Lipedema is a life-changing disease that can greatly impact everyday life. Seeking out treatment is a big ordeal, and with each treatment option available there are certain risks that must be reviewed. Liposuction is typically a safe and effective procedure when performed by trained hands and additional precautions are followed. Current technology allows properly trained vascular, cosmetic plastic surgeons to remove the subcutaneous fat tissue safely and greatly reduce the impact lipedema has on your mobility as long as specialized surgical techniques are followed which limit injury to lymphatics. However, as with any surgical procedure, there is always a certain amount of risk involved. While most risks can be reduced, some are a one in a million chance. Recently, a woman in the United Kingdom experienced firsthand how difficult the most severe and rare risks can impact her life even further.

The Story

Jayney Nascimento, an English woman living in England, recently received liposuction treatment for lipedema. She had experienced the condition for 12 years and was self-conscious about how much bigger her legs were than the rest of her body. Like other individuals with lipedema, she sought out liposuction in the hope of being confident enough to wear a bathing suit again. The procedure went smoothly, and no complications were noted.

Jayney returned home immediately following her procedure to relax and recover from the procedure. After a few days, she began to experience coldness in her legs and excruciating pain. Since Jayney believed it was a side effect of the medication, she did not seek out her doctor until she was taken to the hospital by her daughter. Jayney ending up catching necrotizing fasciitis, a common bacterium that can cause serious but rare infections. This bug can spread in a few short hours and can be life threatening if not caught early enough. While Jayney is fortunate enough to not have to amputate her legs, she now has significant scarring all across her legs.

Why It’s Important

Making sure you have a highly trained physician should always be a top priority. Jayney’s condition may have been caused due to an unclean environment for her procedure, a significant injury to an important lymphatic structure or having a poorly trained physician complete the procedure. An individual with lipedema will have increased strain on their lymphatics and are at increased risk for lymphatic injury. Lipedema liposuction requires significant care to not injure lymphatics that only a highly trained individual should be trusted with. Make sure to ask your physician what their experience with lipedema liposuction is and what kind of side effects their patients have experienced in the past. Liposuction always has associated risks, but they can be reduced when you rely on the most trusted individuals in the field.

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The symptoms of lipedema can be extremely difficult to manage without the proper treatment plan. Lipedema is a condition that causes disproportionate fat buildup in the limbs, but it can also cause other adverse effects, such as fluid buildup in your limbs that is the result of the lymphatic system malfunctioning. When this occurs, your lymphatic system is unable to properly drain fluid back through the system. A variety of treatment options that are effective include compression garments and Complete Decongestive Therapy. Another option to help you manage your symptoms at home and on your own is with the help of a pneumatic compression pump therapy.

How It Works

Pneumatic compression pumps are a small unit that you can easily store at home for your personal use. These pumps are ideal for those looking to treat their lipedema without frequent office visits to their physician. These pumps work in a similar manner to the techniques utilized in manual lymphatic drainage massages. The pneumatic compression pump can be an intermittent pneumatic compression device, otherwise known as an IPC, and is worn on your affected limb. The device will help push back fluids to the center of your body. Enjoy the relief of these treatments at home when you are unable to make a trip to your physician’s office.

The Benefits of Pneumatic Compression Pumps

While treatment options like compression sleeves are great to have around and are an important part of managing your lipedema, they may not provide the full relief you are looking for. Instead, IPCs can help you achieve this relief in daily treatments that are as simple as putting the device on. Treatments for lipedema will require frequent doctor’s visits. Utilizing your IPC can help alleviate the concerns you have by receiving treatment at home. IPCs can also assist in utilizing Complete Decongestive Therapy. This type of therapy is ideal for individuals with extremely high levels of lymphedema

Why You Should Consider an IPC

If you are suffering from the symptoms of lipedema or lymphedema, you can attain the relief you need at home with a pneumatic compression pump. By regularly using your pump, you can minimize the adverse symptoms of lipedema and lymphedema. Receiving your very own IPC unit starts with a conversation with your doctor today!

Understanding the severity of lipedema starts by identify and understanding the symptoms of this lifelong condition. Many individuals without lipedema do not understand that the symptoms can greatly impact your day-to-day lifestyle. Here are the lipedema symptoms and how they can impact your way of life:

Lipedema Symptoms – Larger Lower Legs

One of the most prominent symptoms of lipedema is the disproportionate accumulation of fat, often in the legs, resulting in a column-like appearance. Unlike regular fat buildup that may be greater in certain parts of the leg, lipedema fat tends to build up all over the leg. This will cause your legs to have a trunk-like appearance. Individuals with lipedema can have a circumference that is much larger on their lower half of the body than on the upper half. Unfortunately, this fat buildup causes the skin to become more tender and bruise much easier. The appearance of more bruises can become very noticeable and impact your self-confidence. Finally, you may not be able to move your legs as easily as before, causing mobility issues.

