For a Better Life


We are pleased to announce that Dr. Wright accepts patients for Lipedema Reduction Surgery in-network with United Healthcare.  We are delighted that United Healthcare is working with us to provide the lipedema patient community with in-network lipedema treatment options.  Please be aware that United Healthcare’s medical necessity criteria must be met to their satisfaction before approval.  This includes six months of conservative therapy (diet, exercise, compression), photo documentation showing disproportionate tissue of the extremities, and documentation of functional impairment. We also highly recommend that patients document their personal journey to share with their provider and UHC to prove their need for further treatment.

We aim to help the lipedema community obtain affordable in-network treatment and care.  We will continue to work with other payers to achieve fair compensation for the expertise and outstanding patient care and outcomes we provide to our patients.

Lipedema is a chronic condition affecting many women, causing disproportional fat distribution and significant physical discomfort. Fortunately, UnitedHealthcare (UHC) Insurance offers lipedema treatment insurance coverage, but it’s essential to understand their strict criteria and the steps required to get the coverage you need. We’re here to guide you through obtaining lipedema insurance coverage through UHC while shedding light on Dr. Wright’s success in securing coverage for his patients. 

United Healthcare’s Lipedema Coverage Policy

United Healthcare recognizes individuals’ challenges with lipedema and has developed a policy for treating this condition. However, it’s important to note that they have stringent criteria that must be met to qualify for lipedema covered by insurance. Below is the general outline of what criteria UHC is looking for. At the end of this article, we summarize the entire process that includes this criterion. 

Criteria for Lipedema Treatment Insurance Coverage

To be eligible for treatment for lipedema covered by insurance through UHC, you must meet the following criteria:

Diagnostic Criteria: You must meet all diagnostic criteria for lipedema. This includes having photographs showing disproportional fat distribution consistent with the diagnosis. Additionally, you must have documented evidence of the failure of disproportional fat to respond to medically supervised weight loss or bariatric surgery if your BMI is in class 2 or above (BMI +35).

Conservative Therapy: You should have completed medically supervised conservative therapy for lipedema for at least six months. This therapy includes compression garments, manual lymphatic drainage (MLD), and a low-carb diet. Documenting your efforts is crucial. You must document if symptoms persist despite diet adherence and compression use.

Medical Evaluation: In addition to diagnosing lipedema, you’ll need another diagnosis from your primary care physician (PCP) or a specialist who is not providing surgery for lipedema. This diagnosis should support the need for surgical intervention to treat lipedema.

Functional Impairment: To further substantiate your coverage case, you must provide documentation of functional impairment. This could include how lipedema affects mobility, physical activity, and daily life. Be sure to detail the limitations you experience due to lipedema, as this will strengthen your case.

lipedema treatment insurance coverage

Dr. Wright’s Success with UHC Coverage

One positive aspect to highlight is that Dr. Wright has had significant success in helping his patients secure lipedema insurance coverage treatment through United Healthcare. This speaks to the importance of having a knowledgeable and experienced medical professional on your side when navigating the insurance process. His patients have seen great success with lipedema surgeries and long-term quality-of-life changes. Below he and one of his patients were featured on FOX 2 St. Louis!

The Process of Obtaining Lipedema Insurance Coverage

Now that you understand the criteria for UHC’s lipedema coverage policy, let’s outline the steps to help you secure the coverage you need:

  1. Consultation with a Specialist: Seek a specialist who can diagnose and document your lipedema. This specialist should not be the one providing surgical treatment. Make sure to discuss your functional impairment during this consultation.
  2. Conservative Therapy: Undergo medically supervised conservative therapy for at least six months. Keep detailed records of your therapy sessions, progress, and any lack of improvement.
  3. Medical Documentation: Request a separate diagnosis from your primary care physician or another specialist supporting surgical intervention to treat lipedema. This diagnosis should complement the lipedema diagnosis.
  4. Photographs: Obtain photographs showing the disproportional fat distribution consistent with lipedema.
  5. Consultation with Dr. Wright: If possible, consider consulting with Dr. Wright or a similarly experienced specialist who can guide you through the insurance process. Their expertise can be invaluable.
  6. Submission of Documents: Submit all the necessary documentation to UnitedHealthcare, ensuring that you meet all the criteria outlined in their policy.  Include your personal notes and information about your journey in this submission. 
  7. Advocacy: Be prepared to advocate for yourself and your need for treatment. Insurance processes can be complex, but persistence can pay off.

United Healthcare does offer coverage for lipedema treatment, but they have strict criteria that must be met. By following the steps outlined in this article and enlisting the expertise of a knowledgeable specialist like Dr. Wright, you can increase your chances of obtaining the coverage you need to manage and treat your lipedema effectively. Remember that your health and well-being are worth the effort required to navigate the insurance process successfully.

Read more about the UHC Policy here.

We will make every effort to get patients approved for Lipedema Reduction Surgery; however, final approval for medical necessity and prior authorization is determined by United Healthcare and at the discretion of a Medical Director at United Healthcare.  We cannot guarantee patients will be approved for surgical procedures.

 Why Aren’t More Health Insurance Companies Covering Treatment for Lipedema?

The general rule of thumb for Lipedema Insurance Coverage claims reimbursements is that any given claim must be deemed “medically necessary”. Lymph Sparing Liposuction is nearly always considered a cosmetic surgical procedure in nature or experimental, meaning this is an elective procedure and not a medical necessity. Of course, as explained above, this is not the case for women with Lipedema, as lymph-sparing liposuction is the only treatment option for dealing with this disease that can reverse progression. However, the combination of the surgery being deemed cosmetic and election plus the general under-education and lack of awareness in the medical community has led to the battle patients and Lipedema surgeons are fighting. We must educate and advocate for these surgeries to be covered. 

Coding Lipedema Surgery with Cosmetic CPT Codes 15877-79 

The liposuction CPT codes 15877-79 are cosmetic codes that were never intended to be used by commercial insurers to cover reconstructive or medically necessary procedures to improve function and technically should not be used for reconstructive treatment. Because they are cosmetic codes and are not covered by Medicare, they have never had a value or RVU (Relative Value Units) assigned to them. Some medical insurers like Blue Cross Blue Shield exploit the lack of an assigned value for the codes they insist on using.  If an insurance company assigns little or no value to the surgery, even when it is a covered benefit, they can pay less for the 5-hour surgery than for a 15-minute follow-up office visit. This means that because they use cosmetic codes 15877-79, which can have little or no value assigned by commercial payers like Blue Cross Blue Shield, they can pay so little that they are, for practical purposes, technically “covering” treatment. But in practice, they’re not covering liposuction to treat lipedema. The good news, at least for now, is that UHC is covering Lipedema Surgery with a reasonable assigned value.

