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! 

lipedema surgery

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! 
lipedema surgery

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. 

lipedema surgery

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:

lipedema surgery

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.

lipedema surgery

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!

Hi everyone – it’s Cat again!

If you haven’t read my story or seen any of my videos before, I’m a long-time patient of Dr. Wright and am working towards completing a total of five Lipedema liposuction surgeries with him. I’ve put together some helpful tips and a bit about my story, and you can find all my videos on Dr. Wrights YouTube channel.

My Lipedema Experience infographic featuring Cat

At the end of February, I hit the one-year mark since undergoing my second Lipedema surgery. My initial goal was to get all five surgeries completed within one year of being diagnosed (in October 2019). However, thanks to COVID-19 and life and money and insurance unhelpful companies, here I am; It’s already March of 2021, and I’m praying I can get a third surgery done soon! Until then, I want to continue helping women like me who are struggling with Lipedema, in the hopes that I can show you the light at the end of the tunnel, and help make the journey a little less overwhelming! In the video below and through this post, I’ll take you through what my life has been like since recovering from my 2nd surgery, and what it’s like being half-healed; I’m living in the in-between of some areas being treated while others are still in the midst of the struggle.

My Treatment Plan

After being officially diagnosed and working on non-surgical treatments, I met with Dr. Wright and his team to determine what surgeries I would need and on what areas of my body. We determined that I had Lipedema swelling and fat in my legs, abdomen, and arms, and would need a total of five surgeries: My legs, abdomen, front of my thighs, back of my thighs + buttocks, and my calves. I completed the front of my thighs in December 2019 and the back of my thighs and buttocks in February 2020. I had about 8 liters of fat removed in the first Lipedema removal surgery, and 12 liters (INSANE) in my 2nd surgery. To give you an idea of this volume, 8 liters is about 2 gallons of fat. So between the two, I’m free of a huge amount of lippy fat and am about 35 pounds lighter.

The Liposuction Machine used for Cat's Procedure

Because I live in Austin and Dr. Wright’s office is in St. Louis, the COVID-19 pandemic has made continuing surgeries difficult. His expertise, kindness, and genuine passion for helping women like us make the travel well worth it under any other circumstances, but we’re trying to be extremely cautious with flights. Over the last year, my partner and I have even thought about making the 13-hour drive to his office rather than continuing to wait, but the thought of riding in a car post-surgery is daunting.

Picture illistrating Cat's progress through the procedure

In mid-march, I have a virtual consultation with Dr. Wright to touch base and make plans for my 3rd surgery, this time focused on my calves. I’m so excited to get the next phase rolling, and hoping that the world calms down and allows for safe travel soon!

Recovering from the Lipedema Removal Surgery

My first and second surgery recoveries were actually extremely different. While the overall process and the surgeries themselves were all the same, I needed a week to recover the first time, and about two weeks to recover the second time. My backside was a bit harder to recover from due to the large volume of fat that was taken, and simply because sitting and laying down was more uncomfortable. I was able to drive, work, and get back to most of my routine within a few days, but I preferred to take it easy for the full two weeks because I was still leaking tumescent fluid, and putting on those compression garments is tough for the first two weeks (more like the first 6 weeks, just to set your expectations…) – I preferred to do this in the comfort of my home for as long as possible.

Cat post procedure with a blanket

Interestingly, in the first surgery, I had a lot of numbness on the inside of my thighs, which lasted about a month. Numbness is completely normal after liposuction as your nerves start to heal, so it wasn’t necessarily worrisome, but it was uncomfortable. It made walking extremely uncomfortable and, to the delight of my friends and family, I waddled like a duck for several weeks. So even though I spent more time on the couch after my second surgery, I still “enjoyed” it far more than the first. It’s just proof that every area of the body and every patient is different. But I loved the end results of both!

