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Everything You Need To Know about Lipedema Surgery

 An estimated 17 million women in the U.S. and nearly 370 million women across the globe suffer from a condition known as Lipedema. What is regularly associated with rapid and uncontrollable weight gain in its initial stages can spiral out of control if left undiagnosed. As experts continue researching the causes and best treatment options for women with Lipedema, tumescent liposuction or lipedema reduction surgery remains the only way to reset the progressive disease and provide women with increased mobility and reprieve from daily pain.

Lipedema reduction surgery

What is Lipedema?

Lipedema is a fat disorder, mainly affecting women, that causes an enlargement of both legs due to deposits of fat under the skin. It’s characterized as a “progressive disorder,” meaning it generally worsens over time. In severe and more progressive cases, the trunk and upper body may also be affected, including the arms and upper back, and it’s often misdiagnosed and incorrectly treated as general obesity.

What Are the Symptoms of Lipedema?

Lipedema is a disease that leads to the excessive buildup of fat cells, primarily in the arms and legs. Going far beyond the appearance of extra pounds, those who suffer from Lipedema often have large pockets of fat on their limbs that appear disproportionate compared to the rest of the body. Lipedema is often misdiagnosed and dismissed by medical professionals as simple obesity, leaving affected women with an endless cycle of disappointment, frustration, and pain. Lipedema does not respond to a diet and exercise routine, yo-yo dieting, or juice cleanses.

Women suffering from Lipedema often report the disease associated with painful symptoms that trigger difficulties in dealing with everyday activities. Excessive swelling often comes with pain, numbness, and bruising. In its advanced stages, Lipedema can impact mobility and provoke vascular and lymphatic swelling, leading to further medical complications.

Lipedema reduction surgery

Why Is Lipedema Reduction Surgery Necessary?

Ultimately, effective treatment will require surgical intervention to alleviate the appearance and pain of symptoms. Liposuction performed on the affected limbs is generally the most effective treatment. Removing fat deposits that are diseased helps reduce swelling of the limbs and alleviates the pain that holds patients back from everyday activities.

This surgical treatment can provide a variety of benefits and relieve the symptoms you are experiencing from lipedema. Dealing with lipedema can be difficult, especially if you are just now starting to take control of it.

Why Do We Call Lipedema Liposuction “Lymph-Sparing?”

Lipedema reduction surgery is different from cosmetic liposuction. Studies have shown that women with Lipedema have impaired lymphatic function. Lymphatic fluid promotes the growth of more fat cells, which can overwhelm the lymphatic capillaries (branch-like blood vessels). Extra care must be taken to avoid injuring the lymphatic system and making an already stressed system worse. Using blunt cannulas and generous and special surgical techniques, studies have shown that lymphatic function can improve after this type of liposuction in women with Lipedema. The goal of lipedema reduction surgery is to remove the fibrous tissue and maximally reduce the lipedema tissue. It is a “debulking” surgery, not a cosmetic surgery.Why is Lymph Sparing Liposuction Preferred for Lipedema Patients?

1 – Lipedema Surgery Doesn’t Use General Anesthesia

One of the most beneficial aspects of lymph-sparing liposuction is that the treatment does not rely on general anesthesia. While general anesthesia is used for various treatments, it is generally not recommended for individuals with lipedema. Instead, lymph-sparing liposuction uses tumescent anesthesia to avoid these unwanted complications. General anesthesia can cause severe complications and even death in up to 0.3% of liposuction treatments. Relying on tumescent anesthesia ensures the anesthetic fluid has been distributed throughout the tissue, and it has had time for all the fat tissue to gel.  Patients are conscious for the duration of treatment, while the tumescent liquid acts as a local anesthetic to the treatment area. Patients may take pain pills ahead of time to help with discomfort and sometimes use laughing gas. However, through the process, patients feel little pain and, if anything, pressure in the area being treated. 

Lipedema reduction surgery

2 – Lipedema Surgery Reduces Fat Tissue

Perhaps the most noticeable benefit to lymph-sparing liposuction is how it can reduce the amount of subcutaneous fat tissue in the body. Lipedema reduction surgery not only significantly reduces fat tissue but also removes fibrous tissue, making the limbs lighter, smaller, less tender, and smoother. Following your physician’s guidelines is critical to reduce swelling and inflammation before the treatment. This is done by wearing compression garments and wraps along with receiving manual lymph drainage for several weeks following lipedema surgery and beyond. Patients wear medical-grade compression clothing for at least eight weeks, and manual lymph drainage and massage are typically recommended as an ongoing and regular treatment. 

Your tissue will be decongested, allowing your liposuction treatment to be as successful as possible. Some slight swelling and bruising may return immediately following the procedure, but this is expected and should subside over time. Some patients also report numbness as their nerves in the treated areas respond to treatment. Numbness may last for several months and up to one year, but compared to the reduction in fat tissue, patients still see this as a huge improvement. Compression is critical to be maintained after the lipedema surgery as well, as the lymphatics are re-established. The lymphatic function is often improved.

