Do I have lipedema in my legs and will liposuction help? (Photos)

Question

I've always had a body that was out of proportion and I want plastic surgery. At the end of the day my legs look much bigger than in the morning and it feels like they are "getting full" during the day. Even during my anorexic, underweight phase I had big legs compared to my body. Do I have lipedema and will liposuction help?

Thomas Wright, MD · Answer

Fatanstic, Thank you for sharing your photos.  Lipedema is a disproportionate inflammatory subcutaneous fat disorder that affects the extremities of women. You have swelling symptoms that could be caused by lipedema and your legs are slightly increased in size compared to your waist. However Lipedema cannot be properly diagnosed by photos alone. I recommend you consult with a doctor who is an expert at diagnosing lipedema. There are of course other conditions that can look and feel like lipedema so a proper physical exam and possibly test to rule out other conditions is essential to ensure the correct diagnosis. There is no cure for lipedema and it should be treated comprehensively with diet and lifestyle measures in addition to surgery if needed. I would also recommend you consider medical grade compression to see if this helps your symptoms. Wishing you the best of health.

Boris Volshteyn, MD, MS · Answer

There is a difference between lipedema and regular fat. Some people just have this body frame. The hallmark of lipedema are easy bruising, hypersensitivity of skin and pain. Usually, it is associated with hormonal changes. I suggest seeing a physician who is familiar with lipedema for diagnosis.

Mats Hagstrom, MD (license on probation) · Answer

Lipedema is a bit of an unusual condition and that we don’t know what causes it, there is no test to confirm the diagnosis and there is no treatment other than Liposuction which doesn’t always work all that well.
Based on your pictures I don’t think you have lipedema.
If you look up what lipedema really looks like you’ll start getting an idea of what these patients look like and how much they suffer from their condition.
The hallmark of the condition is worsening lower extremity size despite maintaining a steady weight.
Gradual buildup of swelling is normal physiological function due to gravity and fluid staying in the interstitial space because the lower extremities are below the heart.
Lower extremity swelling at the end of the day is not confirming diagnosis for the condition.
In the end it is a diagnosis based on exclusions.
Your lower extremities are actually pretty typical for middle-aged women who have moderate skin laxity and a female fat distribution.
Typically what makes lower extremities worse with time is more related to the loss of skin elasticity with age which starts at a young age.
Liposuction may be an option for you but keep in mind that thigh Liposuction is technically challenging and a substantial number of plastic surgeons aren’t particularly skilled at liposuction even if they do it on a regular basis. The upper inner thigh tends to not deliver results that are as good as patients had hoped for because skin laxity contributes significantly to contour in this area.
Outer thigh fullness reduce as well but if the problem is more on the backside of the outer thigh (posterior lateral ) then skin laxity is usually contributing significantly to the contour issues.
If you’re interested in having Liposuction that plastic surgeons carefully and thoroughly to make sure you’re in the hands of someone has a fish in school and experience. Do that by having in person consultations at which time you should ask the providers to open up your portfolio and show you the complete collection of before and after pictures. If they only show you what a handful of preselected quality results which may represent the best results of their career and ask them to start showing you more pictures especially pictures of average outcomes for patients who have similar characteristics to your own.
If you’re interested in having Liposuction that plastic surgeons carefully and thoroughly to make sure you’re in the hands of someone has a fish in school and experience. Do that by having in person consultations at which time you should ask the providers to open up your portfolio and show you the complete collection of before and after pictures. If they only show you what a handful of preselected quality results which may represent the best results of their career and ask them to start showing you more pictures especially pictures of average outcomes for patients who have similar characteristics to your own.
The goal should be to see as many before and after pictures of patients with similar body characteristics to your own to get confirmation and a clear understanding of what your results will most likely look like.
Seeing a handful of preselected pictures of quality work May not represent what average results look like in the hands of each provider.
Best,
Mats Hagstrom MD

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