Larger Arms

While lipedema fat buildup occurs more often in the legs, it can also impact your arms. Individuals with lipedema can develop a fat buildup in the arms making them feel heavier. This buildup will reduce your arm’s mobility, making it harder to move.

Lymphatic System Blockage

Lipedema not only impacts our outward appearance, but also the internal functions of our body. Lipidemic fat tissue can interfere and block our lymphatic system. This bodily system is crucial to balance fluids and help your body fight against infections. When our lymph fluid becomes blocked, lymphedema can occur and lead to future health issues such as infections, fibrosis, and hardened skin if left untreated. Fortunately, you can reduce these symptoms through lymphatic drainage massages.

Subcutaneous Fat Tissue

Lipedema is marked by the buildup of subcutaneous fat tissue. Unlike regular fat tissue, subcutaneous fat tissue cannot be reduced with standard diet and exercise. Instead, treatments like liposuction are better able to reduce the symptoms of lipedema. Dr. Wright is a leading liposuction provider for lipedema and can help you reduce its appearance today. By visiting one of our local offices, you can understand your treatment plan through a free consultation and see how your lipedema symptoms can be reduced. While lipedema is a lifelong condition, you can live more easily through a custom treatment plan.

What Is Dercum’s Disease?

Dercum’s disease, also known as Adiposis Dolorosa, is a rare condition that is characterized by multiple, painful fatty lipomas (benign, fatty tumors). It occurs in men and women but is more common in post-menopausal women. The lipomas are located primarily in the subcutaneous tissue. They can occur almost anywhere but often occur on the arms near elbow, legs near the knee and the trunk. Unlike ordinary lipomas, there is also pain that can be severe and sometimes debilitating. It is a chronic condition, meaning that it is a long-lasting condition that is often progressive.

Treatment for Dercum’s Disease

Currently there are very few treatments for Dercum’s Disease. The only effective treatments for painful lipomas at present are surgical options such open excision and liposuction. The current treatments, although they can be effective, have drawbacks which limit their use more broadly. Open surgical excision of painful lipomas is unusually incomplete, and it can lead to scarring which has a potential to create more lipomas. Open surgical excision is time consuming if multiple lipomas are removed and it leaves a visible scar. Liposuction can be expensive and is generally not covered by medical insurance. Although Liposuction can treat a larger area at one time, it also takes a good deal of time and does not completely remove all of the lipomas. 

FDA Approval of a New Drug to Treat Dercum’s Disease

A week ago, Raziel Therapeutics received approval of a new drug at this time designated RZL-012 to treat Dercum’s Disease as an orphan drug.

No matter how much research continues to support the proper diagnosis and identification of lipedema, there is still opposition in the medical community, including from insurance companies. Lipedema is a very real and present condition that affects millions of individuals throughout the world every year. If you have been diagnosed with lipedema or face the challenge of finding a proper diagnosis, you’re no doubt concerned with receiving effective treatment and even how to pay for that treatment. A recent court win by UnitedHealthcare seems to have made this task even more difficult.

Lack of Insurance Coverage

Lipedema is not a temporary issue but instead a lifelong condition that will impact your way of life. Treatments can end up being pricey if you do not have the proper medical coverage. Certain insurance companies continue to fight against coverage for certain treatments, stating they are not required or necessary. If you have lipedema, you know full well how necessary it is to reduce swelling and pain in your affected limbs. Some insurance companies may not even provide coverage at all by claiming it to be a pre-existing condition.

Recently, UnitedHealthcare Insurance Company was able to defeat a proposed class action lawsuit that claimed their coverage did not include proper lipedema treatment. This is a huge loss for the lipedema community. It is imperative that insurance companies utilize the available lipedema research and cover costs of the necessary treatments.

Difficulty with a Proper Diagnosis

Lipedema is a condition that many people, including some physicians, refuse to acknowledge. Physicians will claim that there is not enough research to support the identification of lipedema or that it is just obesity. Lipedema patients know this is not just obesity; the subcutaneous fat tissue associate with lipedema is nearly impossible to reduce with your standard diet and exercise. The medical community as a whole needs to understand this condition better, and Dr. Wright continually advocates for improved education regarding lipedema.

Trust the Professionals in the Field

Even with all the challenges presented by lipedema, there are those who you can trust. Dr. Wright continues to strive for better education, research, and coverage for the lipedema community. Do not let these challenges bring you down even further; let Dr. Wright and his expert team help you to reduce the symptoms of lipedema and live your life. Dr Wright can help find the right procedure to help manage your lipedema symptoms, such as lymphatic drainage massage. Don’t let lipedema take over your life; contact us today!