Life After Lipedema Surgery

As I sit here today, I find myself in a funny limbo in regards to living with my lipedema. The already-treated areas of my legs are doing great! No bruising, no swelling, and no sensitivity at all. In fact, my thighs even feel different to the touch – the remaining fat (I’m no bodybuilder yet, haha) is soft and fluffy – something I’ve never experienced before. The only fat I’ve ever encountered has been dominated by my lipedema fat – firm or tight, bulging, and sore.

But because I’m mid-treatment overall, the remaining areas of my body are still very much experiencing the pain of lipedema. The tops of my legs are great, and the bottom of my legs are struggling. My arms and abdomen are progressing and gaining more fluid and lipedema fat. As I work out, I get excited to see small changes in my thighs and depressed seeing no changes in the other parts of my body. When I bump into something with my calf and I get a pang of pain, I get angry and then grateful when I realize I can’t remember the last time I felt that in my thighs. It’s so many mental and physical feelings and changes all at once!

Other Positive Changes Post Lipedema Removal

There are so many things that anyone outside of the lippy community wouldn’t think twice about but have had a profound and positive impact on my life post-surgery.

How Can I Help You?

As I move into my next three surgeries, I’m sure I’ll have more updates! But until then, what questions do you have about my lipedema journey or the general process for getting treatment? Leave a comment or contact Dr. Wright and his team, and we’d be more than happy to put together more resources for you! We’re all in this together!

All the best,

Cat

Lipedema and Lymphedema Webinar: Mythbusting and Case Controversies
 
Join this lively and interactive discussion with Dr. Wright and other experts!
 
Jun 11, 2020 08:00 PM
 

Still unsure if you have Lipedema? Worried about all the unknowns of seeking treatment? You’re not alone! Meet Cat, one of the numerous women with lipedema, Dr. Wright’s patient who travels from Austin, Texas to St. Louis to complete her five scheduled lipedema surgeries. Cat is a writer, a women’s health advocate, and has a passion for documenting her journey and helping other women through it. As long as she can remember, Cat has struggled with her weight. She was never considered an obese child or teen, was active in sports from a young age, and trained and ran half marathons as an adult. Still, though, she found herself struggling with her weight and living with debilitating pain. She spent her summers avoiding the outdoors (because that meant she had to wear shorts or be miserable), never participated in beach or pool trips, and lived a daily struggle of physical and emotional pain. 

Not knowing any different, her family explained her issues away, helplessly insisting that she naturally had a “pear body shape”, which ran in her family. She bruised constantly, which was diagnosed as anemia. While she is slightly anemic, Cat has reported that her bruising and painful-to-the touch legs have improved drastically after only two surgeries on her lower body. After years of doctors telling her she was overweight and needed to continue to cut down her calories, Cat was at a loss. Below are her experiences, which she’ll continue to update through the remaining surgeries and recovery process.

Lipedema Ruined & Saved This Fat Girl’s Life

In her first blog post related to Lipedema, Cat writes of her journey towards diagnoses, which ultimately led her to Dr. Wright’s office in 2019.

When the Solution is More Painful Than the Problem

After her initial consultation and diagnosis, Dr. Wright and his team put a treatment plan together for Cat. Her first surgery was in December 2019, and this article outlines what she experienced before, during, and after treatment.

Stay tuned for more! Cat recently completed her 2nd surgery on her upper legs and will be reporting back to detail her experiences. Lipedema is estimated to affect 10% of all women across the world – you’re far from alone, and we’re here to help you through this process to a more fulfilling, healthy, and pain-free life. 

In this blog, Cat K shares her real-life experience with lymph sparing liposuction to treat her lipedema.

When the Solution is More Painful Than the Problem

My first Lipedema surgery was at the end of 2019. For weeks after, I did not open my laptop, except the occasional Netflix in bed. To say I was underprepared for the pain and disruption that came with this surgery does not do my folly justice. I was both overly confident and naive. Stubborn and headstrong. And ultimately, humbled and overcome. It stripped me of my desire and motivation to write and document the journey. Quite frankly, it tore me of nearly everything other than pushing through to wake up, muster enough energy to smile at work, and to get home, immediately ready for bed.

