some women find solace in supportive relationships, particularly with their partners. Feeling desired and loved by their partners is essential for their overall well-being. The challenges of intimacy and sexual activity due to lipedema can strain relationships, but open communication and understanding can help foster intimacy and emotional connection.

Empowering Women with Lipedema: Education and Support Networks

Education and support play a vital role in empowering women with lipedema. Access to accurate information about the condition, treatment options, and self-care strategies can help women make informed decisions about their health. Support networks, both online and offline, provide a sense of community and understanding. Connecting with other women with similar experiences can offer emotional support and practical advice.

Additionally, psychological support is crucial for women with lipedema. Counseling or therapy can help address body image concerns, manage emotional distress, and enhance overall well-being. By addressing lipedema’s physical and emotional aspects, women can regain control over their lives and improve their quality of life.

The Way Forward: Advocating for Change and Further Research

The experiences of women with lipedema highlight the urgent need for change in healthcare systems and increased research on the condition. Healthcare professionals must be educated about lipedema to provide appropriate care and support. Developing evidence-based treatment guidelines and exploring novel interventions are essential to improve outcomes for women with lipedema.

In conclusion, lipedema has a significant impact on the quality of life of women who live with this chronic and progressive disease. Their physical and psychological burdens require healthcare professionals to approach lipedema with empathy, understanding, and respect. By providing adequate care and support, we can empower women with lipedema to navigate their journey towards better health and well-being.

Dr. Wright presented at the first World Congress on Lipedema, held in October 2023 in Potsdam, Germany. The common goal of this gathering was to share knowledge, experiences, and ideas related to the understanding and treatment of Lipedema and to benefit from first-hand, high-class education, network, and learn from world-renowned experts about the latest science and best practices in the management of lipedema. 

The Lipedema World Congress is designed to bring together a broad spectrum of healthcare professionals, including lymphologists, plastic surgeons, angiologists, phlebologists, nutritionists, dermatologists, physical therapists, bariatric and Metabo specialists, and radiologists, as well as representatives of patient associates from around the world to share experiences and expertise on an international high-class level and to reflect on how to best incorporate these insights into education and clinical practice. 

Dr. Wright gathered with peers from across the globe to learn the latest science and best practices in treating lipedema and shared his techniques and experiences treating patients. His presentation at the Lipedema World Congress was on how Lipedema Reduction Surgery Improves Mobility, Physical Function, and Multiple Measures of Quality of Life in Women with Lipedema.

World Congress on Lipedema, Potsdam, Germany, 4-7 October, 2023.

This is the first time Lipedema has had its own designated Congress, in which leading experts from over 35 countries gathered to discuss and learn about the disease. More than 500 participants testified that interest in the subject is constantly growing and is bringing important news to the international scientific community. The US-based Lipedema Foundation had a large presence at the Congress, bringing along their staff to share knowledge with the large group of attendees. The Lipedema Foundation alone funds around 10% of the research projects on the disease.

Lipedema World Congress: What Was Discussed?

Many colleagues from overseas also participated with great interest, and numerous representatives of patient associations from various countries joined the professionals. Attendees heard from Sharie Fetzer and Kate Forster of Lipedema UK, Valeria Giordano and Marcella Oggiano of LIO Lipedema Italia, representatives from American Fat Disorders, and leading experts representing Danish, Australian, Dutch, Swedish, Finnish, and Canadian foundations and practices.

World Congress on Lipedema, Potsdam, Germany, 4-7 October, 2023.

Lipedema World Congress: Day 1

Sessions began with live commentaries of surgical procedures on patients; those present could talk, discuss, and ask questions to the surgeons who illustrated their techniques. Dr. Fabio Kamamoto of Brazil began by illustrating the technique of laser ligation with simultaneous endovenous laser ablation (also referred to as EVLA). This was followed by Dr. Mojtaba Ghods and his Potsdam, Germany-based team demonstrating the Lymph-sparing Hybrid Technique: MicroAire PAL Large-Volume Liposuction and Manual Extraction in General Anaesthesia for Advanced Stages Lipedema.

Dr. Fabio Kamamoto illustrates the technique of Laser Liposuction with simultaneous endovenous laser ablation.

