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Lipedema diagnosis

One of Dr. Wright’s newer patients, Crystal, was diagnosed with Lipedema for the first time just 3 months ago, and she’s already feeling the joy and relief that comes with an official Lipedema diagnosis

“I felt a sense of relief and joy come over me instantly,” she says. 

Crystal was diagnosed by Dr. Wright with Stage 3, Type 3, and 4 Lipo-Lymphedema. Over the next 90 days post-diagnosis, she’s undergone two Lipedema surgeries and overcome a lifetime of challenges when it came to “her relationship with gravity”, as she calls it. She lost just over 70 pounds after the two surgeries and is relieved to be on a path of healing. 

Lipedema diagnosis

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 gets worse 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.

 

Nearly 17 million women in the U.S. and nearly 370 million women across the globe suffer from Lipedema. What is regularly associated with unruly weight gain in its initial stages can quickly spiral out of control if left undiagnosed. Often striking in a woman’s mid-20s, 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 present with pockets of fat on the limbs that appear disproportionate in comparison to the rest of the body.

Troubling Signs and Symptoms

Women suffering from this disease often report the association with lipedema pain symptoms that trigger difficulties dealing with everyday life activities. Excessive swelling often comes with pain, numbness, and bruising. In its advanced stages, Lipedema can impact mobility and provokes vascular and lymphatic swelling which can lead to further medical complications.

Lipedema diagnosis

Living with Lipedema Diagnosis

Lipedema is often misdiagnosed as standard obesity, leaving patients to deal with an endless cycle of disappointment and ongoing, painful lipedema symptoms. As they continue, their weight refuses to fall off. Unfortunately, Lipedema does not respond to a simple calorie restriction or increased exercise and ultimately requires surgical intervention in order to alleviate the appearance and pain of symptoms. 

Lipedema diagnosis

Patients often report that the road to their initial Lipedema diagnosis is an uphill battle. Women with Lipedema are typically diagnosed by their primary care provider with traditional obesity, and all treatment methods follow this diagnosis.

Unfortunately, as any Lipedema specialist will tell you, this treatment proves ineffective, and leaves women with Lipedema without answers, without a solution, and with continued pain and continued frustration as their, Lipedema continues to progress. Liposuction performed on the affected limbs is one of the most effective forms of treatment. Removing fat deposits that are diseased not only helps reduce swelling of the limbs but alleviates the pain that holds patients back from everyday activities. But before women with Lipedema and even consider these procedures and treatment options, they must first find a doctor who is an expert in this field and start with a proper diagnosis of the disease.

Getting Help & Lipedema Treatment

Just like Crystal, many women search for answers for years before getting an official diagnosis and validation for their struggles. “My body really needed this healing,” Crystal says. “I needed answers and I was craving [an] explanation why my body was fighting me.” While she contributes 15 pounds lost directly to her surgeries, she says she’s done the non-surgical work to get rid of additional lipedema swelling and fluid alongside surgery. She says she monitors what she eats and when, and eliminated a few types of foods that directly increase swelling, helping her lose more than 50 pounds on her own, and improving the outcomes of both her surgeries tenfold. 

She encourages other women who think they may have Lipedema to contact Dr. Wright and his team to get the same help she’s received. “If you have lipedema or lipo lymphedema like I do, go easy on yourself,” she says. “There isn’t anything you could have done to prevent it, but I’m living proof there are things you can do to live better and have a higher quality of life.”

Good news, these conditions are not life-threatening on their own. However, if undiagnosed or untreated, they will worsen over time and may contribute to several other secondary ailments and complications. If you have signs of swelling, and pain in your body, especially in your legs and arms, seek treatment starting with your primary care physician. Ongoing care of lipedema and lymphedema with a vascular expert lessens the risk of other serious problems.

Hearing the terms lipedema and lymphedema sound strange and Googling them can be downright scary.

For instance:

Remember, you are in control of how you manage your health and well-being. Educate yourself and do not hesitate tol ask for help. A great resource for emotional support from the comfort of your home is https://www.mind-diagnostics.org. A study by researchers at the University of California, Berkeley found online counseling can be just as effective as face-to-face therapy while being more convenient, affordable, and accessible.

Sources:
https://www.healthgrades.com/right-care/symptoms-and-conditions/lymphedema
https://my.clevelandclinic.org/health/diseases/8353-lymphedema
https://www.nhs.uk/conditions/postural-tachycardia-
syndrome/#:~:text=Postural%20tachycardia%20syndrome%20(PoTS)%20is,as%20postural%20orthostati
c%20tachycardia%20syndrome
https://www.aapmr.org/about-physiatry/conditions-treatments/pain-neuromuscular-medicine-
rehabilitation/degenerative-joint-disease
https://www.nhs.uk/mental-health/conditions/body-
dysmorphia/#:~:text=Body%20dysmorphic%20disorder%20(BDD)%2C,affects%20both%20men%20and%
20women.
https://www.betterhelp.com/study/Study_of_BetterHelp_eCounseling.pdf

In celebration of Lipedema Awareness month back in June, Dr. Wright and Dr. Herbst updated the world on the latest insights and understandings on Lipedema vs normal fat. Sponsored by Lipedema UK and Lipedema LIO ITALIA, we’ve summarized the key learnings and helpful information below. Don’t miss updates in the future on our “Lipedema in the News” section, and feel free to watch the full 1.5-hour webinar here.