Contact a Specialist, Even If You Don’t Think Insurance Will Cover!

Despite the challenges and lack of coverage, some physicians, like Dr. Wright in St. Louis, do everything they can to work with patients to get insurance coverage. They are familiar with the ins and outs of different insurance providers, and their teams work extremely hard to get patient coverage. ERISA experts and attorneys can help you work on lipedema treatment coverage, and physicians can help you connect with them if you aren’t sure where to start. 

You might also come across individuals who are self-described as “patient advocates”. These individuals will present themselves as experts in getting coverage for you. Still, they’re not licensed individuals and are unlikely to be bound by patient privacy laws that you’ll get with physicians and attorneys. We are aware of players in this field who are bad actors and ultimately hurt the cases of patient coverage. Be sure to check the BBB listings, names, and addresses of anyone wanting to work with you, along with Google Reviews and website listings. 

Please reach out to our office, and Dr. Wright’s team would be happy to refer you to experts depending on where you are in your Lipedema diagnosis and treatment journey. We’re here to help, and happy to get you started!


Dr. Wright’s innovative lipedema surgery techniques are transforming lives by improving mobility and enhancing the quality of life for patients. He will be conducting a video demonstration of his surgical techniques in a Master Class for Lipedema treatment at this year’s 1st Annual Lipedema World Congress.

As a founding member of Lipedema World Alliance (LWA) and with expertise in this procedure, Dr. Wright will present the Tumescent Local Anesthesia (TLA) approach using power-assisted liposuction. In this course, he will describe his approach and techniques to give the best surgical outcomes and the greatest impact on mobility and quality of life long-term. His video demonstration and Master Class will be conducted on October 4, 2023, in Potsdam, Germany, with international participants from Spain, Italy, Austria, Germany, Norway, Lithuania, Sweden, Australia, India, Argentina, Brazil, USA, Iceland, Denmark, and Turkey. Below, we outline the topics and steps Dr. Wright will discuss.

Pre-Surgical Optimization

Anti-Inflammatory Diet & Compression Therapy

Patients must first implement an anti-inflammatory diet and compression therapy. Their diets should emphasize low-refined carbs and avoiding processed foods, and medical-grade compression optimizes lymphatic function and tissue inflammation. These combined measures can decrease limb size, decrease pain, and lead to softening of the lipedema tissue ahead of surgery.

Pre -Surgical Mapping

Before lipedema surgery, using high-frequency Ultrasound, the greater and smaller saphenous veins are mapped, and adjacent principal lymphatic collecting ducts are located.  The watershed area around the principal superficial lymphatics in the legs is approached with extra care during surgery. 

Generous Tumescent Anesthesia. 

Tumescent fluid helps protect vascular and lymph vessels from injury, so the surgical area must be completely tumescent. Dr. Wright was trained in the Tumescent Technique by its inventor, Dr. Jeffery Klien. He follows The Klein Method and Dosing. General anesthesia adds the risk of general anesthetic medication. It can also lead to areas of inadequate tumescence because the general anesthesia blocks the ability to find areas that were incompletely tumescent.  

The Liposuction Technique 

Dr. Wright uses small (3mm) blunt cannulas to remove as much lipedema-affected adipose tissue as possible. This process works to debulk the area using longitudinal techniques. 

The cannula is directed in longitudinal strokes, especially in the areas marked with lymphatic collectors, so it allows transecting of the lymphatic vessels. This requires frequent position changes, sometimes 8-12 different patient re-positions, to ensure he can remove the tissue using longitudinal cannula strokes. 

After as much lipedema-affected tissue as possible has been removed with the suction cannula, he feels and massages the affected areas to check for any remaining fibrous lipedema nodules. If lipedema nodules are still present, then we manually loosen the nodules. If necessary, we manually extract them with an additional puncture of incision. 

The patient is then placed in medical-grade compression to be worn for 24 hours a day for the first month.

Removing Lipomatosis Nodules

Early-stage Lipedema (Stage 1) has small nodules the size of small seeds or peas, which often appear pearl-size. Middle-stage Lipedema (Stage 2) has larger nodules that feel the size of walnuts or gumballs. The presence of lobules characterizes the later stage, Lipedema (Stage 3). The nodules in Stage may be the same size as those in Stage 2, or they may be larger up to the size of a plum.

In the earlier stages of Lipedema (Stage 1 and most patients in Stage 2), the subcutaneous nodules are removed with lipedema reduction surgery, which involves modification of cosmetic liposuction using tools and techniques that minimize harm to the lymphatics. In lipedema patients with larger or more adherent nodules, the nodules have to be manually extracted.

In these cases, a small incision is made over the nodules that resist removal with a suction cannula and are gently milked out of the skin. Surgeons don’t want to cause any more trauma than is absolutely necessary. However, there are instances where this method is the only way to get larger, more adherent nodules removed. Dr. Wright has several videos of the extraction process you can view here.

Frequently Asked Questions about Lipedema Liposuction

How long does lipedema liposuction take?

The procedure typically takes several hours to complete, depending on the extent of the lipedema.

Is lipedema liposuction painful?

Patients may experience some discomfort and swelling in the days following the procedure, but this can be managed with pain medication and other treatments.

How long does recovery take after lipedema liposuction?

Most patients can return to work and other activities within a week or two, although this may vary depending on the extent of the liposuction and individual healing rates.

Lipedema Surgery Reduces Painful Symptoms

By reducing the amount of subcutaneous fat tissue, you can reduce any pain associated with lipedema. Lipedema reduction surgery, sometimes called Lymph sparing liposuction, will 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.

