Larson Aesthetics:
Lipedema
Surgery
Welcome to Larson Aesthetics, where we specialize in Lipedema surgery to provide relief and improve physical function for those suffering from this uncomfortable condition. Lipedema, a lymphatic disorder that results in an excess deposit and expansion of fat cells, is a chronic disease characterized by often painful swelling in the legs, thighs, buttocks, and arms. Board-certified plastic surgeon Dr. Larson not only specializes in lipedema surgery but is also renowned for being one of the top Lipedema surgeons in the US.
What is Lipedema?
Lipedema is a complex medical condition most often characterized by a large buildup of fat deposited in the lower body, though it can also accumulate in the arms, abdomen, and other areas. This common, yet underdiagnosed disorder can be painful, result in swelling and excessive bruising, and make everyday activities difficult. Lipedema occurs almost exclusively in women. While not proven, it is thought that the pain accompanying lipedema is related to inflammation and reduced oxygen in the tissue. While there is no known cure for lipedema, there are treatments available to lessen the symptoms and prevent further complications.
What causes Lipedema?
The exact cause of lipedema has not been determined, but there appears to be a genetic component, as many cases of lipedema run in families. It is also possible that lipedema is related to hormonal changes, as symptoms often show up or worsen during puberty, pregnancy, menopause, or while taking birth control pills.
What are the Signs or Symptoms of Lipedema?
- Symmetrical enlargement of legs and arms, but usually not in the feet or hands
- Pain or tenderness in the affected areas
- Tendency to bruise easily or for no reason
- Heavy feeling in the legs
- Dimpled legs or arms
- Fat deposits that feel bumpy with small nodules within the fat
- Fatigue
- An imbalance of weight distribution, mostly in the buttocks or legs
- Large, column-like legs
- Loose skin
- No weight loss in affected areas despite diet and exercise
- Fat bulges around the knees or hips
- Varicose veins
What are the Different Stages of Lipedema?
Lipedema is commonly categorized into stages, depending on severity. As lipedema progresses through these stages, the accompanying characteristics such as pain, swelling, and fat accumulation tend to increase. It is important to note that Dr. Larson does not diagnose lipedema. Formal diagnosis comes from an appropriate specialist such as an endocrinologist, obesity specialist, or vascular surgeon.
In this stage, the skin on the affected areas may appear smooth, with an increase of of fat accumulation around the pelvis, buttocks, and hips. Swelling may increase throughout the day but typically resolves with rest and elevation. Symptoms range from mild to severe at this stage.
During this phase of Lipedema, the skin develops indentations, and the tissue feels tougher and more nodular than in Stage 1. Fatty lumps, known as lipomas, may be present, and fat buildup becomes more noticeable on the upper and lower legs. Swelling is more significant at this stage and is less responsive to rest and elevation when compared to Stage 1. Symptoms range from mild to severe at this stage.
During this advanced stage, there is further hardening of connective tissues and persistent swelling that does not resolve with rest and elevation. Excessive amounts of fat cause thigh and knee deformation, impacting mobility and overall quality of life. This stage of Lipedema has the highest rate of orthopedic complications. Symptoms range from mild to severe at this stage.
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Dr. Larson’s Approach to
Lipedema Treatment
Dr. Larson is a board-certified plastic surgeon with extensive experience treating lipedema. He offers a safe and highly effective approach that combines advanced liposuction techniques with skin removal to achieve optimal, long-lasting results.
Dr. Larson will craft an individualized treatment plan tailored to your stage of lipedema. Using a multi-modal approach involving liposuction and skin excision, Dr. Larson is able to accomplish in fewer surgeries what takes other surgeons multiple surgeries. Most treatment plans can be completed in as little as 12-18 months.
For earlier stage cases, generally 1-2 operations are required. These can be performed either in our in-office procedure room or in a surgery center. Dr. Larson also offers awake liposuction for patients that prefer to avoid anesthesia. For early-stage patients with minimal/mild skin laxity, we offer energy-based skin tightening which can help reduce the requirement for skin excisions.