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 gets worse over time. Sufferers living with lipedema experience easy bruising and tenderness, pain in the affected areas, and significant disability in daily life. In severe and more progressive cases, the trunk and upper body may also be affected, including the arms and upper back. Little is known about the disorder, and it’s often misdiagnosed and incorrectly treated as general obesity.

For anyone affected, diet and exercise alone aren’t effective ways to get rid of Lipedema fat; Lipedema fat has proved relatively immune to these lifestyle changes and won’t budge. While women are likely to experience some weight loss with a healthy diet and regular exercise routines, weight loss is usually mostly loss of non-Lipedema fat. In these instances, the painful, stubborn fat remains. This cycle becomes a difficult one to break for those with the disorder: Yo-yo dieting leads to more weight gain. More weight gain leads to increased pain and disability. Increased pain and disability make it more challenging to manage mobility and secondary obesity increases. Lipedema fat also appears to be relatively resistant to bariatric surgery, meaning many women are undergoing dangerous surgeries without experiencing the intended benefit of significant loss of lipedema fat.

Lipedema vs Normal Fat: What We Already Know

Lipedema adipose fat tissue is different from normal adipose tissue. When looking at this fat tissue in lipedema patients, we find a more fibrous, nodular, tender adipose tissue than in patients without lipedema. The look and feel of lipedema fat tissue can be physically seen when performing lipedema surgery in addition to under a microscope when analyzing the tissue components. It’s clearly a different type of fatty tissue, explaining why lipedema patients experience different side effects and symptoms than those with traditional obesity. 

A study published in the International Journal of Obesity in November 2021 (Ishaq et al) highlighted the cellular differences that signaled the differences in lipedema fat than traditional adipose tissue. 

The study had the following key findings:

 

Finding #1: Adipose Tissues Show Distinct Gene Signatures

This means that lipedema fat actually causes the body to turn on a different gene than we see in non-lipedema patients. Fat tissue from lipedema was compared to location, gender and age-matched tissue from non-lipedema patients. In the photo below, we see a heatmap gene expression of adipose tissue by Z-score fold-change value: red indicates upregulation and blue indicates downregulation.

Finding #2: The difference in lipid composition includes significantly increased lipids in lipedema

What does this mean? Lipedema fat has a different metabolism, characterized by a differing production of phospholipid production compared to normal fat.  Lipedema adipocytes are shown on the left half [Header Bright Red] and non-lipedema adipocytes are shown on the right side of the hierarchal plot of lipid composition [Green Header over columns]. 

Finding #3: Lipedema Fat has more stem cells than non-lipedema fat

In this study, stem cells [ADSCs] from lipedema fat were compared to stem cells of matched people without lipedema.  The stems in lipedema are increased in number.

Note: ADSCs are stem cells. They can continuously divide and renew themselves. The ADSCs stem cells can also become mature fat cells or other types of cells to sustain or grow fat tissue. This means that lipedema fat replicates their cells more than regular fat, increasing the growth of this painful, fibrous fat tissue in lipedema patients!

Additionally, Lipedema Stem Cells contain Fat Droplets and have More Fat Droplets per cell than non-lipedema fat cells. The number of fat droplets, percentage of fat-positive cells, and the number of fat droplets per cell were significantly increased in lipedema adipocytes compared to controls. Lipedema fat cells had more fat in them, and the presence of fat droplets in stem cells (ASCDs) indicates maturation toward an adipocyte. 

Finding #4: Cell Cycle Gene like Bub1 are upregulated in Lipedema

Cell-cycle genes involved in regulating cell growth and proliferation are dysregulated in lipedema ADSCs and may contribute to the increased adipocyte number, and maldistribution and accumulation of dystrophic fat in lipedema. Because of the lack of regulation, lipedema cells again are able to replicate and grow at a higher speed and frequency than non-lipedema fat.

For example, Bub1, which is one of the cell cycle genes, is turned on more or upregulated in lipedema.

What does all of this mean?

First, and most validating for people with lipedema, these findings prove that lipedema fat and normal fat are not the same. Adipocytes and stem cells from individuals with lipedema are structurally different and behave differently from cells of normal fat tissue. Second, diet and general nutrition do not affect lipedema fat in the same way it does for non-lipedema fat. Given the same nutritional support, lipedema-derived stem cells proliferated compared to normal fat-derived stem cells. And third, the faster growth of lipedema fat compared to non-lipedema fat can be explained at a cellular level. The different cell biology of the lipedema cells that leads to hyperproliferation of fat tissue may explain disproportionate growth compared to other adipose tissue.

Nature vs. Nurture

While these lipedema vs normal fat findings are exciting for lipedema providers, and even more validating for patients seeking insights and treatment options, one question still remains: Is the biology of lipedema fat different because of genetic differences or is the difference in the fat cell biology of lipedema a product of an altered environment? 

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!

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 gets worse over time. Sufferers living with lipedema experience easy bruising and tenderness, pain in the affected areas, and significant disability in daily life. In severe and more progressive cases, the trunk and upper body may also be affected, including the arms and upper back. Little is known about the disorder, and it’s often misdiagnosed and incorrectly treated as general obesity.

For anyone affected, diet and exercise alone aren’t effective ways to get rid of Lipedema fat; Lipedema fat has proved relatively immune to these lifestyle changes and won’t budge. While women are likely to experience some weight loss with a healthy diet and regular exercise routines, weight loss is usually mostly loss of non-Lipedema fat. In these instances, the painful, stubborn fat remains. This cycle becomes a difficult one to break for those with the disorder: Yo-yo dieting leads to more weight gain. More weight gain leads to increased pain and disability. Increased pain and disability make it more challenging to manage mobility and secondary obesity increases. Lipedema fat also appears to be relatively resistant to bariatric surgery, meaning many women are undergoing dangerous surgeries without experiencing the intended benefit of significant loss of lipedema fat.