Pain is one thing, and overall, I’m able to deal with it. It’s temporary, and a natural partner to any surgical procedure. I anticipated the physical pain, but what I didn’t expect was how long it would linger, and how much it would affect my life in every tiny moment. When I need lip balm, water, or a tissue, the stretch aches. When my feet are cold and I need to put on socks, putting them on myself is out of the question.

Get yourself a friend like mine. Livia drove from Chicago to St. Louis to care for me, including putting my socks on for me, despite my protests that I could handle it on my own.

Perhaps more intimately, going to the bathroom. My god, what kind of torture are compression leggings at 2 AM, and all you can do is think of waterfalls and dripping sinks and rainstorms. Oh, and you also should be sure to drink as much water as physically possible, to help with the swelling. WTF.

While we’re on the topic, what kind of hell are compression garments?

Compression garments (def.): Adult-size Spanx shrunk to the size of a toddler’s leggings, which you must pull up and over your bruised, swollen legs. Then figure out how to take them on and off when you need to use the toilet.

One-month post-surgery and this single piece of clothing is still a pain in my ass — literally. I’m back to driving, I’m back to work, and I can even switch to just one layer of compression (instead of two) when I sleep. Yet by 2 PM, I’m sitting at my desk, struggling to breathe because the pantyhose layer is so tight on my stomach.

When I stand up to stretch, the back of the hose hugs my legs so tight that I have dark red rings around my knees and ankles. In all honesty, today, I gave up. I took off the pantyhose layer in the office bathroom, but I took them off so quickly and had a strong enough head rush that I almost passed out. In the work bathroom. Pants-less.

Bruised and discolored legs and one of many insertion points.

On the bright side, the ridiculousness of my bathroom stupor made me laugh and re-center. The journey has been painful, the solution is painful, and the freedom yet to come will be worth it. Until then, I’m dedicated to sharing the ugly truths and brilliant successes with those who are looking for answers. Or even for those who are just curious; It’s gross and fascinating.

The Lipedema Surgery

  1. I’m traveling from Austin to St. Louis for all five procedures. I arrive the day before surgery for pre-opt (weigh-in, before photos, measurements, etc.). I take it easy the day before surgery and start taking pain medications before bed. These make me tired, but not terribly so.
  2. The morning of surgery, I wake up at 6:30 AM for a light breakfast. I have dry toast and cereal with non-dairy milk. Then I take additional pain medications. Surgery is at 8:30, so I go back to bed for a nap before heading to the office.
  3. Upon arrival, the doctor gives me more meds. I strip down — modesty has no place in these surgeries — and head into the surgery room. Almost immediately upon getting situated, the nurses show me how to use the laughing gas. Like a rookie, I tell them I’ll proceed without it. My friends, DO NOT MAKE THIS MISTAKE.
  4. Now it’s time to get hole-punched. The nurses quickly push lidocaine-infused needles all around my legs, then plug the needle holes with tiny tubes. After I’ve gotten enough holes added, they hook up the tubes to IV-size bags of tumescent liquid. I had five bags of this pumped into my legs to loosen up the fat and numb me. Please note, I was not numbed as the fluid went in. It hurt. Luckily there were enough drugs to feel the pain but not care all that much. It would’ve been even better if I had the laughing gas. After the five bags are done, my legs are rock-hard.
  5. After I’m successfully full of tumescent, the doctor is ready to suck out all the fat, cysts, and excess liquid. And boy did he — 9,000 ml worth.

The tiny holes previously used for the tubes are repurposed for the small suction wand. For the next several hours, I watched the doctor push the rod around and suck out a mix of fat, liquid, and blood.

  1. That’s it. The nurses clean me off, give me my shirt back, and then help me get into the two layers of compression, the first layer being pantyhose and the second layer medical-grade compression leggings. I was later released to my caretaker and friend until post-op the next day.

The Recovery

This brings me back to the beginning: recovery sucks. The first two nights were particularly tough to get through, for three main reasons.

