Lipedema is a condition characterized by the uneven or disproportionate accumulation of excessive fat most commonly on the lower extremities, although some patients may also have this issue with the upper extremities.
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Lipedema is a condition characterized by the uneven or disproportionate accumulation of excessive fat most commonly on the lower extremities, although some patients may also have this issue with the upper extremities. It can be uncomfortable and frustrating for people who otherwise lead healthy lifestyles, but who are quite heavy in their lower bodies. This condition—medically called lipedema—has been the subject of much interest, with several medical professionals referring to it as a disease. To alleviate the physical and emotional burden of lipedema, Dr. DuPéré uses a special liposuction technique at his Toronto clinic in Yorkville.
Thought to be largely hereditary, lipedema is a condition that results in lower extremities (occasionally involving the upper extremities too) that appear disproportionately bulky and fatty as compared to the rest of the body. Lipedema patients are almost always women.
Fat deposits associated with lipedema typically remain limited to the legs and buttocks, although fat may also accumulate in the upper extremities in more advanced stages. Venous issues can appear in later stages of lipedema such as venous insufficiencies, varicose vein development and venous stasis dermatitis (dark blue/brown discoloration around ankles). Although lipedema can be physically painful and cause emotional and physical discomfort and limitations, the condition is usually not dangerous or harmful unless it reaches the end of the spectrum with marked lymphedema (tissue swelling) and venous insufficiency and congestion and possible deep vein thrombosis (clotting). Finding appropriate clothing is a significant issue due to the disproportion upper versus lower body. Unfortunately, the fat associated with lipedema is typically unresponsive to dieting and exercise.
The fat accumulated as the result of lipedema can be effectively reduced with a modified liposuction technique: lymphatic-sparing liposuction with large tumescence volumes. There are many key differences between traditional liposuction and lipedema treatment.
Lipedema treatment typically occurs in stages—as many as 3 separate procedures. This is largely a matter of safety and skin elasticity. As Dr. DuPéré wrote in a blog post on the topic, it’s not uncommon to remove, over time, a large volume of fat—up to 15 litres—when treating lipedema with liposuction.
It is safer to break large volume fat reduction into separate procedures because it reduces the risk of complications during and after surgery. It is a rule to keep it under 5L lipo-aspirate per session in Canada and USA when performed in an out-of-hospital facility. It also allows Dr. DuPéré to create more refined, sculpted results and will allow the skin to contract to some extent between sessions.
Lipedema treatment also often involves flipping the patients on their abdomen and back so the plastic surgeon can reach all areas circumferentially.
Finally, treating the lower legs from knees to ankles requires meticulous work and smaller cannulas, therefore a longer surgical time, as to avoid cannula tracks in this delicate region.
Lipedema patients who undergo liposuction in Toronto with Dr. DuPéré experience a recovery similar to that of most other liposuction procedures. Dr. DuPéré fits each patient with a compression garment to support their treated areas after surgery. It is important to wear the garment for 3 to 4 weeks following surgery, as it also helps to minimize swelling. It is also one of the many precautions against deep vein thrombosis, along with early ambulation (walking around).
Dr. DuPéré looks forward to helping you sculpt your body to reflect your healthy and active lifestyle. Please request your consultation online or call us at (416) 929-9800 to arrange your visit.
Most patients manage their symptoms after surgery with prescribed pain medicine, although most people only use these for a few days.
Patients are ready to return to work and other relatively sedentary daily activities after about 1 week.
It is important to wait longer—often upwards of 6 weeks—before participating in vigorous activities that require lots of muscle movement or have the potential to raise your heart rate.
Lipedema is known to have a hormonal component, as it typically manifests or worsens during periods of significant hormonal changes, such as puberty, pregnancy, or menopause. This hormonal influence can make the condition more challenging to treat, as it may continue to progress despite intervention. Understanding this, Dr. DuPéré takes a comprehensive approach for improving long-term outcomes.
Yes, one of the significant benefits of lipedema surgery is the potential improvement in mobility and physical activity levels. The disproportionate accumulation of fat in the lower body can lead to significant discomfort and restrict movement, making exercise and daily activities challenging. After undergoing lymphatic-sparing liposuction, many patients report enhanced mobility, reduced pain, and greater ease in performing physical activities. This improvement can contribute to better overall health and well-being, allowing patients to engage more fully in an active lifestyle.
Lymphatic-sparing liposuction is specifically designed to minimize damage to the lymphatic system, which is crucial in treating lipedema. The lymphatic system plays a vital role in fluid balance and immune function, and its impairment can lead to complications like lymphedema. Dr. DuPéré uses specialized techniques and smaller cannulas to carefully remove fat while preserving the delicate lymphatic vessels. This meticulous approach helps prevent lymphedema and supports a smoother recovery process, reducing the risk of long-term complications.
In advanced stages of lipedema, patients may develop venous issues such as varicose veins, venous insufficiency, or stasis dermatitis. These conditions can complicate treatment and recovery. Dr. DuPéré carefully evaluates each patient’s venous health as part of the pre-operative assessment. In some cases, managing venous issues may require additional treatments or adjustments to the surgical plan. Post-operative care may also include measures to improve venous circulation, such as the use of compression garments and promoting early ambulation to prevent deep vein thrombosis.
The long-term results of lipedema treatment with lymphatic-sparing liposuction can be highly effective, leading to significant and sustained reductions in pain, improved mobility, and a more proportionate appearance. However, maintaining these results requires ongoing management. Dr. DuPéré emphasizes the importance of a continued commitment to compression therapy, regular physical activity, and a healthy diet to prevent the recurrence of symptoms. Additionally, periodic follow-up visits are recommended to monitor for any signs of progression or complications, ensuring that any issues are addressed promptly.
Compression garments play an important role in both pre-operative and post-operative management of lipedema. Due to the unique distribution of fat in lipedema, selecting the right compression garments can be challenging. Patients should look for garments specifically designed for lipedema, which offer consistent pressure across the entire limb without constricting or causing additional discomfort. Dr. DuPéré advises patients on the best types of compression garments for their specific needs and may recommend custom-fitted options to ensure optimal support and comfort during the recovery phase and beyond.
Staging the treatment of lipedema is a critical aspect of ensuring patient safety and achieving the best possible results. Lipedema treatment often requires multiple surgical sessions due to the large volumes of fat that need to be removed and the limitations on how much can be safely aspirated in one procedure. By breaking the treatment into stages, Dr. DuPéré can carefully monitor the skin’s elasticity, minimize the risk of complications, and allow the body to adapt gradually. This approach also enables more precise sculpting, resulting in more refined and natural-looking outcomes.
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