Do I have lipedema? (Photo)

Question

I have terrible cellulite and most of my fat goes to my legs or arms, I ad lipo done on them once and still have fat pockets

Thomas Wright, MD · Answer

Lipedema is a subcutaneous adipose disease of the arms and legs that causes pain and swelling. Lipedema is characterized by disproportionate subcutaneous tissue that is  relatively resistant to weight loss.  You may indeed have lipedema or it is possible that you have a different body type and cellulite. 
 You don't mention any symptoms. It is debated whether lipedema can be diagnosed without symptoms of pain, bruising, and swelling. However, I think it can be present without these symptoms. Lipedema is best treated comprehensively, including a low-refined carbohydrate diet, low-impact exercise, and medical-grade compression. Surgery is an option for those whose symptoms are not controlled with nonsurgical treatments or for those who want to prevent the possible progression of lipedema. Lipedema Reduction Surgery, LRS, is not the same as liposuction. LRS goals are different than cosmetic liposuction and extra precautions are taken to reduce the risk of lymphatic injury in lipedema. Patients with lipedema are at increased risk for Lymphatic problems.
I recommend you consult with venous and lymphatic specialists as they are most familiar with the diagnosis of lipedema. If you have lipedema, I recommend you work with an experienced lipedema surgeon who has proven quality of life, mobility, and functional outcomes for the best results.  There are a few specialized centers that are focused on treating lipedema comprehensively and safely for the best overall outcomes.  The best lipedema surgical specialists will treat the condition comprehensively and will follow their patients long-term to ensure they are delivering the best functional outcomes for their patients. I have just published a study on the functional and quality of life improvements we have seen after Lipedema Reduction Surgery in our patients. Wishing you the best of health.

Mats Hagstrom, MD (license on probation) · Answer

Most likely, you do not have lipedema, but rather a genetic fat distribution that focuses subcutaneous fat more on your extremities than the average person.
There’s no test for lymphedema. It is a diagnosis of exclusions. The hallmark is increasing subcutaneous fat of the extremities, most commonly lower extremities that tend to increase with age despite successful weight loss.
Lip edema is a relative diagnosis in bed. It is a condition that worsens with age. Understanding what your extremities have a look like previously would help confirm the diagnosis but the diagnosis doesn’t change treatment options so in that sense it’s not particularly useful.
Best,
Mats Hagstrom, MD

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