Lipedema, also known as lipoedema, is a chronic condition that affects many women worldwide. It is characterized by an abnormal accumulation of painful adipose tissue, primarily in the legs. Unfortunately, lipedema is often misdiagnosed as simple obesity, leading to misunderstandings and challenges for women seeking proper healthcare. In this comprehensive guide, we will explore the causes, symptoms, and management of lipedema. We will also delve into St. Louis lipedema treatment options, highlighting the importance of early diagnosis and a multidisciplinary approach to care.

Understanding Lipedema: Causes and Symptoms

Lipedema is a complex condition with various factors contributing to its development. While the exact cause is unknown, there is a strong hereditary component, suggesting a genetic predisposition to the disorder. Hormonal imbalances and significant life events, such as puberty, pregnancy, or menopause, can trigger the onset of lipedema symptoms.

The classic presentation of lipedema is characterized by a disproportionate accumulation of fat in the lower body, while the upper body remains relatively unaffected. The legs may appear columnar or lumpy, with fat deposits often extending from the hips to the ankles. Importantly, the feet and ankles are not typically affected, distinguishing lipedema from regular weight gain.

In addition to the visible fat accumulation, individuals with lipedema experience pain and tenderness in the affected areas. The fat deposits can be sensitive to pressure and may bruise easily. Furthermore, the skin overlying the fat may feel different from other areas of the body, exhibiting reduced elasticity.

The Three Stages of Lipedema

Lipedema is commonly described in three stages, although it is important to note that these stages of lipedema are not necessarily progressive. The stages reflect the severity of the condition and the presence of additional factors such as obesity and lymphedema.

Stage 1: Early Lipedema

At this stage, individuals primarily experience lipedema without significant obesity or lymphedema. The legs exhibit excess fat accumulation, and pressure on the fat deposits may cause pain. The skin remains healthy, and there is no visible swelling in the ankles or feet. While the symptoms may be bothersome, with proper management, Stage 1 lipedema can be effectively controlled.

Stage 2: Moderate Lipedema

In Stage 2 lipedema, the fat accumulation becomes more pronounced, and the pain and discomfort intensify. The affected areas may exhibit increased sensitivity, making daily activities challenging. At this stage, individuals may also begin to notice swelling in the ankles and feet, indicating the potential onset of lymphedema. It is crucial to seek appropriate treatment and lifestyle management strategies to prevent further progression.

Stage 3: Advanced Lipedema

Stage 3 lipedema represents the most severe form of the condition, often accompanied by significant obesity and lymphedema. The excess fat deposits are more extensive, causing considerable pain and impairing mobility. Swelling in the lower extremities becomes more apparent, requiring specialized treatment approaches to manage the combined effects of lipedema, obesity, and lymphedema.

St. Louis Lipedema Treatment Options

In St. Louis, there are various treatment options available for individuals living with lipedema. It is essential to consult with a healthcare professional experienced in managing this condition to develop a personalized treatment plan. A multidisciplinary approach is typically recommended, combining medical interventions, lifestyle modifications, and emotional support.

Medical Interventions

Medical interventions for lipedema focus on symptom management and improving overall well-being. The following treatments may be considered:

Lifestyle Modifications

In addition to medical interventions, lifestyle modifications can greatly impact the management of lipedema. The following strategies may be beneficial:

Emotional Support and Education

Living with lipedema can be emotionally challenging, as individuals may face stigma, body image concerns, and difficulties in finding appropriate healthcare providers. Seeking emotional support and education can significantly improve coping mechanisms and overall mental health. Connecting with support groups, patient communities, and organizations dedicated to lipedema can provide valuable resources and a sense of belonging.


Lipedema is a chronic condition that requires a comprehensive approach to management. Understanding the causes, symptoms, and available treatment options is essential for individuals living with lipedema. In St. Louis, there are dedicated healthcare professionals experienced in diagnosing and treating lipedema. By implementing a combination of medical interventions, lifestyle modifications, and emotional support, individuals with lipedema can effectively manage their symptoms and improve their quality of life. Remember, early diagnosis and treatment are key to preventing further progression and maintaining optimal health. If you suspect you may have lipedema, consult with a healthcare professional experienced in managing this condition to develop a personalized treatment plan tailored to your specific needs.


In today’s society, body image and weight management are often hot topics of discussion. Many individuals strive to achieve their desired physique through diet and exercise. However, for some, the struggle to lose weight in certain areas, particularly the legs, can be frustrating and confusing. This leads us to a common question: Is it lipedema or obesity? In this comprehensive guide, we will explore the key differences between lipedema and weight gain, helping you understand your body better and make informed decisions about your health and well-being.

Understanding Lipedema

Lipedema is a chronic and progressive medical condition characterized by the abnormal accumulation of fat cells, primarily in the lower body. It predominantly affects women, with an estimated prevalence of 7-11% in Western countries. Lipedema causes a disproportionate increase in fat deposits in the legs, hips, and buttocks while sparing the hands and feet. Individuals with lipedema often have a smaller waist and upper body, creating a distinct pear-shaped appearance.

One of the primary distinctions between lipedema and weight gain is that lipedema fat is resistant to traditional weight loss methods such as diet and exercise. Despite leading a healthy lifestyle, individuals with lipedema find it challenging to reduce fat in the affected areas. Lipedema fat can also exhibit unique characteristics, such as a gelatinous texture and the presence of small nodules beneath the skin.

Lipedema is thought to have a genetic component, with hormonal changes during puberty, pregnancy, and menopause potentially triggering its onset or exacerbation. It is crucial to understand that lipedema is not caused by obesity. While many individuals with lipedema may also be overweight or obese, the condition itself is independent of weight status.

Differentiating Lipedema from Weight Gain

It is important to distinguish between lipedema and weight gain to ensure accurate diagnosis and appropriate treatment. While both conditions involve the accumulation of excess fat, they have distinct characteristics and underlying causes.

Symptoms and Presentation

Lipedema presents with specific symptoms that differentiate it from general weight gain. Individuals with lipedema often experience:

In contrast, weight gain typically occurs more evenly throughout the body and is not associated with pain or other physical symptoms commonly seen in lipedema.

Response to Lifestyle Changes

One of the key distinctions between lipedema and weight gain is the response to lifestyle changes. Individuals with lipedema often find that diet and exercise alone do not significantly impact the fat accumulation in the affected areas. Despite their best efforts, weight loss may be minimal or not occur at all in these specific regions. On the other hand, individuals experiencing general weight gain will typically see changes in their body composition through proper nutrition and physical activity.

