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Safer Surgeries and Better Outcomes: Treating Leg Veins in Lipedema

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, 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

  • Endovenous Laser Treatment (EVLT): A minimally invasive procedure that uses laser energy to close off faulty veins, redirecting blood flow to healthier veins.
  • Sclerotherapy: Injection of a solution into the affected veins to collapse and eventually be absorbed by the body.
  • Compression Therapy: Use of medical-grade compression stockings to improve blood flow and reduce symptoms.

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.


At, 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.

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