There’s nothing more frustrating than sticking closely to an exercise routine and never deviating from a diet without any results to show for it. While some may attribute this scenario to a subpar attempt at fighting fat, for many, there is an underlying medical reason that weight isn’t being lost despite a concentrated effort. When diet and exercise aren’t doing the trick and in some cases, weight continues to accumulate over time, it’s time to look more closely at what could be causing this to happen, as seen in this medical study. 

Woman in sports bra and leggings sitting on wall

Nearly 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 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.

Lipedema Symptoms and Signs

Woman with Lipedema posing in her underwear

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 provokes vascular and lymphatic swelling which can lead to further medical complications.

Lipedema is often misdiagnosed as standard obesity, leaving patients to deal with an endless cycle of disappointment and ongoing pain as symptoms continue and weight refuse to fall off. Unfortunately, Lipedema does not respond to an altered diet or increased exercise and ultimately requires cosmetic intervention in order to alleviate the appearance and pain of symptoms. Patients often report that the road to their initial 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.

Examples of Lipedema Signs & Symptoms:

Ball and Chain on Leg

Woman checking legs on couch

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 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. 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.

Selecting Expert Care

When it comes to liposuction specific to treating women with Lipedema, an experienced physician is required to perform the procedure successfully. While 93% of doctors and nurses are not aware of Lipedema or the symptoms it causes, experts in this field are working diligently to advance the field and continue finding the best methods of care. Advanced technique and precision planning are both required to remove diseased fat deposits and achieve long-term results, and as a result, the best way to find solutions is to partner with an experienced Lipedema healthcare provider.

Doctor discussing procedure to Patient

Women suffering from Lipedema should always take the time to ensure they are under the care of a physician who specializes in Lipedema treatment and is willing to work closely with their patients to create customized treatment options.

Stages & Progression of Lipedema

As patients work through getting an official lipedema diagnosis, experts will first need to determine what stage the lipedema is currently at. There are three different stages, or levels of progression used to evaluate how far the disease has progressed in the affected areas of the body – the first stage being the earliest onset, and the third stage the most progressed.

As lipedema progresses through these three stages, the level of pain, tenderness, swelling, and fat accumulation may increase. Depending on the person, different parts of the body can be affected in different ways at each stage.

The Only Way To Reset Lipedema Progression: Lymph Sparing Liposuction

Once you’ve been properly diagnosed by a doctor specializing in Lipedema, patients are advised to start with conservative and non-surgical treatment methods. While lymph-sparing liposuction for Lipedema is the only effective way to stall or stop the progression of Lipedema, non-surgical methods allow the patient and their doctor to first determine what their specific symptoms may be responsive to.

Examples of Conservative Lipedema Practices:

Woman in a lake, legs visible

However, in reality, lymph sparing liposuction will be the most effective and long-lasting treatment option for women with Lipedema. After regular practice of the available conservative Lipedema treatments, Lipedema experts may recommend a surgical plan for addressing the affected areas based on their patient’s specific needs. Lymph sparing liposuction has been shown to improve the quality of life of patients post-surgery, improve their pain long-term, increase mobility, and provide access to a new, more active lifestyle than they’ve previously known.

Modified liposuction surgery is the only available technique to correct and remove the abnormal adipose tissue of lipedema. Liposuction is a surgical treatment that involves the application of local (tumescent and water-assisted) anesthesia, and subsequent removal of adipose tissue through a straw-like device called a cannula. One end of the cannula is connected to a vacuum device, and the other end is inserted through a small incision of the skin and removes.