Distribution of Lipedema Fat

Lipedema fat distribution differs from general weight gain. Lipedema fat primarily affects the lower body, including the legs, hips, and buttocks, while sparing the hands and feet. This leads to a distinct shape and disproportion between the upper and lower body. In contrast, weight gain is typically more evenly distributed throughout the body, without the characteristic pear-shaped appearance.

Psychological and Emotional Impact

Lipedema not only affects physical health but can also have a significant psychological and emotional impact. Many individuals with lipedema experience depression, low self-esteem, and social isolation due to the perceived body image differences and the challenges associated with finding appropriately fitting clothing. Weight gain, on the other hand, may have similar psychological effects but is not specifically linked to the unique challenges faced by individuals with lipedema.

Diagnosis and Treatment

Accurate diagnosis is essential to establish appropriate treatment strategies for individuals with lipedema. If you suspect that you may have lipedema, it is crucial to consult with a healthcare professional experienced in the diagnosis and management of this condition. They will evaluate your symptoms, medical history, and perform a physical examination to assess fat distribution and other associated features.

Currently, there is no cure for lipedema, but various treatment options can help manage symptoms and improve quality of life. Treatment for lipedema may include:

It is important to note that liposuction is not a cure for lipedema but can offer significant improvements in symptoms and overall quality of life for select patients.


Understanding the difference between lipedema and weight gain is crucial for accurate diagnosis and appropriate treatment. Lipedema is a chronic condition characterized by the abnormal accumulation of fat in the lower body, while weight gain is a general increase in body weight. Lipedema fat is resistant to traditional weight loss methods, and individuals with lipedema often experience specific symptoms, such as pain, tenderness, and easy bruising.

If you suspect you may have lipedema, consulting with a healthcare professional or an experienced lipedema specialist is essential to develop an individualized treatment plan that addresses specific needs and goals. Dr. Wright and his team of experts are here for you whenever you’re ready to start your treatment journey!

Remember, your health and well-being are important, regardless of your body shape or size. By seeking appropriate care and support, you can live a fulfilling life and embrace your unique beauty. 

Lipedema is a condition that affects the distribution of fat in the body, primarily in the lower extremities. Lipedema is a progressive disorder and a significant portion of women with Lipedema progress to secondary Lymphedema. Understanding the relationship between lymphatics and Lipedema is crucial in understanding how lipedema develops and progresses. 

It’s characterized as a “progressive disorder,” meaning the tissues enlarge and that, over time, there is a progressive deterioration of lymphatics. When looking at extracellular water content, which is a marker of lymphatic function, the higher the stage of lipedema, the greater the proportion of women with lipedema who also had increased amounts of extracellular water consistent with lymphatic impairment. To put it simply, research is finding that lipedema and lymphatic impairment are related. 

The lymphatic system is responsible for maintaining the balance of fluids in the body and helps remove waste products and toxins through a network of vessels and lymph nodes. When the lymphatics are not functioning properly, fluid can build up, leading to swelling and inflammation. In the case of lipedema, there is often impaired lymphatic drainage. Excess fat cells can pressure the lymphatic vessels, causing them to become compressed and less effective at removing fluid. 

Lymphatic impairment changes the whole biology of the affected tissues. In the legs and arms affected by lymphatic impairment, the biology of the fat cells and other connective tissues is changed. The cells and tissues are always creating proteins and storing and releasing fats as part of a normal, healthy bodily function. As part of this system, lymphatics are responsible for removing fatty acids, cellular debris, and large protein as they work to clean up, remodel, and maintain the structure and function of the tissues. 

When we have lymphatic impairment in our tissues, the biology of these cells completely changes. There is an increased deposit of fibrous tissues, and the fat cells increase in number and size. These cells are no longer doing their job properly, and we don’t have equilibrium; the balance shifts towards tissue growth and fibrosis, leading to swelling and limb enlargement that is typical of lipedema and oftentimes, secondary lymphedema.

As the tissue enlarges in women with lipedema, we start to see more telltale signs of the disease, such as lobules and cuffs at the ankles and wrists. As these lobules and cuffs enlarge, the skin droops and hangs off the body. This, in turn, causes localized swelling and further disrupts the lymphatic flow, leading to a vicious cycle. The tissue enlargement caused by impaired lymphatics further disrupts lymphatic function. Read more about Lipedema Lobules and Nodules here

Let’s break down in greater detail the lymphatic system and its role in maintaining healthy tissue. The lymphatic system is a network of vessels and organs that help remove waste, toxins, and excess fluid from our tissues. It plays a vital role in maintaining a healthy immune system and fluid balance. The lymphatics and veins are closely interconnected. Lymphatic vessels are responsible for carrying lymphatic fluid, which contains immune cells and waste products, while veins are responsible for carrying blood back to the heart. Both systems work together to ensure proper circulation throughout the body. For those struggling with vein health and lipedema, we’ve outlined the causes and treatments.  

How the Lymphatic System Works

Like lipedema, lymphatic circulation has been neglected and largely ignored until recently. For example, the arterial-venous circulation system is nearly common knowledge. Most people learn about it in school, and we have a clear understanding of how it works: The heart pumps the blood through the arteries, which take the oxygenated blood to the tissues, and then the venous system returns the deoxygenated blood to the heart. This is a closed system. On the other hand, lymphatics are an open system that is seldom talked about in school. In this system, we aren’t focused on blood flow but on lymph fluid which is a clear and sometimes yellow-tinted proteinaceous fluid. Lymph is created in the tissues from the fluid that leaks out at the capillary level and contains large proteins, cells, and cellular debris. 

The basic unit near the start of the lymphatic system is the lymphangion, which is a smooth muscle-lined vessel that propels the fluid toward our lymph nodes. The Lymphatic System is self-propelling. There are valves at the beginning of the lymphatic system that ensures that the fluid that enters will not be able to flow out and leave.  Along the way, there are additional valves, much like the venous system, which ensure one-way flow. And also, like the venous system, the fluid is further aided and propelled forward by the contraction of muscles. 

