Would liposuction help my lipedema or should I get a tummy tuck first? (photos)

Be47125 thank you for sharing your photos. Your decision about a Tummy Tuck or Abdominoplasty should be just for cosmetic considerations. It should have no effect on lipedema. Lipedema is an subcutaneous adipose tissue disorder that should be treated comprehensively and can be managed but not cured. Medical grade compression and an antinflammatory diet should be part of any treatment of lipedema. For women with lipedema who need additional help with symptoms lipedema reduction surgery using modified liposuction techniques can decrease pain, swelling and increase mobility.
In theory, insurance covers surgery for some women, who the insurers, not you or your doctors deem are significantly hindered in their ability to perform instrumental activities of daily living. In practice medical insurers impose arbitrary denials for surgery, for example by looking a patient's photo and claiming they do not have lipedema.
Yes, I would recommend choosing a surgeon who has a good deal of experience treating lipedema and has consistently good to excellent results for his or her lipedema patients.

With a diagnosis of lipedema, it is advisable to first address the lower extremity lipedema with liposuction prior to considering a body lift procedure. I recommend making an in-person or virtual consultation appointment with a lipedema specialist for a thorough history and review of photos/physical examination to determine if liposuction is right for you.

I am so happy to hear that other physicians are becoming aware of lipedema and correctly diagnosing patients. Your vascular surgeon correctly diagnosed you with lipedema as I can appreciate simply based on the characteristic shape and distribution of fat and swelling of your legs, both upper and lower. Your legs are forming more of a column like shape with distribution of fat and swelling. Your torso which was previously done with liposuction created a lot of the irregularities in my opinion and should not have been done first. Not only because it is creating irregularities but because it is not properly treating balance and proportion in your body and is creating more disproportion. Your legs should have been considered as part of the overall approach to creating balance and proportion with liposuction surgery. I strongly feel that it is important to have the lipedema in your legs properly treated by an experience lipedema surgeon. As time goes on, this will only continue to get worse and can begin to affect your lymphatic circulation potentially leading to lipolymphedema. In addition to that, the skin elasticity will also begin to decrease, becoming more difficult for well-done liposuction to achieve uniform and even skin retraction. It does look as though from the photographs that what might be necessary to improve the irregularities in your abdomen is a well done abdominoplasty procedure but personally I would not make this a priority right now but rather focus on your legs. It could be possible under further evaluation that I would maybe consider revision liposuction surgery to your abdomen involving a multistep approach with emulsification, release of fibrosis and scarring from the previous liposuction surgery and using a modality such as Renuvion J-plasma to get skin tightening but I would have to make that determination when seeing you in person.

Seek out an expert for a formal evaluation. When we perform liposuction to the lower legs, microcannulas are used to remove fat very superficially without damaging the tissue or causing any scars or irregularities. Multiple energy devices are used to melt fat and tighten skin, which is especially needed in this small, sensitive area. Precision and skill is vital to get the best outcomes.

Coolsculpting and Kybella are non-surgical options that can also be used for fat reduction in the knees.

I recommend getting a formal evaluation with an expert to determine the best course of treatment for you. Best, Dr. Emer

Thank you for your question. You can have both procedures done at the same time, but your doctor might refer you to a rheumatologist that will provide the clearance and to make sure is under control.

Respectfully,
Dr. Emmanuel Mallol Cotes.-

Based on your pictures, it does look like you have heavier legs. However, if you also have increased bruising and hypersensitivity, you may have a lipedema. If you also have symptoms extending into the lower portion of your abdomen, then, most likely, liposuction and partial tummy tuck may be covered.I suggest doing liposuction first. The reason is that once you do liposuction of the legs, you will have extra loose tissue, and then a tummy tuck, later on, can improve the appearance. Liposuction is usually done for pain and not for beauty in the case of lipedema. However, I understand your concern, and I would first start with liposuction for the above reason. Liposuction for lipedema is usually covered by insurance. The majority of the commercial plans do have coverage. We also have been successful in getting authorization even from state Medicaid plans. However, Medicare and other Medicare-like advantage plans do not cover this procedure. Unfortunately, TRICARE is one of the most challenging companies to deal with. Hopefully, it helps. I wish you well.

The analysis of lipedema is a conclusion of prohibition. As such there is no conclusive test to analyse the condition. Liposuction won't further reduce torment and is as a general rule great for on the moderate enhancements. Lower furthest contour issues frequently have a huge skin laxity part and this isn't treated with fat evacuation. Liposuction underneath the knee for example calves and lower legs is especially difficult both as far as tracking down somebody with adequate ability and experience and the recuperation from the strategy. There basically are not a ton of extraordinary treatment choices. Liposuction is presumably ideal, however, it actually is not significant. Liposuction is essentially never covered by clinical protection and will in all probability forever be viewed as a restorative method. Liposuction won't further reduce leg pain. Whereas, A tummy tuck procedure isn't a weight reduction answer for any patient, especially those managing lipedema. Abdominoplasty with liposuction can lessen fat development in the stomach region while tending to saggy, hanging skin. You can either get both or just one depending on the extent of lipedema.

I would be happy to discuss lipedema treatment with you and have treated 100's of patients with this condition. Please see the link below for more information.

The diagnosis of lipedema is a diagnosis of exclusion. In other words there is no definitive test to diagnose the condition.

Liposuction will not improve pain and is in reality good for on the moderate improvements. Lower extremity contour issues often have a significant skin laxity component and this is not treated with fat removal.


Liposuction below the knee i.e. calves and ankles is particularly challenging both in terms of finding someone with sufficient skill and experience and the recovery from the procedure.

There’s simply are not a lot of great treatment options. Liposuction is probably the best but it still lacks significantly.

I don’t think you’ll find any particular surgeon who specializes in lipedema. In the end what you want is someone who has a lot of Liposuction experience with a proven track record of this procedure.

Liposuction is basically never covered by medical insurance and will most likely always be considered a cosmetic procedure.

Liposuction will not improve leg pain.

I suggest scheduling multiple in person consultations with local board-certified plastic surgeons to get a better assessment and more thorough understanding of what can and cannot be accomplished.

Best,

Mats Hagstrom MD