When dealing with lipedema, patients will not experience a quick, single-treatment recovery but instead a lifelong ordeal that can be difficult to maintain. How you handle your lipedema can make all the difference when it comes to everyday life activities. This management is best handled through a variety of treatment options that can help reduce the appearance of lipedema. These treatments also work to decrease various symptoms that can make movement difficult.

Initial Steps for Management

The first steps for managing your lipedema symptoms usually involve more conservative forms of treatment. This can include practicing breathing exercises, wearing compression garments throughout the day, and maintaining a healthy diet. Compression garments can be purchased at your local pharmacy and need to be worn 24 hours a day to remain effective. Compression garments help with lipedema management by encouraging movement within the lymph system. Your physician may also recommend a CDT or Congenital Decongestive Therapy session. CDTs are a great way to relieve swelling through non-surgical options. This process typically entails manual lymph drainage that helps drain your lymph nodes of built up fluids. A significant reduction in swelling can be noticed almost immediately; it can also break apart fibrosis that can be present in a limb impacted by lipedema. Rounding out this beginning step to lipedema management is having a regular skin care routine to keep your skin healthy.

Next Step for Lipedema Treatment

A more advanced form of managing lipedema comes in the form of liposuction. This fat reduction procedure is utilized by physicians, allowing them to provide long term benefits to those who continue to suffer from lipedema. Lymph sparing liposuction uses tumescent local anesthesia and removes subcutaneous fat tissue that cannot be reduced through diet and exercise alone. Multiple research studies have shown than liposuction for lipedema can provide long term benefits that last for up to 8 years. The effects of lymph sparing liposuction make it clear that it is the only effective treatment to truly remove subcutaneous fat tissue in lipedema.

Search for Your Help with Lipedema Today

Lipedema continues to be a lesser known condition within the United States medical community. However difficult it might be in managing your lipedema symptoms and onset, you are not alone. Reach out to one of Dr. Wright’s highly trusted treatment centers to see how our lipedema treatment options can make living with lipedema much easier!

lipedema surgery

While lipedema has been recognized for quite some time now, the idea behind lipedema liposuction is still considered to be a recent development. Treatment for lipedema using liposuction is the brainchild of German dermatologist and surgeon Dr. Gerhard Sattler. He began his studies at the Johann Wolfgang Goethe University located in Frankfurt, where he received his degree in human medicine. Dr. Sattler completed his doctoral studies in 1988 and became a long-term physician with Darmstadt Hospital. Dr. Sattler’s studies started a journey that would eventually lead him to create liposuction for lipedema techniques that are still used to this day.

The Development of Liposuction

Dr. Sattler continued headstrong into his career in human medicine and founded the Rosenpark Clinic with his wife in 1996. His career highlights include the development of liposuction for medical aesthetics in 1989 which led to life-changing advancement in lipedema treatment. Since then, Dr. Sattler has performed over 10,000 different liposuction procedures over more than 25 years. His knowledge and coaching on how to effectively utilize liposuction continue to be invaluable to surgeons around the world to this day.

Two Methods for Lipedema Surgery

The work Dr. Sattler started in 1989 has led to the development of two major forms of lipedema surgery. The first, tumescent liposuction, involves injecting local anesthetics into subcutaneous fat tissue, causing it to swell. The targeted areas become so large that it becomes firm and easier to remove. The second treatment option is water jet assisted liposuction. This alternative form of liposuction uses pressured jets of water to dislodge the subcutaneous fat tissue, allowing it to loosen up and be removed through a cannula. A tumescent fluid is injected prior to the dislodging the fat tissue. This liquid is removed in the final steps, leaving your body with less subcutaneous fat tissue than before. Water jet assisted liposuction is gentler and leaves your body with less bruising than other methods.

Find Help with Your Lipedema

Dr. Sattler’s work has continued to inspire today’s surgeons, including Dr. Wright, to further enhance and make lipedema liposuction available to those in need. Most surgeons have used Dr. Sattler’s work to further train and evaluate their practice on treating lipedema. Contact our team today to see which lipedema treatments are available and right for you. The path to living with lipedema begins with reaching out to our trained team for help. Read about Waer Assisted Liposuction today!

While a variety of treatment options currently exist to help alleviate and reduce the symptoms of lipedema, it is often lymph sparing liposuction that provides the biggest change. Lymph sparing liposuction is often recommended for individuals diagnosed with lipedema who have not experienced significant results with initial treatment options. Lipedema left untreated, can cause significant damage to the body. When this is the case, we recommend lymph sparing liposuction.

What is Lymph Sparing Liposuction?

Lymph sparing liposuction is a minimally invasive treatment that uses high pressured water to loosen up lipedema fat tissue. Suction removes the fat tissue and does so in a way that makes sure no damage is made to any lymphatics or nerves. More severe cases of lipedema may require multiple sessions to achieve the desired level of symptom reduction.

