June 8, 2023

Lipedema is a painful condition that causes excess accumulation of fat in the hips, thighs, legs, and arms, causing millions of people around the world, predominantly women, to feel uncomfortable in their own skin. Despite the prevalence of adipose tissue disorders, many individuals go undiagnosed or misdiagnosed as lymphedema, obesity, or cellulite, leading to a lack of proper treatment and a decrease in quality of life. However, there is an exciting, life-changing solution that has gained recognition in recent years within the medical community - lipedema surgery.

Lipedema surgery is a procedure that removes excess fat from affected areas, providing relief from the physical and emotional burden of the disorder. While it may not cure your lipedema outright, this liposuction-based procedure is an effective treatment option that has helped many patients regain their mobility and confidence. If you want to feel comfortable in your own skin again, literally and metaphorically, then let’s get into the reasons why you should consider lipedema surgery.

In this article, we will first explore the question “What is lipedema?”. Then we will get into its causes, symptoms, and how liposuction for lipedema can provide a life-changing solution for patients with this painful fat disorder. We will also discuss the benefits, risks, and preparation for the surgery, as well as post-surgery care and maintenance.

What is Lipedema?

Lipedema is an underrecognized condition of abnormal fat accumulation that affects an estimated 11% of the population, predominantly women. It’s most commonly seen in the legs and thighs but can also affect the abdomen, hips, and arms. The condition causes a disproportionate swelling of adipose tissue, giving the limbs of those affected by lipedema their characteristic “column-like” appearance.

Lipedema usually begins to accumulate in the early teenage years and gets worse over time as people tend to gain more weight. Ladies may notice when they’re younger that they have bigger legs and calves that get worse as they gain more weight. Abnormal accumulation of fat becomes very obvious often when those same people lose weight through exercise or bariatric surgery. Despite the weight loss, patients with lipedema tend to keep the fat in the affected areas even though they globally lose fat. This results in someone with a skinny face and torso, but extremely wide hips and legs with fat that refuses to go away. Patients with lipedema commonly experience pain, bruising, and tenderness in the affected areas, which can limit their mobility and quality of life. Moreover, the psychological impact of the condition can be equally severe, causing many patients not to feel comfortable in their own skin.

What Causes Lipedema?

What causes lipedema is currently an open-ended scientific question. Genetic factors, hormonal imbalances, and vascular abnormalities have been floated as potential causes, but the evidence is not yet conclusive enough to support any particular theory. What we can say about the origins of lipedema from the current evidence is that it probably has two components:

  • genetic
  • hormonal

Lipedema appears commonly in multiple members of a family, suggesting a high probability that there is some underlying genetic component to the disorder that is not fully understood at this time. Likewise, though we do not fully understand why this is the case, it is common for symptoms of lipedema to occur during hormonal shifts such as:

  • puberty
  • pregnancy 
  • Perimenopause (around menopause)

Now that we know that there are symptoms of lipedema that commonly occur across different members of a family and during hormonal shifts, let’s take a look at those symptoms and clear up the confusion surrounding lipedema, obesity, and cellulite.

Lipedema vs Cellulite and Lipedema vs Obesity

Lipedema is frequently misdiagnosed as obesity or cellulite. This is unfortunate but perfectly understandable due to the confusingly similar symptoms of the three conditions–their symptomatic overlap. Further complicating this picture is that you can be affected by lipedema, cellulite, and obesity all at the same time in spite of the fact that these conditions are often completely independent from one another. In the particular case of lipedema vs cellulite, a dimpling or pebbling of the skin can occur over time in lipedema patients that looks similar to skin dimpling which is popularly identifiable as a symptom of cellulite. However, lipedema and cellulite are two distinct conditions. Having cellulite does not mean that you have lipedema or vice versa. Likewise in the case of lipedema vs obesity, you can be obese and suffer from lipedema. But you can also have a slender body with disproportionately large arms–a telltale sign of lipedema.

Symptoms of Lipedema

Now that we’ve delineated lipedema from obesity and cellulite, let’s revisit the most common symptoms of lipedema that can affect your appearance. These include an excess accumulation of fat in the:

  • hips
  • thighs
  • legs
  • arms

So what are the early symptoms of lipedema? Early warning signs for lipedema tend to manifest during puberty and can include:

  • disproportionately large arms
  • fatty accumulation or a shelf around the kneecap
  • swelling around calves and ankles which are known colloquially as “cankles”

These are symptoms that can affect your appearance. But what about the physical symptoms of lipedema that cannot be seen by others? These include:

  • pain in the affected limbs
  • sensitivity to touch
  • mobility issues
  • swelling
  • feeling weighed-down

What are the psychological symptoms of lipedema? These commonly include:

  • depression
  • anxiety
  • social Isolation
  • eating disorders

Diagnosing Lipedema

Since most doctors still don’t understand lipedema they may confuse it with “lymphedema,” which is a completely different condition that can be caused by a host of other things. While lymphedema affects the feet and can be on one side, lipedema is a bilateral condition that always affects both sides. If we’re talking about lipedema of the legs, the feet will be uninvolved.