Lipedema vs. Obesity

Unlike common obesity, Lipedema is comprised of fat deposits and swelling that typically does not affect the feet or hands; it’s as if patients are wearing a tight bracelet or rope at their wrists or ankles that causes every above to swell and everything below to remain unaffected. At more progressive stages, the swelling increases and leads to a diagnosis of lymphedema, which makes it even less likely Lipedema is diagnosed and treated promptly and adequately.

Despite the strong impact of Lipedema on millions of women across the world, only limited research exists to determine its cause. In many cases, the genetic background can provide some context, but enough research has yet to offer a comprehensive understanding of the disease. 

Dr. Wright and his team at St. Louis Laser Lipo & Vein Center have put together a helpful list of Lipedema Do’s and Don’ts for living with this difficult disease.

DO: Take This Cold Medication Regularly

Guaifenesin, best known by the brand name Mucinex©, and often prescribed as an over-the-counter expectorant to treat the common cold, may help reduce lipedema swelling and inflammation.

To our knowledge, there are no published, controlled studies showing the use of Guaifenisn to treat lipedema or lymphedema. However, there are abundant reports from clinicians and lipedema patients stating Guaifenisn helps lipedema. In our limited clinical experience, about 20 – 30 % of lipedema patients report reduced pain and/or swelling when taking this medication. Plus, there are reports of Guaifenisn being used for pain relief to treat other diseases. Guaifenesin has shown modest but significant analgesic and anti-inflammatory effects in neck and back pain and some other conditions. It is thought guaifenesin may be working as a  muscle relaxant effect that occurs in these conditions. Mucinex / guaifenesin may help pain or it may work as an expectorant in lipedema tissue and thin out extracellular proteins. However, there are no studies to support these theories in lipedema.

Guaifenesin for Lipedema: Dose and Use

Guaifenesin is approved for safe use at 600 mg twice a day (or 1,200 mg twice a day) for no more than 2,400 mg per day. Studies in the use of Mucinex for other medical conditions report it takes a least a week to see effects. I recommend lipedema suffers try this medication for two weeks to see if they notice any positive changes in addition to their consistent treatment plans including compression, supplements, and a healthy diet as prescribed. May not be suitable for people with a persistent cough due to asthma, bronchitis, emphysema, or smoking, or who have a cough that is producing excessive amounts of phlegm. Talk with your doctor first before using Mucinex if you are pregnant or breastfeeding.

DO: Use Diosmin to Combat Lipedema

Diosmin is a flavonoid extract made from orange peels used to treat vein disease. Diosmin helps reduce inflammation along vein walls in people with chronic venous insufficiency and it can also have very positive results for people with lipedema and lymphedema.

Benefits

In a recent case study, Diosmin had positive results when used in combination with other supplements, diet, compression, and other anti-inflammatory measures to non-surgically manage lipedema. Based on these studies, and my experience prescribing Diosmin to patients, I recommend Diosmin as part of an overall conservative management treatment plan for lipedema and lymphedema.

Where to Get Diosmin for Lipedema

In the United States, Diosmin is sold under the brand name Vasculera, which is available in pharmacies by prescription from a physician. Vasculera is approved by the FDA as a medical food.

Diosmin is also available as a supplement without a prescription. We recommend Vein Formula, as we trust its formulation. Be sure to order any supplements from a reputable website for the best safety and quality. Link https://vitasupportmd.com/products/vein-formula-1000

DON’T: Treat Lipedema with Fat Freezing 

Fat freezing—also known as cryolipolysis (or Cool Sculpting) uses cold temperature to reduce fat deposits in certain areas of the body. The procedure is designed to reduce localized fat deposits that do not respond to diet and exercise. It is not intended for people who are obese or significantly overweight. Currently, there is no published research on cryolipolysis for lipedema. Most lipedema fat is not the type of localized fat deposit for which this procedure is intended. Cryolipolysis can cause Paradoxical Adipose Hyperplasia (PAH). This condition can aggravate symptoms, and lead to worsening of lipedema.

DO: Adopt a Mediterranean Diet & Active Lifestyle (Instead of Keto!)

Researchers from Stanford University found both diets improved blood glucose and led to comparable weight loss. However, this study shows keto may elevate LDL cholesterol, lacks essential nutrients, and is more difficult to maintain over time.

Study: During the study, 30 adults with prediabetes or type 2 diabetes followed the Mediterranean diet and the keto diet for 12 weeks each. Both diets served non-starchy vegetables and avoid added sugars and refined grains, but there are three key differences between them: the Mediterranean diet incorporates legumes, fruits, and whole grains – keto does not.

Results:

Note: Please work with a doctor or nutritionist to choose a dietary pattern that fits your needs and preferences. The potential harms of higher LDL associated with keto cannot be dismissed.

Exercising can help to activate the lymphatic drainage system in a patient’s limbs through the foot and calf muscle pump. Workouts that aren’t too strenuous help to move the excess fluids out of affected limbs, as well as reduce additional fat buildup.

