Much about lipedema, a painful condition that affects millions of Americans, is still unknown. That includes what exactly causes excessive amounts of fat to accumulate throughout the lower body in the first place. One of the most under-diagnosed disorders in the nation, patients often are told they are overweight or morbidly obese when, in actuality, that isn’t the case. A cure for lipedema also remains elusive. If left untreated, a host of physically and mentally debilitating symptoms may eventually develop. However, amid this unsettling diagnosis, there is also hope. Board-certified plastic surgeon and lipedema specialist, Dr. Jaime Schwartz of Total Lipedema Care in Beverly Hills, CA,is specially trained to help patients understand what lipedema is, as well as how to successfully treat and manage this condition.
What is lipedema?
Surprisingly common but underdiagnosed, lipedema appears almost exclusively in women. It is believed that genetics may play a role in the disorder, since those whose relatives have it are more likely to develop it themselves. The condition can emerge early in life during puberty as well as after pregnancy, during menopause, and other times when significant hormonal changes occur. Chronic and progressive in nature, lipedema causes abnormal amounts of lumpy, nodular fat to accumulate in areas of the body below the waist, including the hips, knees, calves, buttocks, and thighs, although the arms and abdomen may also be involved. As a result, the lower body becomes disproportionately larger than the upper half.
Sorting through the symptoms
Lipedema symptoms may start out mild, making it easy to assume a patient simply is gaining weight. Because it is progressive, symptoms will change and worsen over time unless preventative measures are taken. Patients often experience pain caused by thick, fluid-filled fat deposits which can grow into folds and flaps that hang over the skin and are sensitive to the touch. Bruising may occur more easily as blood vessels become prone to breakage and the skin loses its elastic feeling. The appearance of spider or varicose veins can be prominent.
In later stages of lipedema, the fist-sized lumps of fat can develop and distribute throughout the tissue, lending a textured, uneven and discolored appearance to the skin. It may take many years for advanced cases to develop into a condition called lipo-lymphedema, which is characterized by thick, hardened, discolored skin. At this stage, the legs no longer appear symmetrical and large fat lumps may impact the limb’s natural movement
Getting a diagnosis
At the Beverly Hills, CA Lipedema Clinic of Dr. Jaime Schwartz, it is common to see and diagnose roughly five types of lipedema. In Type I, fat accumulates on the upper area of the buttocks. A pear-shaped body figure may be present with Type II. Type III involves the hips, thighs and calves, while Type IV affects the arms. Those with Type V lipedema in the calves will feel pressure on joints in their legs which can impact their natural gait. Because so few physicians are knowledgeable about the condition, many who suffer from lipedema fail to receive a prompt, accurate diagnosis. Instead, they may be advised to lose weight despite the fact that the disorder does not respond to traditional weight-loss methods such as following a proper diet and exercise plan. Other Beverly Hills patients may be incorrectly diagnosed with lymphedema, a similar-sounding but entirely separate condition that results from a blockage in the lymphatic system. As a result, fluid will not drain properly from the body. Until lipedema reaches later, critical stages, it does not impact the function of the lymphatic system.
Although lipedema cannot be cured, its symptoms can and should be carefully managed.
Liposuction is the most effective treatment for the condition. It is performed to remove fatty tissue on the abdomen, arms, calves, thighs, and buttocks. It also can serve to lessen congestion and inflammation in the extremities, thus improving the patient’s comfort level. Incisions identical to those used during traditional cosmetic liposuction procedures are employed to extract fatty lipedema deposits. As its name suggests, during water-assisted liposuction (WAL) procedures, water helps to loosen fat cells from the body, which are then suctioned out. Another liposuction technique favored by Dr. Schwartz, called SAFE (Separation, Aspiration, and Fat Equalization), has proven effective in sculpting treated areas for a better appearance.
Lymphatic-sparing tummy tucks, arm and thigh lifts can tighten sagging skin and, when complemented by water-assisted liposuction, remove fat. With a lymphatic-sparing panniculectomy, a large “apron” of fat and skin that hangs over the lower abdomen is removed and liposuction performed. Liposuction also is involved in an upper buttock shelf treatment, which removes large fat deposits on the backside just below the waist. This procedure can restore shape to an area that tends to grow disproportionately large as a result of lipedema. For most surgeries, Dr. Schwartz administers total intravenous anesthesia (TIVA) to lipedema-surgery patients, per Schwartz Rapid Recuperation. This trademarked, specially designed protocol results in fewer complications for patients as they awaken and recover from surgery. As a result, many are able to return to some of their regular activities the next day.
Nonsurgical lipedema treatments can include restricting a patient’s diet in an attempt to eliminate some regular fat from the body. Low-impact exercises such as swimming, walking and yoga may help to build muscles in the legs, which may be beneficial if and when the lipedema progresses. Dr. Jaime S. Schwartz of Total Lipedema Care in Beverly Hills, CA, also will perform blood tests to check hormone levels and note any vitamin deficiencies. Massage techniques can work to effectively decongest the lymphatic system by improving blood circulation and stimulating proper drainage. Patients should wear compression garments and wraps to help minimize fluid retention, especially in the legs and arms as well as following liposuction surgery.
Putting patients first
The first step in treating the effects of lipedema is for patients to receive a proper diagnosis of this complex, progressive condition. Board-certified plastic surgeon Dr. Jaime S. Schwartz works diligently to provide innovative treatment options that allow lipedema patients to successfully manage their symptoms. Contact Total Lipedema Care in Beverly Hills, CA, and schedule an appointment that will help set you on the path toward living your best life.