Dr. Ziah Taufig of Cologne, Germany, demonstrated the Human Med body-jet technique WAL Liposuction in General Anesthesia, followed by Dr. Barbara Herstant of Paris, France, who described with a video presentation the technique of VASER Liposuction + Renuvion J Plasma in General Anesthesia. 

Dr. Ziah Taufig demonstrated the Human Med body-jet technique WAL Liposuction in General Anesthesia.

Finally, the first morning ended with a talk in the presence of our very own Dr. Thomas Wright, who illustrated his MicroAire PAL Liposuction in tumescent local anesthesia technique by video. The images alternating throughout the morning demonstrated how, with the application of effective techniques, the volumetric increase in the areas affected by Lipedema can be consistently reduced, with consequent benefits both functionally and on the symptoms related to the clinical picture.

Dr. Thomas Wright illustrated his MicroAire PAL Liposuction in tumescent local anesthesia technique at the World Lipedema Congress.

The afternoon session began with a presentation by Christine Moffat on the current state of care for patients with lipedema, which highlighted the serious deficiencies that exist in most public and private care systems worldwide. Several presentations on home self-management of the condition followed this. At the end of the first session, the co-chairs of the Congress reminded the audience that the disease was only a little over a year ago, finally recognized by the World Health Organization with its own code (EF.02.2) in the eleventh edition of the International Classification of Diseases, welcomed all those present to a packed and attentive hall.

Dr. M. Ghods Co-Chair

Dr. K. Herbst Co-Chair

Dr. S. Michelini Co-Chair

The second session on the conservative treatment of lipedema followed this. Several authors (Ure Christian, Michelini, Serena, and others) presented their experience, emphasizing the essential symptomatic aspect (although long-lasting and important in terms of symptom regression) of the treatments themselves.

In the third session, papers were presented on the status of genetic studies (still much to be investigated, even though the disease has clearly been revealed as hereditary), on biochemical studies, and on anatomical studies that are bringing us closer to a better understanding of the pathogenesis of the disease. Several authors took turns, including the Australian Rami Shayar and the Italian Saverio Cinti.

The fourth session, with presentations by José Luis Simarro, was devoted to the pathogenic hypotheses of the disease and, in particular, some of its symptomatological aspects, first and foremost, pain.

Dr. Simarro

The fifth and final session of the day was devoted to surgical treatment, particularly the various liposuction techniques, with the complementary aspects of using the various methods. Presentations were given by, among others, Thomas Wright and David Christel.

Dr. Wright

Lipedema World Congress: Day 2

On 6 October, the day began with the General Assembly of the Lipedema World Alliance. The first of its kind, the LWA is a new and innovative association set up in 2022, made up of healthcare professionals, patient associations, and scientific societies. The Association is supported, in part, by ‘founding donors’, including Juzo Italia, Juzo International, LeSearch, Medi International, and Tactile Medical. The LWA’s president, Sandro Michelini, shared the motivations and steps that led to the creation of the association, emphasizing their mission, operating methods, and organizational charter. He also announced the start of registering regular members alongside their founding members. Potential members can review and submit their information to join the LWA here. During the assembly, several proposals were made, including that of organizing, if possible, a ‘dedicated’ international congress every two years in different locations.

The following session was devoted to the relationship between Lipedema and Obesity, which once again highlighted the fact that the association between the two pathologies is neither constant nor interdependent and that, in the case of obesity associated with Lipedema, bariatric surgery, which has a good effect on the classic sites of accumulation of adipose tissue, does not have such an effect in the anatomical sites affected by Lipedema itself.

The next session was followed by the presenter describing in more detail the aims of the Lipedema World Alliance. Johnatan Kartt described the activities of the Lipedema Foundation, which are mainly aimed at supporting scientific research. Dr. Karen Herbst and Dr. Gabriele Faerber then described the American and German Lipedema guidelines. Dr Faerber also compared the main consensus documents currently in place. During the lunch break, there was the opportunity to follow extra-congressional work with the description of other surgical experiences (WAL and other techniques) by several alternating specialists.                              