The lymphatic system differs from the blood circulatory system in that it does not have a muscle “pump” to move fluids into the lymphatic system and eventually return back into circulation. Because of this, good lymph flow depends on proper joint and muscle activity. This is especially true if the lymphatic system is compromised. Individuals suffering from lipedema can receive a great benefit when engaging in diaphragmatic breathing exercises. These exercises are especially beneficial when they are combined together with other parts of a decongestive regimen.

Because fat disorders and lymphedema can often feed into one another, exercise is a great option to help combat both. With its dual purpose of clearing out excess lymph fluid and burning fat, exercise offers exactly what patients need to deal with these disorders.

Types of Exercise

The best types of exercise to help treat lipedema and lymphedema are low-impact exercises and aren’t too strenuous, as strain can increase fatigue and pain levels. Low impact exercises help protect joints. Workouts should also focus on exercises that do not increase lactic acid build-up. 

The types of exercise used should be focused on the individual patient’s needs and ability. Additionally, it is important to use compression garments when exercising whenever possible. Compression garments help to promote blood circulation and lymph fluid flow, which can be severely inhibited in patients who suffer from fat disorders and lymphedema.

Living with Lipedema? 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!

References

Albert-Adrien Ramelet, MD, Pharmacologic Aspects of a Phlebotropic Drug in CVI-Associated Edema

First Published January 1, 2000 Research Article https://doi.org/10.1177/000331970005100105

https://scholar.google.com/scholar?q=diosmin+effect+on+lymphatic+function&hl=en&as_sdt=0&as_vis=1&oi=scholart

https://www.ncbi.nlm.nih.gov/pubmed/8919263

Int Angiol. A lymphatic function of Daflon 500mg., 1995 Sep; 14(3 Suppl 1):36-8

Recommended Sources of Diosmin: https://vitasupportmd.com/

LIPEDEMA DISEASE LINKED TO FAMILY HISTORY

3 independent studies find lipedema is an inherited condition.

As reported by The Cleveland Clinic [#} on its website, the exact cause of lipedema is unknown, but the condition runs in families and may be inherited. This statement is supported by three independent studies conducted by leading research teams in Europe who validated lipedema is a genetic condition. Lipedema appears to primarily affect females, presumably driven by estrogen as it usually manifests at puberty. Lipedema disease is different from obesity and is often misdiagnosed as primary obesity because these conditions commonly overlap.

Researchers hope to continue to study as many families as possible with multiple cases of lipedema to create a stronger genetic linkage and determine the biochemical makeup of this disorder. Having this data may help researchers identify the gene that causes lipedema to increase understanding and improve treatment for this painful condition.

Fig 1. Bauer and etal. study reaffirms relatives of lipedema patients also suffer with lipedema. In most cases, grandmothers and mothers were affected the most, followed by aunts, sisters, and cousins.

KEY RESULTS / FINDINGS

The familial nature of the condition suggests that lipedema can demonstrate heritability[1]. The exact nature of the form of inheritance is difficult to determine.

Of lipedema patients who participated in a study, 73% reported they had one or suspected multiple family members also had lipedema. Most frequently affected was the mother (38%), followed by grandmother (17%), aunt (8%), sister (6%) and cousin (5%).

A study from 2010 showed that within six families of more than three generations with lipedema disease, a genetic autosomal-dominant hereditary pattern [2]was found.

Frequent studies of mother-to-daughter mode of inheritance led researchers to theorize lipedema is a genetic disorder.

Fig 2. The largest family pedigrees (with a minimum of three living affected members in at least two generations) are demonstrated in Figure 2.

Family clusters of lipedema where more than one family member has the condition indicates a genetic component with a possibly X-chromosome[3] dominance inheritance pattern.

All affected family members were female first- or second-degree relatives of female patients.

One family had six living affected members in three generations, two families had five affected members, two had four affected members, and one further family had three living affected members.

As lipedema appears to be most common at puberty, it is reasonable to assume that hormonal influence underlies the marked female limitation shown in studies to date.

Estrogen is also considered to play a key role in regulating the manner of development of the condition.

Study participants:

Between all three studies, women ages 16-83 (average age, late 30s)

Do you suspect you or a loved one may have lipedema? We can confirm your condition and start you on your journey to feeling better. Contact us to schedule an appointment, today.

References

Bauer AT, et al. Plast Reconstr Surg. 2019 Dec;144(6):1475-1484  https://pubmed.ncbi.nlm.nih.gov/31764671/

Ghods M, Georgiou I, Schmidt J, Kruppa P. Disease progression and comorbidities in lipedema patients: A 10-year retrospective analysis. Dermatologic Therapy. 2020;e14534. https://doi.org/10.1111/dtch.14534

Child AH, Gordon KD, Sharpe P, Brice G, Ostergaard P, Jeffery S, Mortimer PS. 2010. Lipedema: An inherited condition. Am J Med Genet Part A 152A:970–976. https://pubmed.ncbi.nlm.nih.gov/20358611/  and https://www.researchgate.net/publication/346917917_Disease_progression_and_comorbidities_in_lipedema_patients_A_10-year_retrospective_analysis/figures

 

 # Cleveland Clinic Lipedema https://my.clevelandclinic.org/health/diseases/17175-lipedema

[1] Heritability is a measure of how well differences in people’s genes account for differences in their traits

[2] Autosomal dominant inheritance is a way a genetic trait or condition can be passed down from parent to child.

[3] The X chromosome is one of two sex chromosomes. Humans have two sex chromosomes, the X and Y. Females have two X chromosomes in their cells, while males have X and Y chromosomes in their cells.

