Lipedema is a condition that occurs when fat is unevenly distributed in an irregular manner beneath the skin, most often in the legs, arms, and buttocks.
Although for many patients it begins as a cosmetic concern, once it progresses, it can eventually cause pain and other symptoms. Lipedema is often mistaken for obesity or lymphedema, but it is a unique condition that requires treatment from a skilled, experienced surgeon. Over time the fat can become hard and fibrous and scar tissue can form around the fat due to inflammation. If this happens veins and lymphatics can become restricted, which will cause pain. Although there is no cure, it can be treated. Lipedema can be very frustrating both physically and mentally, especially if it is undiagnosed. Beverly Hills, CA board-certified plastic surgeon Dr. Jaime S. Schwartz is a renowned plastic surgeon, who regularly collaborates with Dr. Karen L. Herbst, a national expert on lipedema. He also regularly lectures on this topic.
At Total Lipedema Care (TLC) in Beverly Hills, Dr. Jaime Schwartz offers therapeutic nonsurgical and surgical treatments. You may have heard it called the “painful fat disorder,” or thought people who suffer from this were just extremely overweight or morbidly obese. There is much more to the story. The truth of the matter is that having lipedema is not the same as being fat. How can Dr. Jaime Schwartz tell the difference? The adipose cells that form have extra fluid, plus the fat, which causes the area to distort the skin, change its size, shape, color, texture, and sensitivity on one or multiple areas of the body. Fatty areas of the body may show characteristics in the lower body (calves, knees, thighs), the mid-body (torso, hips, buttock, abdomen), and upper arms. As a progressive disorder in men and women, lipedema is not cured — only managed. The fluid buildup can cause chronic pressure and pain in the affected body part (especially if it is near a nerve).
There is ongoing research on what causes lipedema. We do know that it can be genetic, triggered by a stressful even like hormone variations or changes in puberty, pregnancy, or menopause. One in eleven women have lipedema. This is not a fat disorder for just men and women who are overweight or obese. It can present itself in a person who is underweight — it is not limited to the weight/size of the patient. Diet and exercise modification can help alleviate symptoms but will not eliminate the disorder.
A person who is symptomatic of lipedema (most likely to present in women — in fact, one in nine) will look symmetrically swollen in the affected area. In the lower body, the thighs, knees, and calves may look extremely disproportionate to the rest of the body. The fat will stop at the ankle and not affect the feet. In the midsection, lipedema will cause the lower abdomen skin to hang (like an apron). The buttock will not have an even amount of fat either because lipedema causes it to collect on the upper region only – thus the need for an upper buttock shelf treatment. The upper arms are the most visible area that can exhibit lipedema. The arm skin gets so heavy that it atrophies rapidly and looks pendulous (even at an early age). Like the feet, the hands will not show the signs of lipedema as it will stop at the wrist. The fat may take on a cellulite-like appearance, which is also known as “mattress skin.” This disorder can be very frustrating and debilitating, especially if it is undiagnosed. If you have lipedema, you may also experience the following:
Dr. Jaime Schwartz sees patients in all stages and types of lipedema who suspect something is wrong or “not right” with their health when diet and exercise are not helping – no matter the level of effort. If you have lipedema, you may feel like you can’t do anything for your situation. Dr. Jaime Schwartz is one of the few plastic surgeons that treats lipedema, and he wants his patients to feel normal and healthy.
There are five types, which can develop in any body type. The area with lipedema will be hypersensitive to touch, present spider or varicose veins, and fat distributed in abnormal ways under the skin.
The fat collection will not be distributed evenly on the buttocks. It will cause the fat to accumulate on the upper part of the buttocks only (known as the upper buttock shelf). If you have lipedema in the buttock area, you may wear a very large size in your midsection but a small in the upper body. This type of fat can make sitting rather uncomfortable and painful at all times.
Lipedema within the arms may be the most visible out of the five types and is present in 30% of all lipedema cases. With a large amount of fat in the upper arm, lipedema may create a “bat wing” appearance as the skin will hang. If it extends to the lower part of the arm, it will stop at the wrist. The lower arm skin will not hang like the upper arm, but it will look very swollen. This can make wearing T-shirts and form-fitting clothing uncomfortable. Sleeves can often feel very tight or collect at the underarm if too short.
Each stage can also be characterized as a beginning (early), middle, or severe degree of lipedema. The symptomatic features can be categorized into four stages:
While they share common characteristics, lipedema and lymphedema are not the same conditions.
There are many similarities and differences between these two conditions. Dr. Schwartz wants you to know that he will do what is necessary to provide you with a diagnosis that is appropriate for you.
You can manage lipedema, but the treatments (no matter how aggressive) will not cure it. Fortunately, you have Dr. Schwartz and his team if your symptoms seem to worsen after attempts to treat it. At Total Lipedema Care, we want you to feel your best and look healthy without the presence of the fluid-filled fat cells within your body from lipedema. We offer the medical management of lipedema cases in all stages or types. If left untreated, it can progressively diminish the softness of your skin, your mobility, your self-esteem, and the quality of your life. Also, you increase your chances of developing blood clots and lipo-lymphedema, which can lead to skin ulcers, infections, and a severely blocked lymphatic system. Dr. Schwartz will recommend treatment based on your needs and stage of lipedema.
It is easy for a doctor to misdiagnose you as just being overweight or obese because of the extra weight you carry. The fat on your body may tell a different story. This is why you need to consult with fat disorder experts and plastic surgeons well versed in lipedema. If you are looking for a doctor to find answers, treatment, and long-term management, Dr. Schwartz and his team in Beverly Hills understand that lipedema treatment is not about fixing a cosmetic problem – it is about improving your quality of life with a medical intervention. Call and schedule your first appointment today.