The lymphatics start at a lymphatic capillary level, which combines into lymphatic collecting ducts. These collecting ducts further collect together and become lymphatic trunks and enter lymph nodes. In the lymph nodes, the lymph is filtered, and lymphocytes scour and search for foreign cells and proteins that should be removed from the body.  After the lymph is filtered through the lymph nodes, it’s sent toward the center of the body. Eventually, it ends up in the thoracic duct, where it returns to the venous circulation, just in front of the heart. 

 Normal vs. Impaired Lymph Flow in Lipedema

There are well-documented changes in the lymphatics of women with lipedema. Rasmusen and others have reported on dilated lymphatics in lipedema. Many other authors have reported on impairments of lymphatics in lipedema (Gould, Van De Pas). The following is a near-infrared direct lymphography image from research conducted by Dr. Wright. In it, you can see the difference between normal and Lipedema tissue found in the foot and ankle. In this image, there is normal, linear lymphatic flow in the lipedema patient’s foot, which changes to dilated, tortuous lymphatic flow as the lymph flows in the area of the ankle cuff caused by lipedema. 

Normal lymphatic vessels seen with Near InfraRed [ NIR ] Imaging are linear and sharply demarcated, and as lymph moves into lipedema tissue, it becomes less demarcated and fuzzy or has more diffuse borders. Just towards the middle of the image at the foot/ankle border, you see right at the end, the sharp linear images become diffused and then no longer visible. This part is considered abnormal as it gets into the lipedema tissue. 

The above images show that there are dilated lymphatics in lipedema and that there are reports that liposuction can injure lymphatics in lipedema. Now that we know the relationship between the two, it’s imperative that compression and other lymphatic flow-promoting treatments are included in the comprehensive treatment of lipedema. We’ll explain these practices below, and you can read more about the Lipedema Standard of Care here.

Before any type of surgery can be discussed, it’s important to ensure the non-surgical treatments are followed, and the lymphatic function is optimized. Examples of these practices are below, and you can also read an in-depth study about an approach to the best surgical outcomes by first addressing the inflammation in the tissues with dietary and lymphatic treatment. Read Dr. Amato’s research here. 

Compression Therapy for Lymphatic Flow

Compression garments, such as compression stockings or sleeves, can also be useful in providing external support to the lymphatic vessels and promoting fluid movement. In addition to these therapies, maintaining a healthy lifestyle is key. Regular exercise, a balanced diet, and weight management can help reduce the burden on the lymphatics and improve overall lymphatic function. In conclusion, lymphatics and lipedema are closely intertwined. The impaired lymphatic drainage seen in lipedema can contribute to chronic swelling and inflammation, further complicating the condition. Understanding this relationship is vital for effective treatment and management of lipedema, with therapies aimed at improving lymphatic function playing a significant role. Read more about compression therapy here.

Exercise for Lymphatic Flow

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. 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. Learn more about the best types of exercise for lymphatic flow here.


The Rare Adipose Disorder Diet (AKA RAD Diet)

Dr. Wright recommends following a Rare Adipose Disorder (RAD) diet, a modification to a standard Mediterranean diet that helps you maintain a low glycemic index to limit the number of occurrences and levels your blood sugar spikes through the day. To do this, it is recommended that you avoid any refined or processed starches and sugars. These are usually found in pasta, rice, bread, corn, and potatoes. Avoiding processed food – especially processed carbohydrates – will keep your insulin levels low and provide you the best chance of limiting inflammation. Read more about healthy eating and lymphatic flow here.

Manual Lymph Drainage and Experience Lymphatic Drainage Benefits

Manual lymph drainage is just one component of complete decongestive therapy (CDT). In addition to MLD, complete decongestive therapy includes compression, exercise, and skincare. These therapeutic components, when performed together, can ultimately relieve the symptoms of lipedema, which can often be painful.

When you stimulate the lymphatic system, you will feel the effects of several lymphatic drainage benefits:

Increase the capacity of the lymphatic system, which will then let it process more fluid than normal.:

Other lymphatic drainage massage benefits include reduction of pain and swelling and an increase of venous return and circulation. Learn more about this technique here.

Dry Brushing Technique and Benefits of Dry Brushing

In addition to several other procedures and treatments for lipedema, pump therapy, whole-body vibration, and dry brush massage can also increase the circulation of lymph fluids and relieve the sometimes painful symptoms. Learn more about whole-body vibration and dry brush massage below!

Because the lymphatic system lies just below the skin’s surface, dry brushing has been considered an effective treatment for lipedema. The benefits of dry brushing have been shown to provide :

The dry brushing technique is performed with a brush, either with a handle or a strap, that has soft bristles. As the name says, the brush is used dry and without water. You will not get the same results if the skin or brush is wet. With long, gentle, firm strokes, go over your entire body (except the face). The strokes should move the skin toward the heart and neck. Start with the feet and brush upward to the knees, groin, abdomen, and chest. Then brush the hands and arms to the armpits. Read more about dry brushing and lymphatic flow here.

What Kind of Surgery is Safe for Lymphatics in Lipedema Patients?

Lipedema reduction surgery is a spin-off of liposuction focused on reducing lipedema tissues, including fibrous tissue, fat, and extracellular contents. It is possible for lymphatics to be injured by a suction cannula during lipedema reduction surgery and/or cosmetic liposuction. Some argue whether this is possible, but studies show it can, and unfortunately, may happen for some. In a recent study published in the American Journal of Case Reports, According to a study by Wright and Herbst confirms that this can occur.  So, it is essential if you have lipedema or suspect you may have lipedema that you get a proper diagnosis and work closely with skilled surgeons well-versed in lipedema, lymphatics, and lymphedema for the best possible outcomes and treatment plan before you proceed with any type of liposuction.

During liposuction, some temporary interruption to the lymphatic vessels is unavoidable. In most patients, the lymphatics return to normal in the postoperative period, especially for patients with underlying normal lymphatic function [ Read patients without lymphedema or lipedema].  Suction lipectomy with small blunt cannulas and surgical techniques focusing on avoiding lymphatic damage has been reported to halt lipedema progression. [Sandofer 1, 2] A modification of suction lipectomy can result in alleviating or at least improving the swelling, leg heaviness, and fatigue, the need for limb compression, and the need for lymphatic massage in women with lipedema. In patients with impaired lymphatic function such as chronic lymphedema (or lipedema), careful suction lipectomy using techniques to avoid lymphatic injury can result in improved lymphatic function and a decreased rate of secondary infection or cellulitis in the affected limbs. [Gould. Van de Pas 3,4,]. Once you understand that lymphatics are impaired in lipedema and you understand that lymphatic injury can occur, the natural question arises – How can we protect the lymphatic system in lipedema surgery?  Read more about surgical treatments for lipedema here, and contact Dr. Wright and his team at St. Louis Laser Lipo & Vein Center to see what kind of plan is best for you!