June is Lipedema Awareness month, one in which the Lipedema community focuses (even more than usual) on how to reach women who have lived with this painful and distressing disease. While we’ve seen great strides in awareness, insurance coverage, and slightly greater recognition of this disease in the medical community, we continue to fight an uphill battle as women are underdiagnosed or completely dismissed when discussing their struggles and side effects with their providers. As a result, our team has put together some of the most important and impactful information for all of you, and we’re kicking off the month with a webinar from a team of lipedema experts.

Join us on Tuesday, June 7th, 2022 at 8 pm ET to listen to our panel discuss Recognizing Lipedema and Treatment Options. This is a FREE event! 

Register here, or listen to the recording following the webinar at tactilemedical.com/education.

Drs. Steve Dean, Thomas Wright, and Tony Gasparis with Julie Green, OTR/L CLT-LANA, WCC, CLWT discuss lipedema – the pathophysiology, association with vein disease, conservative treatments, and surgical options available for patients. 

What Is Lipedema Reduction Surgery?

Lipedema reduction surgery is different from cosmetic liposuction. Studies have shown that women with Lipedema have impaired lymphatic function. Lymphatic fluid promotes the collection of fat cells, which can cause the obstruction of 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 generous and special surgical techniques, studies have shown that lymphatic function can actually 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.

There are two specialized liposuction techniques that have been shown in studies to benefit individuals with lipedema: water-assisted and tumescent liposuction. In addition to the surgical equipment used, it is important to choose a surgeon with experience and one that is cautious when performing lipedema surgery. These factors can have an important influence on protecting lymphatic flow and function.

Who Is an Ideal Candidate for Lipedema Surgery?

Despite affecting an estimated 11% of women around the world, Lipedema is not yet widely known. Fat cells, (also referred to as adipose tissue) provide the human body with both cushioning and insulation. Lipedema affects the accumulation of these fat cells in the body, resulting in bulging, irregular fat in the affected areas. The legs are the most commonly affected area, but sometimes spreading occurs in the torso, and in many cases, excessive clustering of fat cells is noticed in the arms as well. Regardless of the affected area, the symptoms are equally debilitating, and unfortunately, these fat cells are equally resistant to both diet and exercise programs. 

Unlike Lymphedema or general obesity,  Lipedema has a tendency to affect both limbs equally and generally becomes more apparent over the course of time. Lipedema’s progressive nature makes getting a proper Lipedema diagnosis and treatment imperative and extremely time-sensitive – as the disorder progresses so does the pain, immobility, and discomfort.

In addition to the characteristic disproportionate fat accumulation, there are specific physical signs and symptoms of Lipedema. Do any of the following Lipedema symptoms sound like something you regularly experience?

3 Stages of Lipedema

Overall, Lipedema appears in a series of three stages. Do any of these sound like you?

Stage 1: The patient’s skin is flat and stretched over pearl-sized nodules.

Stage 2: The patient’s skin is indented, covering a layer of fat cells that look like pearl to apple-sized masses. 

Stage 3: Skin is indented, sometimes with much larger bulges, and skin covers pearl-sized nodules in combination with excessively large fat masses, causing lobules along the legs, hips, and thighs and frequently extending to the torso or upper arms.

Photo credit: Linda Anne Kahn at Integrative Treatment of Lipedema

Below are conditions that can be confused with and can affect people with Lipedema. Because there can be so much overlap in appearance and symptoms, only clinicians with the training and experience to diagnose and treat these conditions can differentiate them. 

When is the best time to get lipedema surgery?

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!).

Learn More About Stages of Lipedema Here!

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 improving 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.

Learn More About the Risks and Safety of Lymph-Sparing Liposuction Here!

What Results Can I Expect from Lipedema Surgery?

Perhaps the most noticeable benefit of lymph-sparing liposuction is how it is able to 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. It is critical to follow your physician’s guidelines to reduce any 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 8 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 when compared with 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 reestablished. The lymphatic function is often improved.

Lipedema Reduction Surgery Risks

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 a variety of treatments, it can cause complications for individuals with lipedema. In fact, it can cause complications in as high as 0.3% of liposuction treatments when used. Instead, lymph-sparing liposuction uses tumescent anesthesia to avoid these unwanted complications. In fact, general anesthesia can cause serious complications and even death in up to 0.3% of liposuction treatments when used. Patients are conscious for the duration of treatment, while the tumescent liquid acts as a local anesthetic in the treatment area. Patients take pain kills ahead of time to help with discomfort, and through the process feel little pain, and if anything, pressure in the area being treated. 

Lipedema reduction surgery also makes sure to avoid any additional risks for the treatment. This type of liposuction procedure limits the amount of fat tissue that will be removed at once, and a follow-up appointment is scheduled for the day following the procedure to ensure the treatment and recovery are going as planned. While that may not seem like a benefit at first, it will actually make sure your body does not take any additional trauma than what is needed. The general amount of fat tissue that can be safely removed is around 5.0 liters. Smaller cannulas are also used to also keep down the risk of trauma to the body and an already compromised lymphatic system.

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!

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 quickly spiral out of control if left undiagnosed.

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 in comparison to the rest of the body.

Lipedema is often misdiagnosed and dismissed by medical professionals as simple obesity, leaving affected women to deal 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. Ultimately, effective treatment will require cosmetic intervention in order to alleviate the appearance and pain of symptoms. Liposuction performed on the affected limbs is generally the most effective form of treatment. Removing fat deposits that are diseased not only helps reduce swelling of the limbs but alleviates the pain that holds patients back from everyday activities.