Aside from the excess fatty tissue, patients with lipedema also have trouble with the aching of the affected areas as well as tenderness. Easy bruising results from small bumps into objects or from pets jumping on their owners.

Dr. Elston has extensive experience in diagnosing and treating lipedema patients with liposuction.  This can be life-changing for many women, particularly when they don’t even realize it’s something that can be taken care of. Learn more about liposuction for lipedema at the Elston Clinic.

The Benefits of Lipedema Surgery

The benefits of lipedema treatment or surgery are numerous as the procedure involves a comprehensive approach that targets the underlying cause of the condition and is tailored to the individual patient, considering the extent and severity of their lipedema symptoms. The procedure is effective in reducing or eliminating:

  • painful swelling
  • tenderness
  • bruising
  • heaviness

The benefits of lipedema surgery go beyond physical relief, as it can also improve a patient's mental health and well-being. Lipedema surgery can result in an enhancement of:

  • mobility
  • self-esteem
  • quality of life

Liposuction offers a viable lipedema treatment for those struggling with this condition for years. Patients experience a significant reduction in their symptoms almost immediately, as well as an improvement in their overall quality of life after undergoing lipedema surgery.

What Does Lipedema Surgery Involve?

Liposuction for lipedema or lipedema surgery is similar to traditional liposuction: small incisions are made in the skin through which a small cannula is inserted to suction out the fat cells. During a lipedema surgery, the affected area with excess fatty tissue is numbed and liposuction is performed. This can usually be performed in the clinic for early stages, but more severe cases need to be done in the operating room with an anesthesiologist to monitor your blood pressure and fluid status. Some patients will need multiple sessions to get rid of all the affected fat, but it’s not uncommon to plan for multiple stages and only require one because you feel so much better after the first. Most patients notice a difference on the night of surgery that they feel significantly better with less heaviness and pain from the excess fat despite the soreness from liposuction itself.

The Risks of Lipedema Surgery

The potential hazards associated with the medical intervention for addressing abnormal fat accumulation should be carefully considered before proceeding with the procedure. Like all surgeries, the process is not entirely without potential complications, and patients should be aware of the risks involved. These may include:

  • infection
  • blood clots
  • nerve damage
  • seromas
  • contour irregularities

Any surgical procedure carries a risk of infection. Patients who undergo liposuction for lipedema are at risk of developing an infection at the site of the incision. Signs of an infection include redness, swelling, and discharge from the wound. Lipedema patients are also at risk of developing blood clots, and surgery under general anesthesia further increases this risk. Blood clots can be life-threatening if they travel to the lungs or heart. Patients may be advised to wear compression stockings and take blood thinners to reduce the risk of blood clots. Suctioning fat can also result in nerve damage, which can, in turn, cause numbness or tingling in the treated area though this is usually temporary. In some cases, nerve damage can be permanent. Seromas can occur from aggressive liposuction in an area or from trying to walk or exercise too early after surgery.  A seroma is a collection of fluid under the skin that will have to be drained to allow proper healing.  Contour irregularities are from too-aggressive liposuction near the skin and manifest as ripples or lumps that can be challenging to correct.  Infections, blood clots, nerve damage, seromas, and contour irregularities from lipedema surgery are all great reasons why it is so important to find a physician that you can trust and who will minimize your risk of developing these complications.

Post-Surgery Care, Maintenance, and Lipedema Treatment

Patients are advised to avoid strenuous activities and to rest as much as possible during the first few weeks after surgery. After this period the recovery process following liposuction for lipedema procedure can still take several months, and patients should be prepared to commit to their post-surgery care plan to achieve the best results. Post-surgery lipedema treatment usually involves:

  • compression therapy
  • diet and exercise

Compression therapy involves wearing compression garments that help to reduce swelling and inflammation, improve blood flow, and prevent blood clots. Lymphatic drainage massage can be beneficial in promoting lymphatic flow and eliminating excess fluid and toxins from the body. Finally, a healthy diet and exercise regimen are crucial in maintaining the results of lipedema surgery. Patients should engage in regular exercise once cleared from Dr. Elston and aim to eat a balanced diet.

See our list of supplies below to shop the compression garments we recommend before and after surgery for our patients.