Blog: Understanding Lipedema: 25 Key Facts You Should Know

Weight gain is a sensitive topic. Everywhere you look, there are advertisements, articles, and more shaming people for being overweight. Social media and advertising at large, give the impression that losing weight is easy. The social stigmatization and bullying put the blame and the onus of weight loss on a person’s behaviors and choices. Hence, it creates the belief that weight gain is the result of laziness, poor decisions, and more.

But weight control is not that simple. Many people struggle to lose weight, not because of poor nutritional choices, but because they may have pre-existing conditions that affect the way they look. Lipedema is a disorder which physicians often misdiagnose. Why is this the case? Well, lipedema is not considered “normal” fat. It is mistaken for the symptom of obesity or a different disease.

What is lipedema? Dr. Siamak Agha describes lipedema as a chronic medical condition. He says, “In the women, I treat the distinguishing characteristic is the excess fat or connective tissue in their arms or legs.” The reason this is not run-of-the-mill fat is due to symmetrical build up in your body. In other words, massive growth and weight gain show up in either your arms or legs and, in some cases, both. It is the symmetrical weight gain that leads to misdiagnosis or non-treatment. Many doctors and plastic surgeons incorrectly assume that the patient is overeating and suffering from obesity.

Lipedema disease - Image shows occurences in different parts of the body — Lipedema disease concept. Accumulating fat in the lover part of the female body. Buttocks, hips and calves problems. Cellulite, overweight and swollen. Adipose tissue disorder flat vector illustration

Women almost exclusively suffer from lipedema. There are rare reported cases of men with lipedema. The medical community and science, in general, have not yet determined why this illness presents entirely in the female population. Women tell Dr. Agha they experience pain, easy bruising, and swelling. In some cases, this abnormal fat has a strange and unusual texture. Lipedema sometimes feels like you have walnuts or small peas under your skin.

The most common symptoms of lipedema are fatigue, pain in your muscles, and easy bruising. For some, the pain is constant and severe. Some women express that direct pressure placed on the fat causes acute pain. Have you experienced any of these physical complaints? If you answered yes to any of these symptoms, do not let apprehensiveness stop you from scheduling a consultation with Dr. Siamak Agha.

How does Dr. Agha diagnose and treat lipedema?

One important thing to remember is Dr. Agha is an expert in the field of obesity and reconstructive plastic surgery post-weight loss. His expertise set him apart in his ability to assess your symptoms and make a proper diagnosis accurately the first time. You will begin with a physical exam in our Newport Beach aesthetic center. You will provide Dr. Agha with a detailed medical history. Many plastic surgeons in Orange County are uncomfortable or hesitant to make this diagnosis because of the lack of research-backed information. Further, the lack of specific diagnostic testing makes this more difficult.

Dr. Agha’s trained eye allows him to distinguish the visual difference between lipedema and lymphedema. Lymphedema is swelling affecting only one (1) side of your body and includes hands and feet. Dr. Agha diagnoses lymphedema through imaging and genetic tests. The leading cause is generally the result of lymph node removal or prior cancer treatment. An experienced plastic surgeon must understand the difference between these two (2) ailments. In Newport Beach, you will only find that level of medical knowledge in Dr. Siamak Agha.

Treating lipedema includes more than the surgical removal of fat. Dr. Agha advises patients that liposuction is not the only answer to correct this condition. At the Aesthetic Centers, in addition to body contouring plastic surgery, we also provide patients with broad and long term care related to their weight loss and maintenance goals.

Lipedema is not rare, but we have many frequently asked questions about the disease and treatment. We encourage you to use these as a resource to help you schedule your consultation.

A: It is a common illness affecting up to 10% of the female population.

A: If you have lipedema, then your legs or arms will be enlarged to the point that the weight gain is disproportionate to the rest of your body.

A: The problem with lipedema is that no amount of diet and exercise will cure the illness. If you have weight gain because of lipedema, you will be unsuccessful by trying to fix it yourself with exercising and portion control.

A: Yes. Lipedema is a progressive disease, and the worse it becomes, the more painful and debilitating it will be.

In spite of the prevalence of lipedema, generally speaking, physicians and plastic surgeons are unaware of the condition.

A: While the cause of lipedema is not entirely clear, most experts in the diagnostic field believe it has something to do with hormonal changes. Specifically, at the onset of puberty, during pregnancy, or menopause.

A: You will have swelling and excess fat deposits in your legs. Over 30% of patients also develop the disease in their arms. It is important to note that if you have lipedema, you will not experience swelling in your hands, ankles, or feet. You will bruise easily, experience pain and tenderness in your arms and legs, and usually, over time, the symptoms worsen.

