Is it wise for lipedema and/or dercums patients to get skin removal surgery, considering the risk to the lymphatics?

Thank you for your question regarding plastic surgery to remove skin in the presence of lipedema or dercums with possible damage to surrounding lymphatics. Lipedema can be a difficult condition to treat. In my practice, I deal with many patients with lipedema. With your 100 pounds weight loss and your liposuction, I am sure you have loose skin. Based on the loose skin, I would strongly encourage skin removal. There is no other way to remove the skin without surgery. You did not include pictures so it is difficult to tell exactly your problem area.  Also, it is difficult to determine exactly what kind of thigh or calf surgery you would need. The abdomen would include a tummy tuck, extended tummy tuck or even a 360 circumferential lower body lift. Or you may need a longitudinal thigh lift, spiral thigh lift, lateral thigh reduction, or a complete thigh lift from the groin to the ankle.  These surgery does slightly increase your risk of worsening your lipedema condition. However, overall, I think the benefits far outweigh the risks of worsening your lipedema.  With these procedures, it is highly unlikely the lipedema worsens. To reduce your potential complications, I would suggest you eat healthy foods and continue to exercise. It will be very important post-operatively to wear your compression garments for eight weeks or more. You may also need lymphatic massages after the surgery. Due to your condition, I would also suggest blood thinners to be given for two weeks after the surgery. Thank you for your question regarding the treatment of lipedema with a potential thigh lift or tummy tuck and what are the risks associated with these procedures. Thank you and good luck.  I specialize in reconstructive plastic surgery after weight loss.  If you have any more questions regarding the lower body lift, 360 circumferential lower body lift, belt lipectomy, belt abdominoplasty, or belt dermolipectomy please contact my office. Since the body lift is a big procedure, please seek an experienced, board certified plastic surgeon with significant experience performing the lower body lift. Do your research.  Make sure they have performed at least 100 circumferential lower body lift surgeries and have the before and after pictures to prove it.  Carefully examine their before and after pictures and check their reviews on RealSelf.   If you cannot find an experienced, lower body lift surgeon in your neighborhood, consider traveling out of state if you must. Sincerely, Dr. Katzen. (“Verified” Plastic Surgeon, certified by the American Board of Plastic Surgery, Fellow of the International Society of Aesthetic Plastic Surgery, American College of Surgery, and International College of Surgery and member of the American Society of Plastic Surgery, American Academy of Cosmetic Surgery and RealSelf Hall of Fame.)

Hello, thank you for your question. congratulation on your weight loss, when you have lipedema you will need procedures to improve the medical portion of your condition but if you want cosmetic improvement, you will need staged procedures with liposuction and skin removal. You need a formal evaluation by an expert in body shaping and contouring to determine what is best.

Clearance by your primary care doctor is required prior to cosmetic surgery.  After that, the risks and benefits are really determined by which procedures you are getting.  The more tissue that is removed results in a greater risk of lymphedema and other complications.  However, ensuring patient safety should be a high priority and with a board certified plastic surgeon this is paramount.  Make sure you discuss your concerns with your plastic surgeon and when you feel comfortable you should be ready to proceed with body contouring cosmetic surgery.
Thank you for your question,
Dr. Schreiber, Baltimore plastic surgeon