Should I have Lipodema liposuction before body lift or at the same time? What is the laser alternative to body lifts?

For lipedema its best to have a formal evaluation.  You need a formal evaluation by an expert in body shaping and contouring to determine what is best.  Often numerous surgeries are needed to reduce the size, reduce the lipedema, and then remove the skin later.  To get the most contouring.  Traditional liposution awake and smart liposuction are old methods and do very poorly for tightening skin or significant skin tightening or contouring.  Small problem areas can be improved slightly by these methods.  The best in body contouring not only removes fat with energy devices like VASER ultrasound but also internally heat the skin with radiofrequency devices such as J PLASMA/RENUVION, InMode BodyTite, ThermiRF to heat the under surface of the skin and tighten it at the same time as fat removal. These combinations are called 4D HIDEF VASER contouring and can only be done by a well . trained body contouring specialist. At the same time fat should be harvested, PRP and stem cells added and injected into muscles or indentations/cellulite to get body shaping and contouring.  This is known as a brazilian butt lift when you inject the fat to the buttock for contouring and lifting, but fat can also be used in areas such as the chest/breast, arms/shoulders, calves and face.  Cellulite should also be treated with cellfina, sculptra, subcision and/or fillers such as bellafill, renuva synthetic fat, or sculptra.  If skin is very loose before surgery then it will need to be removed such as lower abdominal skin (tummy tuck/abdominoplasty), breast skin (breast lift), arm skin (brachioplasty).  Overall you need a full assessment, but simple liposuction alone will not tighten skin and needs a combination of various methods -- fat removal, skin tightening, defining, fat grafting, skin removal -- to get the best in body contouring and body sculpting.  Dr. Emer.

Not sure if you have lipedema or not . However, Liposuction or Lipedema Reduction Surgery is generally recommended to be done prior to lifts. The best alternative to an open surgical lift is Renuvion a plasma based energy treatment that is combined with liposuction

So frustrated.   Sorry you are having these issues. Photographs would certainly be helpful in providing a more detailed recommendation, however you may want to address the areas of significant lipodystrophy first with Liposuction prior to body lift surgery. However, depending on anatomy and physical findings, They may be able to be performed simultaneously. Laser liposuction has not proven to be very effective with regard to Skin contraction. Traditional liposuction is still the gold standard.  Consult with a board-certified plastic surgeon to explore the best options for you. Good luck.

Thanks for your question, sosofrustrated. Sorry to hear about your struggles.
It’s hard to give you any proper advice without photos, but if your lipedema is extensive, maybe you can do a traditional liposuction first before undergoing body lift surgery. Consult your reputable and board-certified plastic surgeon about it.
As for a laser alternative to body lift, there isn’t a non-invasive procedure that can give you the same results as a body lift. So if you have a lot of loose skin, getting a body lift is the best option.
Best of luck!