One of the top recommended treatments for dealing with lipedema is lymph sparing liposuction. This surgical treatment is able to 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.

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

Click Here to Learn More About Lipedema!

Why Do We Call It “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 collection of fat cells, which can cause the obstruction of 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 generous and special surgical techniques, studies have shown that lymphatic function can actually 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.

There are two specialized liposuction techniques that have been shown in studies to benefit individuals with lipedema: water-assisted and tumescent liposuction. In addition to the surgical equipment used, it is important to choose a surgeon with experience and one that is cautious when performing lipedema surgery. These factors can have an important influence on protecting lymphatic flow and function.

1 – No 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 a variety of treatments, it can cause complications for individuals with lipedema. In fact, it can cause complications in as high as 0.3% of liposuction treatments when used. Instead, lymph sparing liposuction uses tumescent anesthesia to avoid these unwanted complications. In fact, general anesthesia can cause serious complications even death in up to 0.3% of liposuction treatments when used. Patients are conscious for the duration of treatment, while the tumescent liquid acts as a local anesthetic to the treatment area. Patients take pain kills ahead of time to help with discomfort, and through the process feel little pain, and if anything, pressure in the area being treated. 

2 – Reduces Fat Tissue

Perhaps the most noticeable benefit to lymph sparing liposuction is how it is able to 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. It is critical to follow your physician’s guidelines to reduce any 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 8 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 when compared with 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 reestablished. The lymphatic function is often improved.

3 – Reduces Pain Associated with Lipedema

By reducing the amount of subcutaneous fat tissue, you can reduce any pain that is 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. 

4 – No Additional Risks Included

Lipedema reduction surgery also makes sure to avoid any additional risks for the treatment. This type of liposuction procedure limits the amount of fat tissue that will be removed at once, and a follow-up appointment is scheduled for the day following the procedure to ensure the treatment and recovery are going as planned. While that may not seem like a benefit at first, it will actually make sure your body does not take any additional trauma than what is needed. The general amount of fat tissue that can be safely removed is around 5.0 liters. Smaller cannulas are also used to also keep down the risk of trauma to the body and an already compromised lymphatic system.

5 – Quality of Life

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.

This procedure allows for a more active and healthy lifestyle, which many patients have experienced in 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 provide a higher quality of life for those who have missed it for years. 

Learn About Life with Lipedema Here!

Recovery from Lipedema Surgery

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 need to 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, and 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. 

Schedule Your Lymph Sparing Liposuction Today

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

Click Here to Learn About Insurance Coverage for Your Surgery!

Fall has arrived and with the cold weather looming you may be wondering what you can eat that can be both fulfilling and anti-inflammatory for your lipedema care. It’s easy to learn what you should and shouldn’t eat but sometimes hard to stick to it without the background knowledge of why. Knowing the why can help you make the best decisions for yourself and maybe incorporate some things that you may not have thought of before.   

Follow an Anti-Inflammatory Diet

It is recommended to follow the RAD diet (or Rare Adipose Disorder diet). The RAD diet is basically a modified Mediterranean diet that helps maintain a low glycemic index. The goal is to keep your insulin levels low by avoiding refined or processed starches and sugars that are found in pasta, rice, bread, corn, and potatoes. Avoiding processed carbs and processed food, in general, will help keep your inflammation at bay and in turn reduce your lipedema symptoms. Along with reducing starches, avoiding gluten(found in wheat, rye, and barley) all together may be necessary to limit flare-ups. 

For a healthy lipedema care meal plan, you will want a nutrition plan that is high in omega 3’s. Mainstream health organizations recommend a minimum of 250-300 mg of omega-3s per day, the FDA recommends not to exceed 3000 mg of omega-3, but European Food Safety Authority (EFSA) says up to 5000 mg of omega-3s per day is safe. 

Click Here for More Diet and Supplement Recommendations!

Why Are Omega-3s so Important if You Have Lipedema 

Omega-3s reduce the production of some substances (eicosanoids and cytokines) released during an inflammatory response in the body, reducing inflammation will help reduce lipedema flare-ups. Some added bonuses of increasing your omega-3 consumption are; it may help fight auto-immune diseases, decrease symptoms of anxiety and depression, improve eye health, promote brain health during pregnancy, improve risk factors of heart disease, reduce symptoms of metabolic syndrome, improve mental disorders, fight age-related mental decline, reduce fat in your liver, improve bone and joint health, alleviate menstrual pain, and improve sleep. 

Obviously incorporating more omega-3s into your diet will reduce inflammation and other symptoms that may arise from lipedema but what foods and supplements are best? Fish is high in omega-3s such as Mackerel (4,107mg per serving), salmon (4,123 mg per serving), herring (946mg per serving), oysters (370mg per serving-about 6 raw oysters), sardines(2,205mg per serving), anchovies(951 mg per serving), caviar(1,086 mg per serving). Now if you’re not crazy about fish, there are other options, flaxseeds, chia seeds, walnuts, and soybeans all have a similar amount of omega-3s per serving to their fish counterparts. 

**It should be noted that soybeans are high in omega-6s which can cause inflammation so you may want to leave the soybeans out of your diet.

