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It is not always easy for patients to receive an official lipedema diagnosis. That is due largely to the fact that, despite affecting millions of women nationwide, it remains one of the most underdiagnosed conditions.This painful disorder, in which abnormal amounts of fluid-filled, knobby fat are produced and deposited throughout the lower body and possibly the arms, results in an oddly disproportionate figure and brings on other health and lifestyle issues. The exact cause of lipedema is unknown, as is its cure. However board-certified plastic surgeon Jaime S. Schwartz of Total Lipedema Care in Beverly Hills, CA, is able to provide expert advice for slowing the progression of lipedema during the earliest stage.
It may be difficult for patients with Stage 1 lipedema to know that they have it. Rather, it often appears as though they simply are gaining weight in the lower half of their body. The fat likely will appear on both legs and be evenly distributed from the hips to the ankles (which, along with the feet and toes, are not affected by the condition at this stage). Swelling will be noticable and may worsen throughout the day, but can be reduced through rest and elevation of the affected area. Patients may also experience pain that is not relieved by over-the-counter medications. When pressure is applied, the skin may fail to pit or indent such as when a finger is pressed into it. The fat beneath the skin may appear lumpy.
If diagnosed early, lipedema has the best chance of responding well to treatment. Because it is believed to be triggered by hormonal changes such as puberty, pregnancy and menopause, doctors may prescribe hormonal-therapy medications or herbal supplements to treat it. Dr. Schwartz may order blood tests to detect any vitamin or mineral deficiencies. Lipedema can wreak havoc on the immune system, so it is important that patients maintain their overall health in order to quickly and successfully recover from any infections, illnesses, and wounds that may occur.
Fat produced as a result of lipedema is often resistant to the effects of diet, exercise and other weight-loss methods. However, patients are still encouraged to eat a healthy diet and exercise three times a week for at least 45 minutes in order to maintain their mobility and build up muscles in the legs. Compression garments should be worn to help prevent swelling (a condition called edema) and improve circulation.
Decongestive massage techniques work on trigger points within the lymphatic system to stimulate proper drainage. These may also cause improvements to the flow of blood and lymph fluids, which can prevent swelling. Compression wraps or bandages may be applied in conjunction with massage which, when performed by a specially trained massage therapist, can be particularly effective during the early stages of lipedema, before skin becomes especially swollen and sensitive to pressure.
Without proper treatment during Stage 1, lipedema is likely to advance to Stage 2. This phase shares many of the same symptoms as those previously experienced, except that the amount of fat beneath the skin will increase and the nodules will be easier to feel. In fact, it is not unusual to have fist-sized lumps form. Because the fat is less-evenly distributed, the skin may begin to appear discolored and take on a bumpy, textured appearance. Compression garments should continue to be worn.
During this phase, some patients may undergo lymphatic-sparing liposuction surgery, which is the most effective treatment for lipedema. At Total Lipedema Care in Beverly Hills, CA, Dr. Jaime S. Schwartz performs water-assisted liposuction (WAL). As suggested by its name, this procedure employs water to help break up fat cells that are then extracted with a tube called a cannula via small incisions. Dr. Schwartz also uses an innovative contouring technique called SAFE (separation, aspiration and fat equalization) to preserve the shape of areas that undergo modification. This also promotes better mobility and blood-vessel health. Rather than put lipedema patients under general anesthesia, he opts instead to use total intravenous anesthesia (TIVA) per the Schwartz Rapid Recuperation. This specially designed protocol eases the recovery and healing processes for patients following surgery.
As fat continues to accumulate on the body during Stage 3 lipedema, especially from the buttocks down to the ankles, mobility issues that impact normal movement of the limbs. Large fat deposits may be present around the knees. Discolored skin may feel thick and hardened. Sizeable folds of excess skin may make the body appear deformed. If patients are still able to bear having their skin touched, it is a good idea to continue with decongestive massages techniques during this phase, to help rid fluid from the lymphatic system.
One or more lymphatic-sparing surgeries, including arm and leg lifts, may be performed in order to remove or tighten excess skin that has lost its elasticity due to lipedema. Water-assisted liposuction can be included as part of the these and other procedures such as a reconstructive tummy tuck. A panniculectomy may be used to remove large, apron-like flaps of fat that hang over the stomach. During an upper buttock shelf treatment, liposuction removes large and often embarrassing fat accumulations from an area on the patient’s backside, just below the waist.
By undergoing these procedures, patients in Beverly Hills, CA, may be able to stop Stage 3 lipedema from progressing to its advanced fourth stage, called lipo-lymphedema. During this final phase, fat deposits can cause lymph nodes to become blocked or damaged and prevent the proper drainage of lymphatic fluid. Swelling will appear throughout the entire lower body, including the feet and ankles. Continued uneven distribution of fat will occur in the legs, further limiting movement. At this point, if it has not already done so lipedema may develop in the arms.
It may feel as though patients are fighting an uphill battle as they work to treat and maintain their lipedema symptoms in order to keep the painful, debilitating condition from progressing. All of that effort is certainly worth it, and board-certified plastic surgeon Dr. Jaime S. Schwartz can help. We invite you to contact Total Lipedema Care in Beverly Hills and schedule an appointment to learn more about the innovative noninvasive and surgical techniques which may successfully keep advanced lipedema at bay.