Lipedema liposuction before skin removal. (photos)

Question

I lost 200 pounds but have lipedema and didn't lose as much from my legs as I did from the waist up. I have seen two doctors who conflict about whether or not I should have the lipedemic fat removed through WAL before I have the excess skin removed. I'm concerned about the effect on my lymphatic system of just going with the skin removal, but don't want to pay for two surgeries to the same areas if one will suffice. Anybody know what I should do?

David S. Rosenberg, MD · Answer

i would perform the liposuction first.  I often do liposuction under sedation so that it is cheaper and an easier recovery for the patient than with general anesthesia.  Then 6-9 months after the liposuction have the skin removal.  That will give you the best result in my opinion. Good luck! DSR

Mats Hagstrom, MD (license on probation) · Answer

Based on the amount of fat you lost from your legs your lipedema may not be that bad.
Often people with lipedema do not lose substantial amounts of fat of their lower extremities even after massive weight loss.
The decision to have more fat removed before skin tightening procedure the pencil how much subcutaneous fat is present.
You obviously have a substantial amount of loose skin.
I like to call Lew skin the enemy of liposuction.
I say this because loose skin often is very deceptive and looks like Fric layers of fat.
Says it also does not get treated for liposuction it often eyes results.
In your case I understand you're looking for a skin removal procedure.
The best way to assess I think you're fat layer is is not to pinch your skin.
What's better is to put your skin at my attention and then gently push in with your finger until you touch the muscle layers below.
For example laying on your side gently push on the skin of the outside of the thigh to see how thick the layers of fat are.
The same can be done laying on the bed and putting one leg up in the air.
I personally do not like to perform any type of aggressive liposuction in conjunction with fat removal procedures.
I perform almost all liposuction and procedures with local Anastasia and mild sedation.
This makes liposuction slightly less expensive because of savings from a formal operating room and an anesthesiologist.
One way to look at if you need fat removal before your skin surgery is to put it in context of how thick your subcutaneous fat this on other parts of your body.
If the five layers are your lower extremities match the rest of your body with the exception of skin laxity then perhaps you do not need to have liposuction first.
Conservative liposuction could probably be done in conjunction with skin removal surgery as well.
In the end you can think of the decision as being based on if you want the thinnest likes possible or just getting rid of the loose skin.
Based on your pictures you need a fairly aggressive thigh lift.
You also have skin laxity below your knees.
I'm not sure if you've considered having skin removal that far down.
There's nothing wrong with having more than two consultations.
Either one of the two doctors you consulted with may be able to give you very good results.
Best of luck,
Mats Hagstrom M.D.

Lipedema liposuction before skin removal. (photos)

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