That afternoon, the resumption of proceedings was devoted to nutritional aspects; the presentations showed that the ketogenic diet (Giovanna  Pitotti, Malgorzata Jeziorek, and other authors) and ‘low carb’ are the most effective dietary regimes in the disease. This was followed by the session on epidemiological and diagnostic aspects, with speakers touching on differential diagnosis aspects (Rachelle Crescenzi, Epameinondas  Gousopoulos, and other speakers), including that between Lipedema, lipohypertrophy, and Secondary Lymphoedema. The last session highlighted the possible interactions between Lipedema and the lymphatic system. It featured other important and well-known speakers such as Stanley Rockson, Alberto Onorato, Jean-Paul Belgrado, and Hakan Brorson.

International experts possible interactions between Lipedema and the lymphatic system.

The evening ended with the Gala Dinner, during which the Lipedema Foundation honored Ghods for his scientific and care commitment. There were also some truly uplifting moments of fellowship and fun, during which it was possible to deepen mutual understanding between the various participants, as well as on some of the topics discussed after the presentations.

The Founder’s Dinner for the Founders of Lipedema World Alliance.

Lipedema World Congress: Day 3

Saturday morning began with a plenary discussion on the results of the first two steps of the Delphi study, which was so well attended that it lasted for much of the coffee break time. The lively and substantive discussion led to the final draft [ of the contents of the paper that will be published in the coming weeks.

Lipedema World Congress Delphi Consensus Statements

Dr. Kruppa prepared 100 statements about lipedema to review by the participants, and prior to the meeting, the statement had been modified and winnowed to 69 statements. The open session was chaired by Dr. Michelini, Dr. Kruppa, and Dr. Cresscenzi. During this time, Dr. Wright and nearly 100 experts worldwide discussed and debated the consensus statements. 

The goal of this important project is to define what is agreed to be understood in the field of lipedema research and treatment. Also, to point out areas where more research and coordination are needed. The results of this work are hoped to produce a position paper focusing on lipedema coordinated by the Lipedema World Alliance. This document aims to comprehensively cover various aspects of lipedema, including its nature, epidemiology, pathophysiology, diagnosis, and treatment approaches. The intention is to create a resource that assists healthcare professionals, researchers, funders, and individuals impacted by lipedema in understanding the current opinions of experts and gaps in knowledge and management of the condition. 

Left to Right: Dr. Crescenzi, Dr. Kruppa, and Dr. Michelini preside over the Delphi consensus discussions.

This position paper is the basis and starting point for further areas to be explored as they relate to lipedema. Given the evolving nature of lipedema research and the varying degrees of evidence available, reaching a unanimous consensus in certain areas might prove challenging. Acknowledging this, the project will employ a multi-step Delphi method to facilitate expert collaboration. This method will enable the group to iteratively evaluate and refine statements related to lipedema based on the current literature and collective expertise.

The last conference sessions followed this, the first of which was dedicated to basic science, histology, and molecular analysis. Among the various papers presented, the one by Cannataro, who, with the coordination of the writer, carried out on tissue samples selected and taken by the Plastic Surgeon Nicola Vaia in Rome, together with his wife Erika Cione (biochemist at the University of Cosenza), showed the data of a preliminary study that highlighted the presence of an ‘up-regulator’ micro-RNA as a possible ‘marker’ of the disease, arousing lively interest in those present (at the moment, the diagnosis of the disease is essentially clinical).

Dr. Cannataro explains data from a preliminary study that highlights the presence of an ‘up-regulator’ micro-RNA as a possible ‘marker’ of Lipedema.

The last session was again dedicated to various liposuction procedures. Various speakers took turns (including Agostino Bruno, Enriquez Burgos, Uwe Wollina, Corrado Cesare Campisi, Thomas Su, and others), highlighting some aspects relating to the effectiveness of the techniques and the sparing of other anatomical structures (first and foremost, the loco-regional lymphatic system). 

As already mentioned, one of the novelties of the Congress was the role of the patients’ associations, which was much appreciated. This participation was precisely in the spirit advocated also by the WHO, of sharing the experiences of healthcare professionals with patients’ associations and, above all, finalizing the collaboration itself to the drafting of consensus documents useful in clinical practice and functional for recognition at the level of individual country governments.

Lipedema World Congress: Looking Ahead

The first World Congress on Lipedema upheld its promise to be an unparalleled gathering of experts and stakeholders in the field. Dr. Wright was honored to contribute his knowledge, learn from renowned experts, and collaborate with peers worldwide. Together, they’re paving the way for advancements in the understanding and management of lipedema. 

