How will the Lipoedema/lipedema progress as I get older?
The progression of lipedema is variable. Some women have little or no progression. Other women progress more rapidly. Rapid progression is associated with hormonal and stressful events such as childbirth, menopause, weight gain, and rarely other illness.
Will Lipedema have any other health implications or put me at greater risk of other conditions?
The most common complications or health implications caused by lipedema are mobility limitations. Accelerated arthritis of knee and ankles, gait limitation from a bulk excess of adipose around the joints primarily of the knees, and ankles. Secondary obesity, partially related to mobility impairments.
Vascular risks are Increased risk of varicose veins and secondary lymphedema and there can be an increased risk of blood clots associated with lipedema when combined with obesity. Lipedema can cause a small vein vasculopathy that leads to an increase in easy bruising, spider veins [telangiectasias], and varicose veins. If secondary obesity occurs with lipedema, there is an increased risk of DVT or blood clots.
Are there any medical treatments that I could benefit from? Have there been any new advancements in treatment?
Medical or nonsurgical management of lipedema consists of treating secondary lymphedema if it is present, diet, medications, supplements, and lifestyle changes. Most women with lipedema have some secondary edema/lymphedema in their legs and arms. The management of the secondary lymphedema focuses on the compression garment use, manual lymphatic massage, and pneumatic compression pumps. Studies have shown that women with lipedema are very insulin sensitive and so we recommend a low carbohydrate diet emphasizing whole food with a low glycemic index. Diosmin which is a supplement extract of citrus fruit, guaifenesin, and amphetamines have been recommended for the treatment of lipedema. Maintaining an active lifestyle with cardiovascular and resistance exercises is strongly recommended. Water-based exercises can be particularly helpful because they give resistance, cardiovascular, and support lymphatic flow.
Can you diagnose and tell me what stage of Lipedema I have over Skype or Facetime?
No, the diagnosis of lipedema or lipoedema cannot be determined without a physical exam. It is essential for competing for diagnoses to be ruled out and diagnostic clinical signs need to be palpated to make a proper diagnosis of lipedema. Likewise, the stage of lipoedema/lipedema cannot be determined without a physical exam. A physician experienced with the diagnosis of lipedema will detect nodularity in the skin and subcutaneous tissue and the presence of edema/lymphedema. These factors, plus lobules or festoon/dewlaps. Many patients are surprised at how thorough the in-office diagnosis and evaluation is – you should expect to spend several hours in the office. We provide in-depth evaluations, including an ultrasound of the affected areas, measurements, full-body photos, questionnaires for symptoms, and in-depth consultation to determine the best treatment options. None of these can be appropriately or adequately provided via web meeting, and we wouldn’t be providing the standard of care we guarantee if we did so.
What are the risks/ benefits of surgery over medical treatment for lipedema?
The likely benefits of lymph sparing liposuction are decreased pain, heaviness, tenderness and swelling, improved mobility, stance, and leg alignment. The potential risks of the surgery are rare but include decreasing likelihood: lymphatic and skin injury and or scarring. Risks that are less than one in ten thousand include Blood loss, Deep Vein Thrombosis [Blood Clot], complications from anesthesia, infection, and the least likely complication would be death.
How long would I likely be bandaged for post-surgery and how long would I need to be wearing compression stockings?
Compression after surgery is generally recommended for 2 months. The compression garment is best combined with compression stocking for optimal lymphatic flow and prevention of blood clots. Compression may be required life long if there is secondary lymphedema, and the longer patients continue compression therapy, the better outcomes they will have!