There’s nothing more satisfying and exciting for Dr. Wright and his team at Laser Lipo & Vein Center than celebrating patient wins! One of our favorite patients, Rita, spent her time in quarantine focused on getting through her lipedema surgeries, recovering safely at home, and both she and our team couldn’t be happier with her results! Rita’s experience is proof that Lipedema surgery can transform patient experiences as they walk through life (literally!) from pain and immobility to pain-free progress!
Rita has undergone three Lipedema surgeries on her legs and has seen dramatically positive results. She’s continued to follow a generally healthy diet both before and after her surgeries but did not implement any form of diet changes, so these results are primarily the outcome of her lipedema surgeries! She’s gone from a size 24 to a size 14 in jean size, lost 30 pounds, and is now more easily active and mobile day-in and day-out.
There are so many day-to-day activities that those without Lipedema wouldn’t think twice about, but patients with Lipedema struggle with and dread. Post-surgery, Rita has reported back to our office that after losing 10 pants sizes and removing the irregular lipedema fat in her lower body, she has no problems fitting into those frustrating chairs with arms on either side, she has enjoyed walking around the amusement park with her 10-year-old daughter without having to take breaks, and overall has enjoyed her active lifestyle, without the pain that used to accompany it!
What is Lipedema?
Lipedema is a subcutaneous fat disease that primarily affects women. When we reference the “subcutaneous” tissue and fat, we’re referencing the layer of tissue directly under the skin.
Shockingly, Lipedema affects an estimated 17 million women across the globe. This disease affects a huge number of women, the majority of whom are still walking through their world in a lot of physical and mental pain. Lipedema is a disease that leads to the excessive build-up of fat cells, primarily in the arms and legs. Women suffering from it often have “pockets” of fat on their limbs that appear disproportionate in comparison to the rest of their bodies. This disease causes an enlargement of the legs due to deposits of fat under the skin, and typically gets worse over time, making diagnosis and treatment essential.
It’s common for women with Lipedema to have a small upper body, while their lower body is disproportionately larger (kind of like an extreme pear-shaped body). Pockets of fat develop in the affected areas and appear to bulge in and out of the top layer of the skin. This is often mischaracterized as cellulite, rather than painful lipomas.
These pockets of Lipedema fat are accompanied by painful symptoms, such as excessive swelling, pain to the touch, numbness, and very easy bruising. If my dog jumped up on my legs, it was excruciating. Everyday occurrences that most people don’t think twice about, like accidentally bumping into a table or chair, can cause deep, painful bruises.
As Lipedema progresses over time, these symptoms will continue to get worse as more Lipedema fat accumulates, and many women report that they are less and less mobile or active as time goes on. As a result, these women are stuck in a terrible cycle; they are less mobile, so they often gain weight, then it’s even more difficult and painful to be active, and the cycle goes on and on.
With Lipedema, we experience fat accumulation in specific areas, which may help indicate if your weight gain is normal or not. If you’re gaining pockets of fat that are out of proportion to other areas, this may be a tip-off that you have Lipedema.
While many women also see weight gain in their arms, it’s common that the following areas are greatly affected:
- Cankles: an accumulation of fat around the back of your ankles, causing an “ankle cuff.” This type of weight gain is a clinical sign only seen in Lipedema. Not all patients get this, but if you have it, it may be an indicator.
- Bat Wings: Weight gain in your upper arms, causing a “bat win” effect. This is seen in about 80% of women with Lipedema.
- Saddle Bags: Large areas of fat that project outwardly beyond the normal curve of your hip, also known as “football saddlebags” (because they look like there’s a football on the sides of your hips).
- Buttock Self: This is a larger buttock that sticks out significantly from the lower back when looking at your silhouette from the side. This is another feature seen in most women with Lipedema.
What Causes Lipedema?
We know that Lipedema is inherited in about 60% of women, and early studies show a genetic component is definitely at play (read more about that here!) and is the result of a malfunction of the Lymphatic System. The lymphatic system is a network of tissues and organs that help rid the body of toxins, waste, and other unwanted materials. This system transports lymph fluid throughout the body and is important for maintaining a healthy immune system. This disease affects the lymphatic system’s tiny vessels (microvessels) that cause a build-up of excess fluid around the body’s tissue cells. These tissue cells (located in the subcutaneous layers we discussed above) are then full of excess fluid, causing the swelling, soreness, bruising, and pain that many women with Lipedema report.
As researchers continue to gain understanding and genetic proof of Lipedema and differentiate it genetically from other diseases that they’re commonly misdiagnosed with, it will only become easier for women with Lipedema to get a proper diagnosis. Then, as the disease is more widely known and understood, treatments will become better and better, it will be more difficult for insurance providers to refuse coverage for treatments. Hopefully from there, more doctors will be trained in treating women with Lipedema properly, so treatments will become more accessible across the country! Read more about the first-ever Standard of Care Guidelines for Lipedema here!
How do you treat Lipedema?
There are two categories of treatment, surgical and non-surgical. Insurance providers require patients first try non-surgical treatment options before they’ll consider approving lipedema surgery, and Lipedema providers should be able to walk patients through this. While Lymph-sparing liposuction is the only treatment option that can provide permanent results by removing the lipedema fat, non-surgical options can help slow progression and are also necessary post-surgery (so it’s still important to practice them!).
Non-Surgical Treatment Options
To the dismay of patients, wearing medical-grade, tight compression garments 24-hours per day, seven days per week, is the key to improve circulation for the lymphatic system, making this a go-to prescription from Lipedema experts. Compression garments come in a variety of strengths and will be prescribed based on the stage and type of affected areas. The tighter the compression, the better.
A healthy and consistent lifestyle of clean eating and low-impact exercise to address obesity will also help with Lipedema. A diet focused on low-carb and low-sugar has proven successful. Low-impact exercise such as walking, water aerobics, yoga, or gymnastics has also reported success. Patients must avoid yo-yo dieting while also permanently losing or, at the very least, maintaining their weight. What works for one patient may not work for another. Diet and exercise recommendations and healthy practices are essential, but ultimately should be based on the individual with the understanding that weight gain is not an option.
Some patients opt-in to Manual Lymph Drainage massage (MLD), a gentle skin massage used to stimulate the circulation of the lymphatic system. While experts have yet to find significant evidence that MLD helps with Lipedema directly, some patients prefer it for its “hands-on” nature to addressing their symptoms.
Lymph-Sparing Liposuction for Lipedema
For patients in the later stages of Lipedema, the pain and disruption to daily life are not permanently addressed with compression garments, diet, and exercise alone. Traditional liposuction that uses general anesthesia, radio frequencies, ultrasound, or lasers are possibly damaging to the lymphatic vessels, and as such are not an option for Lipedema patients, either. However, Lymph-sparing liposuction is safe, using surgical techniques that avoid lymphatic injury, and the use of local tumescent anesthesia reduces the risk of complications. Generally, the most painful areas should be treated first, starting high on the legs and then moving downward in future surgeries.
Start Your Life-Changing Journey
Even with all the challenges presented by lipedema, there are those who you can trust. Dr. Wright continues to strive for better education, research, and coverage for the lipedema community. Do not let these challenges bring you down even further; let Dr. Wright and his expert team help you to reduce the symptoms of lipedema and live your life fully! Dr. Wright can help find the right procedure to help manage your lipedema symptoms. Don’t let lipedema take over your life; contact us today!