Along with omega-3s, there should be a heavy focus on fiber in your diet plan. It is recommended that men get 38 grams of fiber a day and women 25 grams of fiber per day. Fiber can be split into soluble fiber(metabolized by good bacteria in the gut, water-soluble) and insoluble fiber(does not dissolve in water). Fiber feeds the good gut bacteria and works with our bodies in symbiosis by breaking down what we cannot on our own. By consuming fiber, we are feeding our gut bacteria “prebiotics” which the bacteria break down to produce necessary nutrients, short-chain fatty acids. Short-chain fatty acids feed the cells in the colon which can reduce gut inflammation. Fiber is also a necessary element to help you feel full and stay full longer! Also, it slows down digestion by absorbing water and in turn, increases the number of vitamins and nutrients the body can absorb. 

Omega-3s and fiber are incredibly important to reduce lipedema inflammation but what does that mean for what you should eat? Think of the standard food pyramid, instead of the high consumption of grains, it’s recommended to consume high levels of low-carb vegetables, herbs, and spices, such as cabbage, eggplant, carrots, cauliflower, Bok choy, peppers, broccoli, cucumbers, asparagus, etc. Here are some herbs for an extra boost of anti-inflammatory action: ginger, garlic, turmeric(with black pepper for absorption), cardamom, green tea, rosemary, and cinnamon. 

Next on the pyramid, you should consume a smaller amount of healthy fats like nuts- Peanuts, almonds, Brazil nuts, macadamia nuts, hazelnuts, pecans, avocados, coconut oil, and olive oil. Brazil nuts in particular have a large amount of selenium, a necessary nutrient that helps reduce the painful swelling that lipedema causes. It should be noted that only two brazil nuts a day can make a difference!

The next part of our pyramid is healthy protein. We’ve touched on a few fish for your omega-3s but you could also include eggs, chicken, turkey, tofu, shrimp, and tuna. Protein is another important component to help you feel full and stay full longer which helps reduce cravings. 

Lastly, we have lower-carb fruits, beans and legumes, and moderate-carb vegetables. Some lower-carb fruits include berries, melons, kiwis, mangos, and raisins. It is best to try to eat the rainbow! Each color has different nutrients and antioxidants necessary for a long-term healthy body and it’s much easier to track the colors you’re eating versus every nutrient each fruit/vegetable has in it. 

Patients with lipedema often have low levels of vitamin D3 so supplementing with four times the daily recommended dose of vitamin D is helpful along with Diosmin, and selenium if you are not able to eat brazil nuts. Fish and krill oil are great supplements to take on days you are not consuming high amounts of omega-3s

Now that we’ve covered food, what else can you do to keep lipedema symptoms aways?  There are multiple ways to keep your lymphatic fluids flowing such as yoga, dry brushing, massage, and compression garments. 

Yoga & Deep Breathing

Yoga is all around great for your whole body by lengthening, strengthening, and deep breathing, it can improve your health and mental wellbeing. Lymphatic yoga is even better for lipedema! Lymphatic Yoga can help move the stagnant fluid in the lymph system through the body and to the heart. Dynamic yoga such as sun salutations is great because it keeps you moving from one pose to another and encourages the movement of fluids. Any inversion poses and backbends will help fight gravity that keeps fluids in the lower part of your body from moving to the upper parts. Twists help with stimulating organs and stretching the spine. 

The lymphatic system lies just below the surface of the skin so dry brushing has been shown to stimulate the lymph system and help move venous blood. Dry brushing should be done with long firm strokes towards the heart. Start from your feet to the legs and groin and then hand to your armpits. An added bonus is your skin will be exfoliated and feel amazing! 

Massage & Deep Breathing for Lipedema Care

Lymphatic massage is a great way to reduce swelling and improve lymphatic circulation. You can go to a professional massage therapist who specializes in lymphatic massage or you can learn how to do it on yourself at home! When performing these techniques you should make sure you are relaxed, don’t perform this if it is too painful, and it should only affect your skin, so deep pressure is not needed.

Start by connecting to your deep breaths, slowly inhaling from your nose and out through the mouth. Try to make these breaths as long as possible with a pause between each breath. Like the dry brushing, you start from your feet and pull the skin up towards your heart with light pressure, so the skin stretches. Continue this all around the ankles, then calves and thighs. 

Compression

Last but not least, you can use compression garments! Luckily it will be getting colder so it won’t feel so hot and restricting to adding in an extra layer of clothes. It is best to use medical-grade garments because fluid flows from higher pressure to lower pressure and medical-grade compression garments have graduated compression. The compression at the lower part of the garment will force lymphatic fluid from the lower part of your body up through your body back towards your heart. Again, we’re fighting gravity so compression garments will need to be tighter for the legs versus your arms.

Learn More About Compression Garments Here!

You Got This

Now you have all the options to keep your lipedema symptoms low over the winter months, from eating the rainbow to yoga, massage, and compression garments. It’s a difficult disease to battle but you’re not alone, and now you have a few extra tools that can help you along the way. Contact us today!

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.

Learn More About Lipedema Here!
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.

Find More Non-Surgical Treatment Options Here!

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!

Hello to everybody! My name is Cat, and I’m a patient of Dr. Wrights, and a writer and content creation in the Women’s Health space. Dr. Wright and I work closely together, and I’ve put together some helpful information to give you the high points of the Lipedema treatment journey.

Everything You Need To Know About Lipedema, from 1 Lippy Lady to Another

For the first 29 years of my life, I walked through the world with the bitter understanding that I would never have a body I could be proud of. I became resolved to the fact that even though I live in Austin, Texas, where we average 300 days of sunshine and 8 months of 90-100 degree heat, shorts would never be a comfortable option for me. And in the few months of cold, boots over my shins were out of the question. What a cruel joke, right? In the summers I’m too hot, and in the winters I’m too cold.