  1. My puncture holes leak everywhere. The tumescent liquid is still leaking, and now there’s blood. I have padding, but it soaks through. I got absorbent pads from the hotel, but I still leak all over their bedding.
  2. Going to the bathroom. Rolling compression up and down the legs is another circle of hell.
  3. The first shower. Instructions were to wait until Day 2. I was to take off one layer at a time, waiting at least ten minutes in between. And boy, did I not have a choice. After removing layer two, I did end up kneeling on the bathroom floor, pants-less. I then had to take a 20-minute rest before I could proceed.

Like the naive, hard-headed person I am, I had a post-op appointment the day after surgery and then proceeded to the airport to fly home. I cannot begin to tell you what a mistake this was. I needed wheelchair assistance through security and to the plane, and then from the plane to my sister picking me up. Pro-tip, even if it should be obvious:

Listen to the professionals. Don’t travel home the day after surgery, when you’re in pain and oozing fluid.

Fast forward one month, and I’m sitting on my couch, no longer leaking fluid. I can drive again, I can put on my socks, and I’ve gotten my average time to get dressed down to about 15 minutes. I’ve lost 26 pounds, specifically from my inner thighs and knees. I don’t have full feeling in my legs just yet, but I can walk almost normally, stretch carefully, and next week I plan to return to yoga.

For all the pain, cursing, and moments of regret when I couldn’t get my compression hose over my butt, I’ve stuck to the schedule and am ready for the next procedure. Despite the solution feeling more painful and desperate than the Lipedema itself, I see small pieces of progress each day, signaling that I’m on the right track. After a lifetime of chronic pain and disappointment, I consider this a win.

If you’re curious about Lipedema and think you might have it, you can read more about my journey before diagnosis here. If you’re interested in learning more from my doctor and his incredible team, visit Dr. Wright’s website here.

lipedema surgery

While lipedema has been recognized for quite some time now, the idea behind lipedema liposuction is still considered to be a recent development. Treatment for lipedema using liposuction is the brainchild of German dermatologist and surgeon Dr. Gerhard Sattler. He began his studies at the Johann Wolfgang Goethe University located in Frankfurt, where he received his degree in human medicine. Dr. Sattler completed his doctoral studies in 1988 and became a long-term physician with Darmstadt Hospital. Dr. Sattler’s studies started a journey that would eventually lead him to create liposuction for lipedema techniques that are still used to this day.

The Development of Liposuction

Dr. Sattler continued headstrong into his career in human medicine and founded the Rosenpark Clinic with his wife in 1996. His career highlights include the development of liposuction for medical aesthetics in 1989 which led to life-changing advancement in lipedema treatment. Since then, Dr. Sattler has performed over 10,000 different liposuction procedures over more than 25 years. His knowledge and coaching on how to effectively utilize liposuction continue to be invaluable to surgeons around the world to this day.

Two Methods for Lipedema Surgery

The work Dr. Sattler started in 1989 has led to the development of two major forms of lipedema surgery. The first, tumescent liposuction, involves injecting local anesthetics into subcutaneous fat tissue, causing it to swell. The targeted areas become so large that it becomes firm and easier to remove. The second treatment option is water jet assisted liposuction. This alternative form of liposuction uses pressured jets of water to dislodge the subcutaneous fat tissue, allowing it to loosen up and be removed through a cannula. A tumescent fluid is injected prior to the dislodging the fat tissue. This liquid is removed in the final steps, leaving your body with less subcutaneous fat tissue than before. Water jet assisted liposuction is gentler and leaves your body with less bruising than other methods.

Find Help with Your Lipedema

Dr. Sattler’s work has continued to inspire today’s surgeons, including Dr. Wright, to further enhance and make lipedema liposuction available to those in need. Most surgeons have used Dr. Sattler’s work to further train and evaluate their practice on treating lipedema. Contact our team today to see which lipedema treatments are available and right for you. The path to living with lipedema begins with reaching out to our trained team for help. Read about Waer Assisted Liposuction today!