Back pain is a common problem that affects many people. But for those who suffer from lipedema, it can be much more than just an annoyance. Lipedema is a chronic condition that causes painful swelling in the legs and buttocks. Fortunately, there is a life-changing solution – lipedema surgery.

In this article, we will explore what lipedema is, its symptoms, causes, diagnosis, and treatment. We will also discuss the different types of lipedema surgery and the benefits of undergoing this procedure. Plus, we’ll look at the recovery process and the success stories of those who have gone through it themselves.

lipedema surgery

What is Lipedema?

Lipedema is a condition that primarily affects women and is characterized by painful swelling of the legs and buttocks. It is known as a “painful fat disorder” because it causes fat to accumulate in the lower body, leading to discomfort and difficulty moving. 

Lipedema can be difficult to diagnose because its symptoms are often similar to other conditions, such as obesity and lymphedema. Additionally, the cause of lipedema is still unknown, although it is believed to be a genetic disorder triggered by hormonal changes.

Symptoms of Lipedema

The most common symptom of lipedema is swelling of the legs and buttocks, and oftentimes the arms and abdomen. This swelling is usually symmetrical and occurs mainly in the lower parts of the body. It can also cause a feeling of tightness in the affected area, as well as aching, burning, and tenderness. The skin in the affected area may also appear dimpled, and the affected person may experience difficulty walking and standing for long periods.

In addition to physical symptoms, people with lipedema may also experience psychological symptoms such as low self-esteem and depression.

Diagnosis and Treatment of Lipedema

Lipedema can be difficult to diagnose because its symptoms are often similar to other conditions, such as obesity and lymphedema. To diagnose lipedema, your doctor will do a physical exam and ask about your medical history. They may also order tests, such as an ultrasound or MRI, to get a better look at the affected area.

Once lipedema is diagnosed, treatment may include lifestyle changes, such as diet and exercise, to reduce swelling and pain. Compression garments can also be used to help reduce swelling. In more severe cases, liposuction or liposculpture may be recommended to remove the excess fat.

Lipedema & Back Pain – Why It Hits Different

A lot of women with lipedema have back pain because the “shelf” of weight accumulated on the lower back distorts the spine. The distortion from the fat lobule over the shelf will be sore if patients are on their feet or sitting for long periods. Many patients have chronic lower back pain without any relief because the constant existence of heavy lipedema tissue causes it. 

Within a day or two after the tissue removal, patients report experiencing relief never experienced before. Unlike a pulled back muscle or a pinched nerve, surgery and the removal of this area’s fatty tissue and fluid is the only way to get relief.

Lipedema Surgery – A Life-Changing Solution

Lipedema surgery is a life-changing solution for those suffering from lipedema of all types and stages, and especially with chronic secondary issues like back pain. This surgery involves the removal of excess fat from the affected area through liposuction or liposculpture. This surgery can help reduce the swelling, discomfort, and pain associated with lipedema. It can also improve mobility, reduce the risk of infection, and improve self-esteem.

Benefits of Lipedema Surgery

There are many benefits to undergoing lipedema surgery. It can help reduce the swelling and pain associated with lipedema and improve mobility. It can also reduce the risk of orthopedic complications and improve self-esteem. Additionally, lipedema surgery can help reduce the risk of developing lymphedema, which can be a severe complication of lipedema. For patients with back pain, the surgery can provide almost immediate relief and allow them to have the ability for daily tasks once again once impossible – as simple as getting a good night’s rest, or the ability to perform accessible exercises more comfortably, like yoga and deep, restorative stretches. 

Lipedema Surgery Before and After Weight Loss

Lipedema surgery can be an effective treatment for those who have experienced significant weight loss. After weight loss, the skin in the affected area may be loose and saggy. Lipedema surgery can help to tighten and firm the skin and reduce the swelling and pain associated with lipedema.

Lipedema Surgery Recovery

Recovery from lipedema surgery can take several weeks. During this time, it is important to rest and avoid strenuous activities. Your doctor may also recommend compression garments to help reduce swelling and improve comfort.


Lipedema surgery is a life-changing solution for those suffering from lipedema. It can reduce the swelling and pain associated with lipedema and improve mobility. It can also reduce the risk of infection and improve self-esteem. If you are suffering from lipedema and are looking for a solution, contact Dr. Wright and Laser Lipo and Vein Center for help with lipedema and back pain.

lipo risks

Have you ever wondered why some women have no issues maintaining their weight, despite your constant struggle to lose weight no matter what you do? Have you ever heard of Lipedema Legs? If you’re a woman and have noticed weight gain in your lower body that you can’t seem to control, you may have lipedema. Lipedema is a chronic and progressive medical condition that affects the limbs (and sometimes the abdomen, too!) of women. In this blog, we’ll be exploring the causes, symptoms, and treatment options for lipedema legs.

Introduction to Lipedema Legs

Lipedema is a medical condition that affects many women worldwide. The condition is also known as Lipoedema. It is a disorder that causes fat to accumulate in the legs, hips, buttocks, arms, and/or abdomen of many women. Fat accumulation occurs in the form of nodules and can cause pain, inflammation, and swelling. It is estimated that 11% of women in the United States suffer from lipedema, and most are unaware of their condition.

Lipedema Legs

Lipedema Causes and Symptoms

Lipedema is believed to be linked to genetics and hormones. Research suggests that hormones such as estrogen may play a role in the development of lipedema. It is also thought that lipedema has a vital hereditary component, meaning if your mother or grandmother had lipedema, you might be more likely to develop the condition. The symptoms of lipedema legs vary from person to person. The most common symptom is swollen legs, especially in the lower legs. Other symptoms include pain, tightness, and discomfort. In some cases, lipedema can cause pain, numbness, and tingling in the legs. The leg fat can also be easily bruised and is often resistant to diet and exercise.