Lipedema Procedure Tools

There are two techniques of liposuction that can be safely used to treat lipedema, provided the surgeon has experience in techniques to avoid injury to the lymphatics. Note: Lipedema patients often have impaired lymphatic function, so great care must be taken to avoid further damage. The two liposuction techniques that are safest and most effectively used by surgeons with a great deal of experience with the treatment of lipedema are tumescent liposuction and water-assisted liposuction. These two are the only research-backed surgical treatment plans for lipedema

Tumescent liposuction for Lipedema

involves the introduction of large volumes of tumescent solution into the fat below the skin space to tumesce (or swell) the area. This solution contains lidocaine anesthetic, which causes local numbness; epinephrine, which causes constriction of blood vessels to reduce the risk of bleeding; and saline, which causes swelling of the adipose tissue and protects the vascular structures from trauma. The solution is allowed to infiltrate the tissue, and its salinity causes the adipose tissue and cells to swell and separate from the connective tissue, at which point the cannula is used to aspirate the fat.

Water-Assisted Liposuction

This type of liposuction treatment for Lipedema does not involve over-swelling [tumescence] of the adipose tissue. Instead, small amounts of tumescent solution and water are introduced into the adipose tissue. Once sufficient numbing occurs, a modified cannula with an attached fan-shaped and slightly pressurized saltwater jet is inserted into the subcutaneous space and applied to separate the adipose cells from the tissue, while simultaneously aspirating the solution and detached cells.

Trust the Professionals in the Field

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. Dr. Wright can help find the right procedure to help manage your lipedema symptoms, such as lymphatic drainage massage. 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 provokes vascular and lymphatic swelling which can lead to further medical complications.

No 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. 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. 

Why Do We Call It Lymph Sparing?

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.

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 the surgery. These factors can have an important influence on protecting lymphatic flow and function.

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. 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 surgery and beyond. Patients wear medical-grade compression clothing for at least 8 weeks, and manual lymph drainage and massage is 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. 

Reduces Pain Associated with Lipedema

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

No Additional Risks Included

Lymph sparing liposuction 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.

Recovery

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 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. 

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 pay off 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, make every day 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. 

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.

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

When the Solution is More Painful Than the Problem

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

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

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

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

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

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

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

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

Bruised and discolored legs and one of many insertion points.

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

The Lipedema Surgery

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

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

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

The Recovery

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

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

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

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

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

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

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

While a variety of treatment options currently exist to help alleviate and reduce the symptoms of lipedema, it is often lymph sparing liposuction that provides the biggest change. Lymph sparing liposuction is often recommended for individuals diagnosed with lipedema who have not experienced significant results with initial treatment options. Lipedema left untreated, can cause significant damage to the body. When this is the case, we recommend lymph sparing liposuction.

What is Lymph Sparing Liposuction?

Lymph sparing liposuction is a minimally invasive treatment that uses high pressured water to loosen up lipedema fat tissue. Suction removes the fat tissue and does so in a way that makes sure no damage is made to any lymphatics or nerves. More severe cases of lipedema may require multiple sessions to achieve the desired level of symptom reduction.

Treatable Symptoms with Lymph Sparing Liposuction

Lymph sparing liposuction can treat a variety of symptoms that are commonly associated with lipedema.

Fat Buildup – Perhaps the most noticeable symptom of lipedema that lymph sparing liposuction can treat is the amount of lipedema fat content. Lipedema is associated with subcutaneous fat tissue that cannot be treated through diet and exercise alone. Lymph sparing liposuction is a fat reduction procedure that will reduce the appearance of this fat buildup. The goal for most individuals with lipedema is to appear as close as possible their appearance before the onset of lipedema.

Mobility – The more severe cases of lipedema are commonly associated with limited mobility, making it difficult for the patient to get around. The subcutaneous fat tissue restricts mobility in the legs and greatly impacts quality of life. By removing a significant amount of fat tissue in the legs, it will be easier for those with lipedema to get around.

Restricted Blood Flow – Not only will subcutaneous fat tissue make it difficult to move but also restrict the blood flow in our veins/arteries. Blood flow in your veins will be encouraged by reducing the amount of fat tissue around them.

Getting Your Lipedema Treatment

If you believe you are experiencing lipedema symptoms, make sure to seek the treatment you deserve. Dr. Wright leads a team of qualified individuals in St. Louis that can help you receive the highest quality lipedema treatment, including lymph sparing liposuction. The treatment you need starts with a simple phone call today!