How is Lipedema Treated?

Although there is currently no cure for lipedema, there IS treatment designed to improve the patient’s quality of life.  When treated early, there can be some cosmetic benefits, but even surgical treatments are primarily therapeutic by reducing pain, increasing mobility and restoring quality of life. 

Non-Surgical (Temporary)

Unfortunately, there is no one particular non-surgical treatment that consistently and effectively treats lipedema, especially in the long-term.  Methods are designed to prevent the fat cells from getting bigger, but this is nearly impossible to achieve due to the condition’s physiology.  Many women with lipedema testify of trying many different techniques within each category over the years with only varying success.

Most efforts focus on reducing inflammation, improving lymphatic flow, improving physical health, improving emotional health and managing pain. Often, many of these are done together to try and maximize the benefit as illustrated in this diagram from Fat Disorders Resource Society.   

  • Compression Garments & Wraps
  • Dietary Supplements & Medications
  • Diet changes
    • Anti-inflammatory/RAD/Paleo
  • Exercise
    • Swimming, Walking, Lymphatic Yoga, Cycling, Pilates

Surgical (Permanent)

Ultimately, the most successful and persistent treatment for lipedema involves getting rid of the diseased fat cells themselves, which requires some type of surgical procedure.

Radical Surgery 

  • Brachioplasty and Thighplasty – These procedures require general anesthesia and often a stay at the hospital. A long incision is made on the inside of the arm (or leg) and the diseased fat and connective tissue are undermined and then surgically cut out leaving the underlying muscles intact.  This radical approach significantly reduces the size of the limb but patients frequently have numbness for long periods of time and the underlying lymphatic drainage system is irreversibly injured resulting in long-term swelling of the limb (edema).

Minimally-Invasive Surgery 

  • Liposuction – Liposuction, in various forms, has been in existence for over 40 years for cosmetic purposes. It has been well-studied and refined to yield superior results with minimal complications.  Through small, strategically-placed holes in the skin, liquid numbing medication is pumped into the fatty tissue (Step 2) through a thin, hollow tube (called a cannula).  After the numbing medication takes effect, the fat cells are loosened and sucked out with the liquid (Steps 3 and 4).  The patient is placed in compression garments (think tight yoga pants) for weeks after the procedure to help the skin contract and shrink to its new size (Step 5).  Different types of liposuction exist based on how they loosen the fat cells from the tissue.  More recent devices are less traumatic and only remove fat cells while preserving valuable nerves, connective tissue and blood vessels.
    • Primary types of liposuction
      • Original – uses a cannula with a sharp end to scrape out tissue under the skin
      • Ultrasound-assisted – uses ultrasound device at the tip of the cannula causing high frequency vibrations to break up and liquefy tissue under the skin
      • Laser-assisted – uses a laser on the tip of the cannula to destroy and liquefy tissue under the skin
    • Newer types of liposuction
      • Vibrasat or HD Lipo – Power-Assisted Liposuction (PAL) – Uses slower vibrations to shake fat cells loose, leaving nearby tissue, nerves and blood vessels intact
      • Water-Assisted Liposuction (WAL) – Uses high-pressure saline to “power wash” the fat cells away from other tissue under the skin.

The medical field has taken these liposuction tools developed for cosmetic procedures and utilized them for patients with lipedema.  However, we know that lipedema patients are unique and simply using “the same tool for a different problem” may not yield wanted or expected results.  The European doctors have found this to be true.   Many of their doctors have a background in vascular medicine rather than cosmetic medicine.  Utilizing that background, combined with careful observation and treatment of lipedema patients for over 20 years, they have modified their liposuction procedures and treatment plans to achieve even better results.  This has been termed lymphatic-sparing liposuction.  Their results are so superior than other procedures that patients (who are able) travel from around the world to be treated with this technique because it was virtually impossible to find in the United States.