After decades of rigorous diet and exercise, strict calorie counting, and perfect attendance at my accountability groups, I was at a complete loss. How could my body take me across the finish line of a half marathon, yet it couldn’t shed a single pound through my training? And how are my legs and butt this outrageous? Sure, there are perks to a body shape that most people envy, but only at the cost of extreme self-consciousness, depression, and intense leg pain and bruising. And how can every diet I try have absolutely zero permanent effects on my weight? Is that even scientifically possible? As it turns out – it is. Below is me in Dr. Wright’s office for my original diagnosis. I flew in for a morning appointment and flew home that night. What a whirlwind!

Photograph of one of Dr. Wrights clients

If you’ve made it to this website, I’m so happy you’re here! This means you’ve magically stumbled upon the answers that our doctors never told us – maybe they didn’t know, maybe they didn’t care to know, or maybe they were blinded by their very typical diagnosis of obesity (or lymphedema, or venous insufficiency, or some other incorrect thing). But as we dig into Lipedema and everything you need to know about it, I welcome you with a virtual hug, and I encourage you to take a moment to celebrate.
You are not crazy.
You are not simply ‘obese’.
It’s not your fault.
You are not alone.
And if knowledge is power, my dear friend, you are about to be the most powerful you’ve ever been!

What is Lipedema?

Evil.
And 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.

Diagram of Skin Structure

Shockingly, Lipedema affects an estimated 17 million women across the globe. When I said you weren’t alone, I wasn’t kidding! This disease affects a huge number of women, the majority of whom are still walking through their world the way I was walking through mine: lost, sad, and 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 body. 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.

3 Stages of Lipedeman Infographic

I personally had an extremely tiny waist, wore a size small top, and XL or XXL bottoms. My arms were mostly unaffected until my late 20s, but my legs were large, heavy, and totally disproportionate from the time I was 12 years old. What 12-year-old has already developed a pear-shaped body? Lipedema 12-year-olds, unfortunately. Pockets of fat developed in my legs and appeared to bulge in and out. The fatty bulges that I used to think were just extremely bad cellulite were actually pockets of Lipedema fat all over my thighs.

These pockets of Lipedema fat are accompanied by painful symptoms, such as excessive swelling, pain, numbness, and very easy bruising. If my dog jumped up on my legs, it was excruciating. If I bumped my hip into the side of a table, I knew I’d wake up with a deep, painful bruise the next day. 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.

Photo of lipedema on calves

While many women also see weight gain in their arms, it’s common that the following areas are greatly affected:

Learn More About Lipedema Here!
 

What Causes Lipedema?

This is where things start to get really exciting. It was only in mid-2019 that my research brought me to Lipedema, and at the time of my first surgery to treat it (in December 2019), there was still very little known about the causes. Experts in the field had hypothesized that the disease was hormonal in nature and very likely had a genetic component, but research was still too early to tell. But for all the doom and gloom 2020 has brought the world, we’ve also seen some really big and exciting movement in understanding the cause of this enigmatic disease.

We know that Lipedema is inherited in about 60% of women, likely through genetics, 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.

Infographic displaying Conditions Like Lipedema

Researchers now also have evidence that suggests there are specific biomarkers of this specific lymphatic malfunction that will provide medical providers a way to recognize – in our DNA – the differences between lymphedema, lipedema, obesity, and other potential lymphatic diseases.

But why is that so exciting? Just because we know what causes it doesn’t make it hurt less, right? Well, that’s kind of true, but kind of not! As researchers continue to gain understanding and genetic proof of Lipedema and differentiate it genetically from other diseases that we’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!

While it’s true that the disease itself is still painful and terrible, getting the research out there will allow for a much earlier diagnosis than women with Lipedema are used to. While I’m frustrated that it took me 30 years to get a diagnosis, I’m actually one of the lucky ones. Most women aren’t diagnosed until much later in life, well into their 50s, 60s, and even 70s. This advancement could be the beginning of the end for that trend!

Read More About What Causes Lipedema Here!

How do you treat Lipedema?

There are two categories of treatment, surgical and non-surgical. During my first visit to Dr. Wright’s office after being officially diagnosed, we first put a non-surgical treatment plan together so that I could start it right away. After that, we went through my surgical treatment plan because I was already in an advanced stage. Today, I’ve completed 2 of my 5 scheduled surgeries, with a delay thanks to the COVID-19 pandemic. I’m so grateful that we went through both treatment plans because I am now back to practicing my non-surgical treatments while I wait for my next surgery. Both are necessary, especially because Lipedema is a progressive disease! Even after my surgeries are complete, I’ll be continuing with the non-surgical practices for the rest of my life. Below is one of the first full body photos I’ve ever taken of myself, shortly after healing from my 2nd surgery.

Post surgery photo of a client

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.

Find More Non-Surgical Treatment Options for Lipedema Here!

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.

Infographic about treating Lipedema

How Do I Start Getting Treatment for Lipedema?

I can confidently say that you’ve already done the most difficult part of this Lipedema journey – you lived with it without any answers! Now, it’s time to work on getting a formal diagnosis and working with your medical provider on what plans and timeline will work best for you. Review our 4-Step Guide to Getting a Lipedema Diagnosis, and as always, reach out to Dr. Wright if you have any questions! His website is a wealth of resources and knowledge, and he’s truly passionate about furthering the treatment and research to help women like us (I speak from experience!).

Infographic of the 4 Steps to a Lipedema Diagnosis