Symptoms of Lipedema Legs

Lipedema legs can cause a wide range of symptoms, including swelling, pain, and tightness in the legs. The leg fat can also be easily bruised and is often resistant to diet and exercise. In some cases, lipedema can cause numbness and itchiness or tingle in the legs. In addition, leg fat can cause an uneven weight distribution, resulting in pain and discomfort.

The symptoms of lipedema can vary from person to person. Some people may experience little to no symptoms, while others may experience more severe symptoms. The severity of the symptoms can also vary over time.

How to Diagnose Lipedema Legs

The diagnosis of lipedema legs is based on a physical examination and a review of the patient’s medical history. The doctor will look for signs of fat accumulation in the legs, hips, and buttocks. They may also check for signs of inflammation and swelling. The doctor may also perform a lipedema test, which involves measuring the circumference of the legs, hips, and buttocks. This test can help determine if the patient has an accumulation of fat in the affected areas. In addition, the doctor may perform a stemmer sign test.

Lipedema Legs

The Stemmer Sign in Lipedema Legs

The stemmer sign is a test used to diagnose lipedema. The test involves pressing the thumb against the skin of the affected area. If the skin does not indent, this is a sign of lipedema. This test is used to differentiate between lipedema and other causes of swollen legs, such as lymphedema. The stemmer sign test can also help determine the severity of the lipedema. In mild cases, the skin may indent slightly, while in more severe cases, the skin may not indent at all. This can help the doctor determine the best course of treatment for the patient.

Lipedema Test and Treatment

Once the diagnosis of lipedema legs has been made, the doctor will recommend a treatment plan. The treatment plan will vary depending on the severity of the condition. In mild cases, the doctor may recommend lifestyle changes such as diet and exercise focused on decreasing inflammation triggers.  Medical-grade compression help reduce the inflammation is lipedema tissue in the legs.  In more severe cases, the doctor may recommend medication or surgery. Medication and surgery are typically used to reduce the swelling and inflammation associated with lipedema. Medication can help reduce the number of fat cells in the affected area and can also help reduce swelling and inflammation. Surgery can help remove fat cells from the affected area and can also help reduce swelling and inflammation.

Finding a Lipedema Doctor Near Me

If you think you may have lipedema, you must see a doctor. The doctor will perform a physical examination and review your medical history. They may also perform a lipedema test and a stemmer sign test. Once the diagnosis has been made, the doctor will recommend a treatment plan. Treatment may include lifestyle changes, medication, and surgery.

Lipedema legs can be a difficult condition to live with, but with the right treatment, it is possible to manage the disease. With the right treatment, you can live a healthier and more active life.

Guidelines for the management of lipedema recommend the use of compression for patients with lipedema. The care guidelines recommend a multidisciplinary approach to treatment involving proper diet and exercise, manual lymphatic drainage, and wearing properly fitted, medical-grade compression garments. We’ve summarized everything women with Lipedema need to know about compression garments below, but you can find more information 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. 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.

compression garments

Why Are Compression Garments Needed for Women With Lipedema?

Compression garments are used to help limit the swelling that occurs in Lipedema. This swelling contributes to the progression of lipedema, and can also lead to other painful and dangerous diseases.

Chronic swelling (also called “edema”) in the legs is a risk factor for eventually developing cellulitis and venous insufficiency and is one of the primary symptoms of lipedema. A recent study showed that swelling of the legs from any cause leads to an increased risk for leg skin infections or cellulitis. For women suffering from Lipedema, this can add insult to injury in an already debilitating disease accompanied by sensitive and easily bruised skin. If left untreated, cellulitis can move into the lymph nodes and bloodstream and require more serious medical treatment, and is one of many reasons why compression therapy for lipedema patients has more than one benefit!

What Is the Goal of Compression Therapy?

For patients with Lipedema, there are many reasons to consider using compression garments or compression pumps. From clinical experience, it’s been noted that Lipedema and Lymphedema patients show faster and less complicated healing after surgery when patients are undergoing MLD/pump treatment before surgery. For individuals who have lipedema, lymphedema, or lipo-lymphedema, compression garments are often used to assist lymph circulation by increasing the pressure in the tissue to propel lymph fluid through the body. Lymphedema causes excess fluid to become trapped in the extremities, especially the legs, and compression garments pressure the skin and veins, helping them clear lymph and decongest. If we can utilize the garments to decrease the levels of chronic edema, we may also decrease the chances of developing cellulitis.

compression garments

Compression garments can help reduce pain and heaviness felt in the limbs from fat disorders (such as lipedema) by decreasing swelling in the fat and throughout the limbs. Compression may also reduce the rate at which the fat cells grow and help to prevent fat disorders from progressing to more serious stages. In other words, compression can be one of the best treatments for lipo-lymphedema or fat caused by lymphatic diseases, in addition to cellulitis prevention.

Benefits of Compression Therapy

Skin Care to Prevent Infection

Many patients don’t realize that edema (swelling) is just the beginning if untreated, and more severe conditions can occur. Skin infections, such as cellulitis, are more common in areas affected by lymphedema swelling than in normal skin, so women with lipedema have a higher likelihood of this condition. This is another reason compression therapy is imperative, whether you undergo surgery or not. If infections are not treated quickly, they may spread and become sepsis (blood poisoning or bacteremia), which can become fatal. Areas of long-term lymphedema swelling sometimes develop rare forms of cancer, such as lymphangiosarcoma or Stewart-Treves Syndrome (STS), that are frequently fatal. Any purple discoloration or tender nodules that develop on lymphedema-affected skin should be evaluated promptly by a medical professional.

Today, most doctors recommend conservative and preventative measures to keep you, such as daily washing of wounds or cuts that bacteria could infiltrate and applying protective creams, ointments, and bandages when necessary to surface damage or dehydrated, flaky skin. Preventative medications, such as antibiotics, may be recommended when patients experience several recurrences of cellulitis.