About Dr. Wright

Dr. Thomas Wright is a leading expert in venous and lymphatic medicine, with 15+ years of experience dedicated to advancing lipedema treatment. As the medical director of Laser, Lipo, and Vein Center, he’s among the first 200 US surgeons to attain diplomat status with the American Board of Venous and Lymphatic Medicine. He is a Fellow of the American Venous and Lymphatic Society. His research contributions include peer-reviewed papers on lipedema and co-authoring the US Lipedema Standard of Care Guidelines. Dr. Wright’s expertise covers lipedema reduction surgery, fat transfer, and minimally invasive skin tightening. Trained by Dr. Jeffrey Klein, he has performed thousands of tumescent liposuction procedures for cosmetic and lipedema patients, collaborating with institutions like Washington University and the University of Arizona to deepen our understanding of lipedema.

We are pleased to announce that Dr. Wright accepts patients for Lipedema Reduction Surgery in-network with United Healthcare.  We are delighted that United Healthcare is working with us to provide the lipedema patient community with in-network lipedema treatment options.  Please be aware that United Healthcare’s medical necessity criteria must be met to their satisfaction before approval.  This includes six months of conservative therapy (diet, exercise, compression), photo documentation showing disproportionate tissue of the extremities, and documentation of functional impairment. We also highly recommend that patients document their personal journey to share with their provider and UHC to prove their need for further treatment.

We aim to help the lipedema community obtain affordable in-network treatment and care.  We will continue to work with other payers to achieve fair compensation for the expertise and outstanding patient care and outcomes we provide to our patients.

Lipedema is a chronic condition affecting many women, causing disproportional fat distribution and significant physical discomfort. Fortunately, UnitedHealthcare (UHC) Insurance offers lipedema treatment insurance coverage, but it’s essential to understand their strict criteria and the steps required to get the coverage you need. We’re here to guide you through obtaining lipedema insurance coverage through UHC while shedding light on Dr. Wright’s success in securing coverage for his patients. 

United Healthcare’s Lipedema Coverage Policy

United Healthcare recognizes individuals’ challenges with lipedema and has developed a policy for treating this condition. However, it’s important to note that they have stringent criteria that must be met to qualify for lipedema covered by insurance. Below is the general outline of what criteria UHC is looking for. At the end of this article, we summarize the entire process that includes this criterion. 

Criteria for Lipedema Treatment Insurance Coverage

To be eligible for treatment for lipedema covered by insurance through UHC, you must meet the following criteria:

Diagnostic Criteria: You must meet all diagnostic criteria for lipedema. This includes having photographs showing disproportional fat distribution consistent with the diagnosis. Additionally, you must have documented evidence of the failure of disproportional fat to respond to medically supervised weight loss or bariatric surgery if your BMI is in class 2 or above (BMI +35).

Conservative Therapy: You should have completed medically supervised conservative therapy for lipedema for at least six months. This therapy includes compression garments, manual lymphatic drainage (MLD), and a low-carb diet. Documenting your efforts is crucial. You must document if symptoms persist despite diet adherence and compression use.

Medical Evaluation: In addition to diagnosing lipedema, you’ll need another diagnosis from your primary care physician (PCP) or a specialist who is not providing surgery for lipedema. This diagnosis should support the need for surgical intervention to treat lipedema.

Functional Impairment: To further substantiate your coverage case, you must provide documentation of functional impairment. This could include how lipedema affects mobility, physical activity, and daily life. Be sure to detail the limitations you experience due to lipedema, as this will strengthen your case.

lipedema treatment insurance coverage

Dr. Wright’s Success with UHC Coverage

One positive aspect to highlight is that Dr. Wright has had significant success in helping his patients secure lipedema insurance coverage treatment through United Healthcare. This speaks to the importance of having a knowledgeable and experienced medical professional on your side when navigating the insurance process. His patients have seen great success with lipedema surgeries and long-term quality-of-life changes. Below he and one of his patients were featured on FOX 2 St. Louis!

