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Lipedema

thighs1See us for Lipedema in Philadelphia, Pennsylvania, Maple Shade, New Jersey, Bala Cynwyd, Pennsylvania, and the surrounding areas. The Falcone Center for Functional, Cosmetic and Integrative Medicine offers advanced treatments for those women seeking to get rid of unwanted fats from arms, buttocks and legs.

 

Lipedema is a chronic disorder that causes accumulation of disproportionate fatty tissue on the arms, buttocks and legs of women. It can cause up to a ten size clothing  difference between the upper and lower body.  It is not uncommon to see a woman suffering from Lipedema wearing a size 4 top and size 14 pants.

Lipedema often goes undiagnosed by doctors. This is problematic as early diagnosis and treatment can prevent it from getting worse. It is estimated to effect up to 11% of women. As it progresses, Lipedema can become painful and if untreated, it can lead to decreased mobility and multiple health problems impacting the quality of life, emotionally and physically for patients.

For most patients, it begins to develop in puberty and can worsen in response to trauma, surgery, peri-menopause or pregnancy. Lipedema has been seen in both morbidly obese and in anorexic women. Hormones are known to have an effect on the condition and it can be inherited but the underlying cause is still unknown.

Factors considered when diagnosing Lipedema:

  • Disproportionate fat accumulation in the legs, hips and arms when compared to the upper body. Hand and feet are unaffected.
  • Legs can appear to have extensive cellulite and feel soft.
  • Swelling is symmetrical and can worsen in warm weather
  • When pinched, the fat can be much more tender and painful in affected areas when compared to the abdomen or back.
  • Upper arms are disproportionately larger then the lower arms.

4  Stages of Lipedema

Stage 1. The skin in the affected area is soft and smooth. Swelling increases during the day, but typically resolves with rest and elevation.

Stage 2. The skin develops indentations and the tissue areas of lipedema begins to feel more tough and nodular. Large fatty deposits (lipomas) begin to form on the upper and lower legs and around the ankles. Eczema and skin infections (erysipelas) may also be present. Swelling increases during the day, but does not resolve as easily as in Stage I with simple rest and elevation.

Stage 3.  Swelling and hardening of connective tissues is present. Symptoms do not improve with rest and elevation alone. Large masses of skin and fat cause deformities in the knees and thighs. 
Manual lymphatic drainage and compression socks can often help with swelling.

Stage 4. This stage is also called Lipo-Lymphedema. There are larger amounts of skin and fat overhanging the legs. Lymphatic fluid can begin to leak from vessels creating swelling making the legs feel stiff. Manual lymphatic drainage and compression may or may not help therefore wraps and medications are usually necessary.

Five Types of Lipedema

Type I – affects the buttocks

Type II- affects the buttocks, thighs and hips

Type III- affects the buttocks, hip, thighs and calves

Type IV – affects the arms

Type V- affects the calves

Treatment Options

Treatment options are dependent on the severity and location of the lipedema.

Options include the following:

1) Exercise to helps to burn fat, avoid further weight gain and increase flexibility and mobility.

2) Water Therapy exercise programs allowing for weightless exercise for patients experiencing mobility issues.

3) Compression Garments to help improve blood flow, prevent swelling and facilitate drainage of lymphatic fluids.

4) Compression Pumps also called Intermittent pneumatic compression pumps (IPC’s) help to massage the areas to stimulate lymphatic drainage. Your family doctor can write a prescription for a take home device.

5) Lymphatic Drainage Massage Therapy

6) Water Assisted Liposuction, Aquashape by BodyJet  and/or Tumescent Liposuction under local anesthesia Both of these methods of liposuction are available at the Falcone Center

WATER-JET ASSISTED, Aquashape by Body Jet Liposuction Treatment Of Lipedema

At this time, Liposuction is the only method of removing fat accumulations created by Lipedema. Diet and exercise can reduce “normal” fat found in the abdomen and flanks but lipedema fat often remains even after bariatric surgery or extreme dieting.

If a lipedema patient does lose weight, the reduction in size is often seen in the abdomen or back while the area with lipedma has little improvement.  This creates mental and emotional stress  when a person finds that they are unable to change their shape.

