Do I have Lipoedema and if so, can I have a body lift prior to treating it? (Photos)

Surgery after bariatric surgery or massive weight lossFirst of all, let me congratulate you on weight loss success. Unfortunately, I cannot tell you for sure if you have a Lipedema or not just based on the pictures. The main criteria for Lipedema is painful fat. The main signs of Lipedema are accumulation of fatty tissue in the lower half of the body from waist down to the ankles. However, this is just a basic traditional understanding of lipedema. Lipedema can also involve abdomen, arms, forearms. It’s usually spares feet and hands. When the patient lose a significant amount of weight after bariatric surgery, some of the heaviness in the legs will eventually go away, however, patients will still experience hypersensitivity of the skin, easy bruising, heavy feeling In the legs that gets worse at the end of the day and especially during hot and summer months. I need to make sure that you’re allowed to venous insufficiency and other conditions that may cause swelling of the legs prior to defaulting to Lipedema diagnosis.If you truly have Lipedema, your reconstructive surgery including liposuction and excision of excess of skin, potentially could be covered by your insurance. There’s a protocol based on insurance company policies and procedures, that you have to follow in order to get those authorized and approved. My suggestion would be first to determine if you have a Lipedema and if you have insurance coverage for it. If you do, I would start with liposuction first and then perform skin excision on the abdomen, hips, thighs and any other areas affected by it. If you choose to go with skin excision first and then do liposuction, then you’ll end up with more loose skin.

Hello
Lipedema is disproportionately large legs and thigh irrespective of the overall weight. Feet are always spared in lipedema. However you will require detailed assessment including scan to rule out other causes of increase in girth of the leg. If it is lipedema then WAL (body-jet AKA aquashape liposuction) is ideal technique as it spares the local lymphatic channel. It can be combined at the same time as lower body lift.

Hello and thank you for your question. Congratulations on your weight loss. I believe that you do have lipedema, some people spell it lipoedema  (British spelling). I like to call it resistant fat. I do a lot of liposuction for this problem. I also specialize in post massive weight loss body contouring. In your case I would suggest doing the LBL first. At the same time aggressive liposuction of the saddlebags can be done. At a second surgery you could get the liposuction and thigh lift done together. Some patients who have severe lipedema of the legs, I suggest first doing liposuction and later the thigh lift. In your case you are not severe enough to warrant that.WAL suction is not a must. I use regular tumescent power assisted liposuction.  Still no proof that WAL is better.Good luck. Peter Fisher M.D