Symptoms of Cellulitis May Include the Following:

For people with poor circulation – such as diabetics or women with Lipedema and or Lymphedema, additional precautions for avoiding skin injury are recommended, but overall are still conservative and focus on healthy and consistent skincare. For example, the health providers at the Mayo Clinic recommend you inspect your feet daily, check for signs of injury or infection early on, moisturize skin regularly to avoid dryness or cracks, and trim fingers and toenails with great care to avoid injuring the skin and wear clean and protective footwear and gloves often.
Like Lipedema, there’s a lot we still don’t know about cellulitis; we know it can be caused by several types of bacteria infecting deeper layers of the skin, and we know that it causes swollen, red, painful areas in the skin. We know it commonly affects the feet and lower legs. But we don’t know how the bacteria get into the body of many people affected. And new studies suggest something else we did not know previously – compression therapy may help prevent this painful condition.

A recent study by the New England Journal of Medicine divided 84 patients into two groups. Participants in each group experienced chronic swelling in their legs and also suffered from cellulitis on an ongoing basis. In the first group, participants received compression therapy and were provided education on how to prevent their cellulitis from returning. In the second group, participants received the same education but did not undergo compression therapy. The groups returned for follow-up therapy and education every six months for up to three years, until the entire trial experienced a total of 45 cases of cellulitis. When someone in group two experienced a return of their cellulitis, they were moved to group one to under compression therapy.

Overall, the quality of life in both groups was the same, and there weren’t drastically different experiences between groups one and two. However, the group who received therapy and cellulitis prevention education experienced only 6 new cases of cellulitis, while the second group experienced 17 cases. While the study was small, and additional studies are needed, early indications suggest compression therapy will result in a lower recurrence of cellulitis than education and conservative treatments alone. We have known for years that people with lymphedema have an increased risk for cellulitis, and they benefit from compression. However, this study showed leg swelling from any cause puts affected individuals at risk for infections, and compression helps reduce this risk.  

Where Can I Find Compression Garments?

It’s essential that compression garments are appropriately measured to ensure they fit correctly. Incorrectly fitted compression can be painful and even make lipedema symptoms worse! Most cities have a medical supply store that will measure you and then help you find the appropriate garments, but if you’re ordering them online, you’ll have to measure yourself by following their guidelines. For online orders, we recommend and

Ready to Learn More about Lipedema Surgery in St. Louis? Let’s Chat!

Still not sure where to start? That’s okay! Physicians such as Dr. Wright can provide you with the needed treatment plans that it takes to reduce your lipedema symptoms. 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 spiral out of control if left undiagnosed. As experts continue researching the causes and best treatment options for women with Lipedema, tumescent liposuction or lipedema reduction surgery remains the only way to reset the progressive disease and provide women with increased mobility and reprieve from daily pain.

Lipedema reduction surgery

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 worsens 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.

What Are the Symptoms of Lipedema?

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 compared to the rest of the body. Lipedema is often misdiagnosed and dismissed by medical professionals as simple obesity, leaving affected women 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.

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

Lipedema reduction surgery

Why Is Lipedema Reduction Surgery Necessary?

Ultimately, effective treatment will require surgical intervention to alleviate the appearance and pain of symptoms. Liposuction performed on the affected limbs is generally the most effective treatment. Removing fat deposits that are diseased helps reduce swelling of the limbs and alleviates the pain that holds patients back from everyday activities.

This surgical treatment can 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.

Why Do We Call Lipedema Liposuction “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 growth of more fat cells, which can overwhelm the 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 and generous and special surgical techniques, studies have shown that lymphatic function can 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.Why is Lymph Sparing Liposuction Preferred for Lipedema Patients?

1 – Lipedema Surgery Doesn’t Use 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 various treatments, it is generally not recommended for individuals with lipedema. Instead, lymph-sparing liposuction uses tumescent anesthesia to avoid these unwanted complications. General anesthesia can cause severe complications and even death in up to 0.3% of liposuction treatments. Relying on tumescent anesthesia ensures the anesthetic fluid has been distributed throughout the tissue, and it has had time for all the fat tissue to gel.  Patients are conscious for the duration of treatment, while the tumescent liquid acts as a local anesthetic to the treatment area. Patients may take pain pills ahead of time to help with discomfort and sometimes use laughing gas. However, through the process, patients feel little pain and, if anything, pressure in the area being treated. 

Lipedema reduction surgery

2 – Lipedema Surgery Reduces Fat Tissue

Perhaps the most noticeable benefit to lymph-sparing liposuction is how it can 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. Following your physician’s guidelines is critical to reduce 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 eight 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 compared to 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 re-established. The lymphatic function is often improved.

3 – Lipedema Surgery Reduces Painful Symptoms

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

What Are The Risks of Lipedema Surgery?

Significant blood loss is the most commonly reported side effect of lipedema surgery. Women with lipedema very often have large varicosities and studies have shown enlarged networks of veins in the legs of women with lipedema. Liposuction can cause significant blood loss if these veins are not treated before surgery. Even with proper preoperative treatment of dilated and varicose veins and good tumescent technique in women with lipedema, if the surgery is large enough, there can still be significant blood loss. In some cases even a blood transfusion has been needed in the postoperative period.  The next most common complication of lipedema reduction surgery or lipedema liposuction is blood clots. Women with lipedema are, on average, heavier than women without lipedema making the risk of blood clots with the surgery greater.  The risk of blood clots and other thrombotic complications can be greatly reduced with postoperative blood thinners. Careful surgeons should risk stratify their patients for possible blood clot complications and put them on prophylactic postoperative blood thinners.  Infection is always a risk of any surgery including lipedema surgery.  There has been a report of fat embolism with lipedema surgery.  Death has to be included as a possible outcome. We are not aware of any deaths from lipedema surgery, but of course it is possible that any surgery can, in very rare circumstances, result in death.  Finally, lymphatic injury is a real risk of liposuction and is a special concern for women with lipedema. Smaller cannulas are also used to keep down the risk of trauma to the body and an already compromised lymphatic system.  With care and proper surgical technique lymphatic injury need not occur. In fact in skilled surgical hands lipedema reduction surgery may actually improve lymphatic function. 

What Quality of Life Can I Expect After Lipedema Surgery?

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.

Lipedema reduction surgery

This procedure allows for a more active and healthy lifestyle, which many patients have experienced for 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.

What Is Recovery from Lipedema Surgery Like?

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 must 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. 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. 

Ready to Learn More about Lipedema Surgery in St. Louis? Let’s Chat!

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

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.”