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Lipedema
in Beverly Hills, CA & Tucson, AZ

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.

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WHAT IS LIPEDEMA?

  • Abnormal build-up of thick connective tissue in areas such as legs, thighs, stomach, buttock shelf, hips, and arms.
  • Typically see a large size discrepancy between the upper and lower body.  It can be extremely painful and affect daily life. 
  • Is hormonal and often times begins at puberty and gets worse with pregnancy, birth control pills, and menopause. 
  • Can become very PAINFUL and limit normal activities such as walking even short distances.
  • May increase inflammation in the body leading to “flu-like” symptoms such as brain fog and memory loss.
  • Often misdiagnosed as Obesity or Fibromyalgia. 
  • Affects approximately 11% of women!

UNDERSTANDING THE CONDITION

At Total Lipedema Care (TLC) in Beverly Hills, Dr. Karen Herbst and Dr. Jaime Schwartz offer 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 we know the difference? The adipose cells that form have extra fluid, plus the fat, which causes the area to distort the skin and change its size, shape, color, texture, and sensitivity in 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).

Lipedema Treatment in Beverly Hills, CA & Tucson, AZ

“We now know a lot more about lipedema than we used to, for example, we now know that inflammation plays a role in the progression of lipedema and maybe even the initiation of lipedema. We also have a lot more treatments for lipedema that help reduce the pain, swelling, and heavy feeling in the lipedema tissue. Finally, insurance is now covering more lipedema reduction surgeries now than in the past in big part thanks to the work Total Lipedema Care has done with government and insurance companies.” – Dr. Karen Herbst, MD, Ph.D., Leading Lipedema Researcher

WHAT ARE THE CAUSES?

​There is ongoing research on what causes lipedema. We do know that it can be genetic, triggered by a stressful event like hormone variations or changes in puberty, pregnancy, or menopause.

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.

WHAT ARE THE SYMPTOMS?

A person who is symptomatic of lipedema will look symmetrically swollen in the affected area. The lower body, 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:

  • You have pain and sensitivity in the affected area.
  • You feel chronically fatigued or malaise.
  • You bruise easily.
  • You experience brain fog.
  • You have medial knee fat pads.
  • Your legs and feet may be swollen after standing or moving.
  • You have firm nodules under the skin.

Dr. Jaime Schwartz and Dr. Karen Herbst see patients in all stages and with all 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 about your situation, but this is not true! The team at Total Lipedema Care is dedicated to helping their patients to feel their best selves.

WHAT ARE THE TYPES?

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.

TYPE I: BUTTOCK

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.

TYPE II: BUTTOCK/HIPS/THIGHS
You may see Type II lipedema as just having a “pear-shaped” figure, which is a normal reaction. However, when the fat buildup and swelling become more advanced, the buttock, hips, and thighs become very disproportionate to the rest of the body.
TYPE III: HIPS/THIGHS/CALVES
Encompassing the entire lower body to the feet, Type III lipedema can make legs feel very heavy. With the enlargement of the hips, thighs, and calves, a patient with this type of lipedema may find it difficult to walk without feeling pressure and pain. There will be thick fat pads surrounding the knees and folds of fat on the inner and outer thigh. Commonly, Type III patients walk with the thighs rubbing together, which can lead to the break down of the skin and infections.
TYPE IV: ARMS
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.
TYPE V: CALVES
Patients with lipedema in the calves only may benefit from wearing compression garments to help with the swelling. The enlargement of the calves will have a negative impact on the lower body in general as it will put pressure on the joints, disrupt the natural gait, and contribute more discomfort as it gets progressively worse.

WHAT ARE THE STAGES?

STAGE I
  • Skin is still unaffected (no dimpling or cuffing)
  • Body parts may start to look disproportionate but not severe
  • Pain occurs but will feel better when the area is in a compression garment or elevated
  • Will respond to treatment the best at this stage
STAGE II
  • Skin will start to change in appearance (may see a cobblestone-like pattern in the skin)
  • Swelling becomes more frequent and longer-lasting, even with elevation
  • Lipomas (large, benign tumors) may be present
  • Depending on the type of lipedema, Stage II should respond well to treatment
STAGE III
  • Tissue affected by lipedema will naturally begin to feel hard and chronically appear swollen
  • Connective tissue may feel fibrotic (knotty)
  • Large amounts of fat will overhang and distort the shape of the body part
  • Early onset arthritis on joints overburdened with the weight of excess fat
  • Will not respond well to less invasive treatment methods
STAGE IV
  • The most aggressive form of lipedema (will not respond too well to most treatments)
  • Extensive swelling and hardening of the legs and arms
  • Multiple areas will have flaps of skin and folds of fat that overhang on the body
  • Can develop lipo-lymphedema (non-pitting edema will present as pitting edema)
  • Diet and exercise may help keep either condition from getting worse, but it will not cure it. Losing weight is helpful but may not make a significant impact on the course of lipedema and/or lymphedema.
  • A telling sign of lymphedema is a condition called pitting edema, which is only present in the late stages of lipedema or pre-lymphedema. By pushing on the skin with one finger, a lymphedema patient will retain the depression in the skin from the touch.
  • Both conditions have a fluid buildup within the tissue. Lymphedema, however, has an accumulation of fluid that is protein based, not water based.
  • A compromised lymphatic system from lymphedema can cause the skin to be prone to ulcers, infections, and blood clots.

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.

IS IT LIPEDEMA OR LYMPHEDEMA?

While they share common characteristics, lipedema and lymphedema are not the same conditions.

  • A patient with lymphedema has a blockage in the lymphatic system, which means fluid will not drain properly from the body. Lipedema is not initially as severe. It starts out as fat that is distributed in irregular ways under the skin that collects fluid within the fatty tissues. Not until lipedema is in the critical stages will it endanger and undermine the functionality of the lymphatic system.
  • Lipedema symptoms present within both sides of the body. This is not true for lymphedema. You can have one healthy leg and one enlarged leg where the lymphatics are not working properly.
  • Lymphedema does not discriminate at where it will show up, including the hands and feet. Lipedema will stop (or cuff) at the wrist or ankle, which is a hallmark characteristic of the condition.
    Lipedema Treatment in Beverly Hills, CA & Tucson, AZ

    HOW DO YOU DIAGNOSE IT?

    At Total Lipedema Care (TLC) Dr. Jaime Schwartz & Dr. Karen Herbst offer 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 and Dr. Karen Herbst tell the difference? The adipose cells that form have extra fluid, plus the fat, which causes the area to distort the skin and change its size, shape, color, texture, and sensitivity in 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).

    CAN LIPEDEMA BE TREATED?

    You can manage lipedema, but the treatments (no matter how aggressive) will not cure it. At Total Lipedema Care, we want you to feel your best and look healthy without the presence of 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 sYou can manage lipedema, but the treatments (no matter how aggressive) will not cure it. At Total Lipedema Care, we want you to feel your best and look healthy without the presence of 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 and Dr. Herbst will recommend treatment based on your needs and stage of lipedema.ystem. Dr. Schwartz and Dr. Herbst will recommend treatment based on your needs and stage of lipedema.

     

    Lipedema Treatment in Beverly Hills, CA & Tucson, AZ

    BEYOND YOUR 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 Dr. Herbst along with their teams in Beverly Hills and Arizona understand that lipedema treatment is not about fixing a cosmetic problem – it is about improving your quality of life with medical intervention. Call and schedule your first appointment today.

    GET DIAGNOSED

    Helping patients worldwide live pain-free!  Patients travel from all over the U.S. and abroad to receive care from Total Lipedema’s team of leading experts who are known for offering the most advanced and effective Lipedema treatments.