There is hope if you are suffering from Lipedema

Water-Jet Assisted Liposuction (WAL) also know as Aquashape or Body-Jet liposuction, is a gentle lymph sparing liposuction technique used to remove lipedema fat, under local anesthesia. The treatment is done while you are awake in our office. Research shows that gentle lymph sparing liposuction techniques can produce good long-term reduction in pain and slow down or stop the progression of lipedema.

Conservative methods such as compression socks, stretch wraps, manual lymphatic drainage massage, and medications can help with lipedema symptoms but relief tends to be temporary and not everyone responds.  Conservative methods will not help with mobility issues nor stop the progression of fat accumulation.

If you suffer from Lipedema and are ready to have a Water-Assisted Liposuction (WAL) procedure, call the Falcone Center to schedule your complimentary consultation. You will hopefully notice a dramatic improvement in your symptoms soon after your procedure. The need for therapies such as manual lymphatic drainage and compression socks can be greatly reduced in almost all patients, and in some cases, conservative therapies can be eliminated, after lymph sparing, Aquahape, Water Assisted Liposuction (WAL).

Dr . Falcone has been a liposuction specialist since 2007 and has been performing Water Assisted Liposuction with the Body Jet, Aquashape device since it was first FDA approved in 2009.  She prefers Water Assisted Liposuction to contour all thigh regions as it is very gentle to the connective tissue leaving lymphatic vessels and connective tissue largely intact. The tissue is much less traumatized then in a traditional liposuction procedure and patients typically heal faster.

The goal of liposuction in the treatment of lipedema is a bit different then a cosmetic patient simply seeking to reduce the size of an unwanted small bulge on their inner or outer thigh.  With lipedema, the goal is to alleviate pain, increase mobility, and to prevent progression of the disease. The cosmetic appearance after treatment is less of a concern as excess skin may occur when very large amounts of fat are removed. Patients may require a second procedure or thigh lift after six months if optimal cosmetic appearance is desired. Every effort will be made to provide an acceptable contour but in some patients, the level of deformity and skin laxity of the tissue will prevent a good cosmetic appearance post liposuction treatment. Lipedema patients will fit much better into their clothing but out of clothing, any cellulite, loose skin, excess skin or skin color changes that were present prior to the surgery will likely remain to some extent post-treatment.

Water assisted liposuction, Aquashape by Body Jet is the preferred method because of its lymphatic-sparing capabilities.  To learn more about Lipedema treatment at the Falcone Center, contact us to set up your complimentary consultation.

How to Decide if a Lymph Sparing Aquashape by Body-Jet Liposuction Technique is Right for You

Liposuction cannot cure lipedema. It is a very effective method of fat reduction and symptom relief. Like any surgical procedure, liposuction has risks and not everyone is a good candidate. You will discuss your medical history with Dr. Falcone during your pre-operative appointments and appropriate testing and medical clearance will be obtained prior to your procedure.

Although, liposuction is generally safe in healthy individuals, it can have risks such as infection, bleeding, and trauma to the area. Post-operative swelling in the area after liposuction is more prolonged in individuals with lipedema. The swelling can gets worse before it gets better, and the full benefit may not be realized for six months or longer.  Most patients with lipedema experience significant improvement of many or all of their symptoms fairly soon after their procedure but healing time is very dependent on a variety of factors.

Post-operative compression garments often have to be custom made for Lipedema patients and they can be expensive ranging from $100 to $200.  The Falcone Center team can help you with the measurements and ordering of garments. It will take a minimum of 2 weeks for custom garments to be made.  Surgery dates must be scheduled accordingly. Because it is difficult to predict post-operative measurements when large amounts of fat are removed, we recommend that patients find a good tailor who can further customize the garment post surgery or an additional garment can be ordered during the healing phase.

Despite the excellent liposuction skill of Dr. Falcone and effective nature of the Water Assisted Liposuction, Aquashape device, it is impossible to remove all lipedema fat through liposuction. Safety parameters, the amount of fat in the area prior to treatment, the number of areas involved and the extent of fibrosis in the area will all affect the amount of fat removed in a single liposuction procedure. Most patients with significant lipedema will require multiple surgeries and unfortunately, insurance rarely covers the cost. This will be discussed during your consultation and surgical planning will be jointly decided to address your areas of concern in order of priority.

The Falcone Center does not accept insurance but we offer three different financing options and patients can use a medical spending account to pay for their procedure. CareCredit®, LendingUSA and Healthcare Financing Solutions.

*Every patient is unique and individual experiences will vary regarding downtime and results.