Each year, I see a number of patients with disproportionately enlarged lower extremities. These patients commonly say the tendency to accumulate fat on the legs and hips “runs in the family.” This condition often involves the lower portion of the body such as the outer and inner thighs, knees, and lower areas. Occasionally it can involve the upper extremities and the buttocks. Typically, the trunk is thin and athletic. Often, these patients are people who live healthy lifestyles include proper nutrition and regular exercise. These patients likely suffer from a condition called lipedema.
My approach to treating lipedema at my Toronto clinic is with a special-type of liposuction called “lymph-sparing” liposuction; a larger than typical amount of tumescence solution is used to create more spaces for the aspiration cannula and to minimize injuries to lymphatics and veins. Tumescence solution also contains adrenaline which minimizes blood loss and bruising. Typically, a series of 1 to 3 liposuction procedures are required. I say “series” for 2 main reasons. The first one is safety. We can safely remove up to 5 litres of fat in one surgical session. The risk of complications increases beyond this volume.
It is not rare, over time, to remove 5 to 15 litres of fat in a single patient suffering from lipedema over several surgical procedures.
Recovery is similar to any large-volume liposuction. I recommend a compression garment for 3 to 4 weeks after surgery. I also recommend taking iron supplements for 3 to 6 weeks before surgery and then 4 weeks after—300 milligrams 3 times daily, if possible. Cost will also vary with the type of procedure required.
There are some recommendations I make to all body contouring patients: maintaining a healthy diet and good exercise protocol are paradigms of positive long-term results.
Dr. Marc DuPéré