3 – Lipedema Surgery Reduces Painful Symptoms

By reducing the amount of subcutaneous fat tissue, you can reduce any pain associated with lipedema. Lipedema reduction surgery, which is sometimes referred to as Lymph sparing liposuction, will be able to help you increase mobility without having the pain you have been feeling with lipedema since it started. This is huge for women with lipedema, especially because the pain and bruising is the leading symptom of seeking treatment. Women report a significant improvement in their ability to move around more freely, exercise more regularly, and enjoy day-to-day activities that were previously off-limits. Bumping into a chair or a corner no longer causes large bruises, playing with the family dog doesn’t cause pain when they jump, and everyday activities are no longer considered out of reach. 

What Are The Risks of Lipedema Surgery?

Significant blood loss is the most commonly reported side effect of lipedema surgery. Women with lipedema very often have large varicosities and studies have shown enlarged networks of veins in the legs of women with lipedema. Liposuction can cause significant blood loss if these veins are not treated before surgery. Even with proper preoperative treatment of dilated and varicose veins and good tumescent technique in women with lipedema, if the surgery is large enough, there can still be significant blood loss. In some cases even a blood transfusion has been needed in the postoperative period.  The next most common complication of lipedema reduction surgery or lipedema liposuction is blood clots. Women with lipedema are, on average, heavier than women without lipedema making the risk of blood clots with the surgery greater.  The risk of blood clots and other thrombotic complications can be greatly reduced with postoperative blood thinners. Careful surgeons should risk stratify their patients for possible blood clot complications and put them on prophylactic postoperative blood thinners.  Infection is always a risk of any surgery including lipedema surgery.  There has been a report of fat embolism with lipedema surgery.  Death has to be included as a possible outcome. We are not aware of any deaths from lipedema surgery, but of course it is possible that any surgery can, in very rare circumstances, result in death.  Finally, lymphatic injury is a real risk of liposuction and is a special concern for women with lipedema. Smaller cannulas are also used to keep down the risk of trauma to the body and an already compromised lymphatic system.  With care and proper surgical technique lymphatic injury need not occur. In fact in skilled surgical hands lipedema reduction surgery may actually improve lymphatic function. 

What Quality of Life Can I Expect After Lipedema Surgery?

While the recovery can get painful, especially in more heavily used areas such as the arms and calves, patients will report that the payoff is well worth it. Lipedema fat more often accumulates around the lower body, including the thighs and buttocks. Women will often see the majority of their Lipedema fat in these areas. However, they can also commonly find Lipedema fat accumulation around the inner knee and backside of their leg. After the removal of lipedema tissue in these areas, patients are not only more mobile and can get around more easily, but they experience far less pain in their daily lives.

Lipedema reduction surgery

This procedure allows for a more active and healthy lifestyle, which many patients have experienced for years (and in some instances, it’s been decades). If paired with proper compression therapy, a healthy diet, tons of water for hydration, and responsible maintenance, women with lipedema are afforded a much higher quality of life and more enjoyable day-to-day. The reduction of irregular and heavy fat can improve joint function, making everyday tasks such as walking, climbing stairs, tying shoes, or even getting up from a chair much easier than before. Normal tasks that many take for granted are daunting and painful for women with lipedema, and lymph-sparing liposuction can help reset the clock by several years to help.

What Is Recovery from Lipedema Surgery Like?

While lymph-sparing liposuction for lipedema is generally safe in healthy individuals, risks such as infection, bleeding, and trauma to the area may occur. Post-operative swelling in the limbs after surgery, which occurs with any liposuction procedure, is more prolonged in individuals with lipedema. The swelling typically worsens for a few months before it gets better, and the full benefit may not be realized for six months to a year. However, overall, most patients with lipedema experience significant improvement of many or all of their symptoms, with varying individual results. It’s not uncommon for Dr. Wright and his team to complete the procedure, and their patient notices a change before they leave the office, especially when large amounts of fat tissue are removed. 

Although some people who have lipedema in one specific area may need only one procedure, most people undergo multiple lymph-sparing liposuction procedures to address all the different areas affected by lipedema. The multiple liposuction procedures must be staged or separated to be done safely. The timing of the procedures depends on multiple factors, including the clinical stage of lipedema in the patient, the amount of fat being removed, the patient’s health and mobility, and other logistical factors. Generally, each procedure should be spaced out by at least three months to allow for proper recovery.

After the lipedema surgery, patients go home the same day but should be sent home already in their compression garments. The first afternoon after surgery should be spent resting, and it’s likely patients are extremely drowsy from the procedure and medications. The following day post-op check-in should be completed before returning home. Patients will be sore and will continue to experience drainage of tumescent fluids. Padding around the incision points is required for several weeks. Compression garments are worn around the lock for the first several weeks, then worn during the daytime hours only before eventually tapering off after 12 weeks. 

Ready to Learn More about Lipedema Surgery in St. Louis? Let’s Chat!

As you can see, lymph-sparing liposuction has plenty of exciting benefits. This procedure can make living easier with unwanted symptoms such as difficulty with mobility, pain, and tenderness. Physicians like Dr. Wright can provide you with the needed treatment to reduce your lipedema symptoms. Contact us today!