The Process of Obtaining Lipedema Insurance Coverage

Now that you understand the criteria for UHC’s lipedema coverage policy, let’s outline the steps to help you secure the coverage you need:

  1. Consultation with a Specialist: Seek a specialist who can diagnose and document your lipedema. This specialist should not be the one providing surgical treatment. Make sure to discuss your functional impairment during this consultation.
  2. Conservative Therapy: Undergo medically supervised conservative therapy for at least six months. Keep detailed records of your therapy sessions, progress, and any lack of improvement.
  3. Medical Documentation: Request a separate diagnosis from your primary care physician or another specialist supporting surgical intervention to treat lipedema. This diagnosis should complement the lipedema diagnosis.
  4. Photographs: Obtain photographs showing the disproportional fat distribution consistent with lipedema.
  5. Consultation with Dr. Wright: If possible, consider consulting with Dr. Wright or a similarly experienced specialist who can guide you through the insurance process. Their expertise can be invaluable.
  6. Submission of Documents: Submit all the necessary documentation to UnitedHealthcare, ensuring that you meet all the criteria outlined in their policy.  Include your personal notes and information about your journey in this submission. 
  7. Advocacy: Be prepared to advocate for yourself and your need for treatment. Insurance processes can be complex, but persistence can pay off.

United Healthcare does offer coverage for lipedema treatment, but they have strict criteria that must be met. By following the steps outlined in this article and enlisting the expertise of a knowledgeable specialist like Dr. Wright, you can increase your chances of obtaining the coverage you need to manage and treat your lipedema effectively. Remember that your health and well-being are worth the effort required to navigate the insurance process successfully.

Read more about the UHC Policy here.

We will make every effort to get patients approved for Lipedema Reduction Surgery; however, final approval for medical necessity and prior authorization is determined by United Healthcare and at the discretion of a Medical Director at United Healthcare.  We cannot guarantee patients will be approved for surgical procedures.

 Why Aren’t More Health Insurance Companies Covering Treatment for Lipedema?

The general rule of thumb for Lipedema Insurance Coverage claims reimbursements is that any given claim must be deemed “medically necessary”. Lymph Sparing Liposuction is nearly always considered a cosmetic surgical procedure in nature or experimental, meaning this is an elective procedure and not a medical necessity. Of course, as explained above, this is not the case for women with Lipedema, as lymph-sparing liposuction is the only treatment option for dealing with this disease that can reverse progression. However, the combination of the surgery being deemed cosmetic and election plus the general under-education and lack of awareness in the medical community has led to the battle patients and Lipedema surgeons are fighting. We must educate and advocate for these surgeries to be covered. 

Coding Lipedema Surgery with Cosmetic CPT Codes 15877-79 

The liposuction CPT codes 15877-79 are cosmetic codes that were never intended to be used by commercial insurers to cover reconstructive or medically necessary procedures to improve function and technically should not be used for reconstructive treatment. Because they are cosmetic codes and are not covered by Medicare, they have never had a value or RVU (Relative Value Units) assigned to them. Some medical insurers like Blue Cross Blue Shield exploit the lack of an assigned value for the codes they insist on using.  If an insurance company assigns little or no value to the surgery, even when it is a covered benefit, they can pay less for the 5-hour surgery than for a 15-minute follow-up office visit. This means that because they use cosmetic codes 15877-79, which can have little or no value assigned by commercial payers like Blue Cross Blue Shield, they can pay so little that they are, for practical purposes, technically “covering” treatment. But in practice, they’re not covering liposuction to treat lipedema. The good news, at least for now, is that UHC is covering Lipedema Surgery with a reasonable assigned value.

Contact a Specialist, Even If You Don’t Think Insurance Will Cover!

Despite the challenges and lack of coverage, some physicians, like Dr. Wright in St. Louis, do everything they can to work with patients to get insurance coverage. They are familiar with the ins and outs of different insurance providers, and their teams work extremely hard to get patient coverage. ERISA experts and attorneys can help you work on lipedema treatment coverage, and physicians can help you connect with them if you aren’t sure where to start. 

You might also come across individuals who are self-described as “patient advocates”. These individuals will present themselves as experts in getting coverage for you. Still, they’re not licensed individuals and are unlikely to be bound by patient privacy laws that you’ll get with physicians and attorneys. We are aware of players in this field who are bad actors and ultimately hurt the cases of patient coverage. Be sure to check the BBB listings, names, and addresses of anyone wanting to work with you, along with Google Reviews and website listings. 

Please reach out to our office, and Dr. Wright’s team would be happy to refer you to experts depending on where you are in your Lipedema diagnosis and treatment journey. We’re here to help, and happy to get you started!