Treatable Symptoms with Lymph Sparing Liposuction

Lymph sparing liposuction can treat a variety of symptoms that are commonly associated with lipedema.

Fat Buildup – Perhaps the most noticeable symptom of lipedema that lymph sparing liposuction can treat is the amount of lipedema fat content. Lipedema is associated with subcutaneous fat tissue that cannot be treated through diet and exercise alone. Lymph sparing liposuction is a fat reduction procedure that will reduce the appearance of this fat buildup. The goal for most individuals with lipedema is to appear as close as possible their appearance before the onset of lipedema.

Mobility – The more severe cases of lipedema are commonly associated with limited mobility, making it difficult for the patient to get around. The subcutaneous fat tissue restricts mobility in the legs and greatly impacts quality of life. By removing a significant amount of fat tissue in the legs, it will be easier for those with lipedema to get around.

Restricted Blood Flow – Not only will subcutaneous fat tissue make it difficult to move but also restrict the blood flow in our veins/arteries. Blood flow in your veins will be encouraged by reducing the amount of fat tissue around them.

Getting Your Lipedema Treatment

If you believe you are experiencing lipedema symptoms, make sure to seek the treatment you deserve. Dr. Wright leads a team of qualified individuals in St. Louis that can help you receive the highest quality lipedema treatment, including lymph sparing liposuction. The treatment you need starts with a simple phone call today!

There has been some movement from a major health insurance provider, Aetna.    Policy number 0031, which addresses Aetna’s policy on cosmetic surgery was updated on March 29, 2019.  This updated policy does include a subheading for “Liposuction for Lipedema”. The policy summarizes the literature Aetna reviewed when updating the policy.  This literature included the standard of care clinical guidelines from Dutch and German lipedema experts. The policy also reviews studies showing the benefit of liposuction for Lipedema.

It is not entirely clear from the update what this means because in the same policy: Aetna’s CPB-003, they have listed the CPT Codes for liposuction surgery, CPT 15878-15879, suction-assisted lipectomy; upper and lower extremity, as “CPT Codes not covered for indications listed in the CBP” (pages 18 and 19 of the policy). This contradiction at a minimum makes it difficult to know for sure.

This means that although Aetna has recognized some of the research on lipedema and reviewed the clinical guidelines and recommendations, they still may not cover the liposuction procedure codes.  The policy does address CPT 15877 suction-assisted lipectomy; trunk as a covered code when certain selection criteria are met. However, the medical criteria the policy, states are for liposuction when performed with a panniculectomy and also liposuction when performed with breast reconstruction after a mastectomy and not lipedema.

Aetna has covered lymph sparing liposuction for patients with lipedema before and this policy update makes it more likely that they will cover it in the future but there always be restrictions. We work with medical insurance companies every day to get them to cover lymph sparing liposuction for our lipedema patients. All the patients who have received insurance coverage so far have demonstrated to the medical insurance company they have completed conservative non-surgical treatment of lipedema without adequate relief of their lipedema symptoms. Conservative measures that should be done prior to approval by insurance companies include: wearing compression garments, dietary interventions such adherence to a low carbohydrate diet [either ketogenic diet or the more balanced anti-inflammatory diet] and lymphedema therapy. These conservative treatments are not just a requirement for the insurers and all of the standards of care guidelines they are an important part of managing lipedema for the rest of the patient’s life. Building a persuasive case for insurance company coverage for surgery involves a multiple visit documenting the stepwise adherence to at least a couple levels of conservative management of the symptoms of lipedema. Often the insurer will also need additional information from their insured patients on how the lipedema disease is impacting their life and mobility.

There is some good news for patients with lipedema: Aetna major health insurance provider reviewed the information on the effectiveness of a specialized type of liposuction for lipedema when certain medical necessity criteria are met. The next review date for this policy is January 9, 2020. We are hopeful that we will have published US studies ready for review when Aetna reviews this policy again and have more good news to report.

We have included the link below to the full Aetna CPB-0031 for your review.

Currently, most of the supplies needed to manage lipedema and lymphedema are not covered by Medicare. Compression garments, donning devices and wraps, which are critical for the proper care and management of these diseases are not covered except when caused by cancer treatment. These garments are quite expensive and need to be replaced as often as every six months. The lymphedema can be just devastating when caused by an inherited condition as is the case of lipedema or an infection. If lymphedema is not properly controlled by compression garments it progress and spiral into a progressively disabling condition.

The Lymphedema Treatment act will improve coverage for lymphedema from any cause from Medicare. Other insurance will follow Medicare lead. This legislation is critical for improving the health and lives of patients who suffer from lymphedema. There is much to do. Please follow these links to learn how you can contact your representative in the US Congress and Senate. Also, learn how to promote awareness for this important cause through social media.