A: The first thing you must do is schedule an appointment with Dr. Siamak Agha. This fat will have an unusual or weird feeling to it, as though it should not be there. It is this symptom that indicates its lipedema and not some other underlying medical issue. Often, misdiagnosis occurs when side effects mimic those of other diseases.

A: Yes, obese patients may develop lipedema or lymphodema. Obesity complicates the diagnosis further. You must schedule an appointment right away with a board-certified plastic surgeon like Dr. Siamak Agha.

A: No. At the moment, there is no way to prevent lipedema. There is no known cause or trigger. Genetics and hormones likely play a role, but their exact role is still unclear.

A: There are two (2) approaches for treating lipedema. For some patients, there are non-surgical methods of preventing the progression and managing the symptoms. For other patients, their only option to stop the disease is through surgery.

A: Compression garments may aid in the reduction of swelling as well as prevent the disease from progressing. There is a slight chance that manual lymphatic drainage and massage might decrease the connective tissue build-up. Diet and exercise are not a non-surgical option.

A: While there are zero non-surgical ways to cure lipedema, Dr. Agha employs a surgical method to eliminate the illness. It is a hybrid medical and plastic surgery approach. Dr. Agha performs liposuction to get rid of all the extra fat in your legs or arms.

A: There are many different methods of liposuction for fat removal. Each patient is different. Therefore, Dr. Agha employs a personalized surgical plan to remove your lipedema. For this ailment, the method which shows the most success is the use of tumescent liposuction.

A: With tumescent lipo, Dr. Agha uses a gentle, vacuum-like cannula to remove and reshape the affected areas. The cannula is smaller, and it allows for more precision, control, and as a result, you will see a smoother result.

A: Dr. Agha’s goal is to remove the excess fat. He does this by injecting the connective tissue with a local anesthetic, usually epinephrine. It causes the capillaries to shrink. Once your capillaries have shrunk, it causes the fatty tissue to harden and swell, making it easier to remove. A benefit to patients is less bleeding, reduced medication, and a faster recovery.

A: Currently, insurance providers do not cover liposuction as a treatment for lipedema. In particular, tumescent lipo to correct lipedema is a relatively newer form of treatment. In the past, fat removal by lipo is considered cosmetic and not medical. As the medical community advances, we hope that insurance will cover it. Tumescent liposuction has a high success rate in the treatment of lipedema.

A: Currently, liposuction is the gold-standard for lipedema treatment in Newport Beach. If you are looking to improve other areas of your body, we encourage you to discuss a wide array of body contouring procedures Dr. Agha performs. He will discuss with you alternative ways to get rid of excess skin and re-shape your arms and legs.

A: It is very typical to be scared of surgery. At the Aesthetic Centers, we put patient safety first. Dr. Agha considers liposuction a lower-risk surgical approach.

A: Dr. Agha takes the time and attention to detail to get rid of the fat cells without causing damage to your lymph nodes. When lymph nodes are damaged during liposuction, they often lead to other medical conditions that cause weight gain and discomfort. Dr. Agha is acutely aware of this and avoids this risk at all costs.

A: Yes! While diet and exercise will not correct lipedema, the ability to maintain your weight and health is significant to your overall health. In fact, after your surgery, diet and exercise will play a more critical role in your long term results.

Q: Are there any cosmetic benefits?

A: Dr. Agha’s primary concern is to correct your lipedema while sparing your lymphatic system. You may see changes to your legs and arms, but this is not a guaranteed result for the treatment of lipedema.

A: In short, the answer is no. While there is no cure for lipedema in the sense that it is not definitively cured with any medical approach. The process of fat removal is permanent. Further, if you continue to eat healthy, exercise and maintain proper care, you decrease the risk of reoccurring symptoms

A: This is a possibility but not a common occurrence. In these instances, the continued use of compression garments and other long term care will be discussed during your appointment with Dr. Agha.

A: Every person experiences pain differently. Typically, you will be able to get back to your daily routine and activities around the two (2) week mark. At four (4) weeks, most patients can resume all their normal activities.

What should I do next?

It’s as easy as picking up the phone or sending an email through our website. Dr. Agha and his team are happy to speak with you if you suffer from lipedema and are interested in discussing your personalized treatment options. You may contact one of our Patient Coordinators at the Aesthetic Centers by calling us at (949) 644-2442. We are here to help you regain your life, reduce the pain, and get you moving again. Make sure and ask about our virtual consultations with Dr. Agha.