For more advanced-stage patients, a series of 3-4 operations is generally required. This is because as the disease progresses, higher stage patients have more lipedema fat and more skin that needs to be removed. As a board-certified plastic surgeon, Dr. Larson operates under strict safety protocols that are standardized to optimize patient outcomes and reduce complications. Larger operations, including cases where more than 5 Liters of liposuction is performed, are usually performed in a hospital setting. A typical in-hospital liposuction case would involve up to 10 Liters of liposuction in a single operation. Because these operations are performed in a hospital setting, Dr. Larson is also able to perform larger, more involved operations that combine high volume liposuction with skin excisions. After your operation you will be monitored in the hospital overnight and discharged the next day by Dr. Larson. This allows our patients to efficiently and safely progress through their lipedema treatment in a way that maximizes results and safety.
Dr. Larson typically stages operations 3 months apart to allow adequate healing, and alternates between operating on the lower body and upper body until the treatment plan is complete.
Below is an example treatment plan for a stage 2/3 lipedema patient with affected legs and arms.
Stage I: Liposuction Lower Body
Stage II: Liposuction Arms with Arm Lift
Stage III: Additional Liposuction Lower Body with Leg Lift
Here are some of the key benefits of Dr. Larson’s approach:
- Safe and Effective: Procedures are performed in a hospital, certified outpatient surgery center, or in-office procedure room for optimal safety and comfort.
- Efficient Treatment Plans: Even with higher stage patients, Dr. Larson can often complete treatment plans in less than 12-18 months, minimizing disruption to your life.
- Long-lasting Results: Lipedema affects both fat and skin, so both often need to be addressed. Non-surgeons and others who only offer liposuction fail to address the skin, leading to suboptimal results and early recurrence. Dr. Larson provides effective and long-lasting results by treating both excess fat as well as excess skin.
- Focus on Patient Care: Our team is dedicated to providing personalized care and support throughout your entire treatment journey.
Why choose Dr. Larson?
It is important to choose a surgeon that has specialized training and experience in lipedema surgery. There are many non-surgeons trying to treat lipedema that lack experience in advanced liposuction and skin excisions. This causes more surgeries than necessary, with suboptimal results. Many of the patients we see have been through this, and their lipedema has come back. Additionally, non-surgeons do not have hospital operating room privileges, and in the event of an emergency do not have the ability to take you to the operating room for emergency surgery.
Choosing Dr. Larson is choosing a board-certified plastic surgeon with extensive experience and training in treating lipedema. Unlike many surgeons treating lipedema, Dr. Larson takes a comprehensive approach to treat both the diseased lipedema fat, as well as the excess skin that often needs to be removed. Dr. Larson performs complex, large-volume surgeries where he liposuctions large areas, and excises excess skin. The result is condensing these usually longer treatment plans into 3 or 4 operations.
By choosing Dr. Larson, you can be confident that you’re receiving the most advanced, effective, and compassionate care available for lipedema treatment.
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Financing your Lipedema Surgery
Larson Aesthetics knows that navigating insurance can be difficult, which is why our team includes insurance experts with over 40 years in the insurance industry. Our goal is that every patient that needs treatment is able to get covered under their health insurance plan. Lipedema is a disease and should be treated as such. We work with your insurance company to obtain an authorization, an out of network exception, and create a single case agreement. With a single case agreement, your full treatment plan is negotiated with your insurance company before your operations take place. This process avoids you paying any up-front surgical costs. Although we are an out-of-network provider, we negotiate with your insurance company to be considered in-network, saving you from paying high out-of-network expenses. Our aim is to make your lipedema treatment as smooth and patient friendly as possible.
Out-of-Town Patients
Many of our wonderful patients are out-of-town patients coming from across the nation. As such, our staff is well versed in providing assistance with travel accommodations and connecting you with aftercare services to ensure continuity of care. We also offer telemedicine visits for consultations and follow-up appointments. Let us know how we can support you throughout your lipedema treatment journey.
Frequently Asked Questions
A: Obtaining insurance authorization, an out of network exception, and negotiating the single case agreement usually takes several months to complete. Once completed, we are able to schedule your first operation. Generally, Dr. Larson will wait 3 months between stages to allow time to heal. Therefore, 2 stage treatment plans can be completed within 6-8 months, whereas 4 stage treatment plans can take 12 months or more. We will customize a treatment plan for you, but most patients are able to complete their full treatment 24 months from their first visit.
A: All cases are individual, but most patients require 1 to 4 operations. For early-stage cases, typically 1-2 surgeries are needed. For more advanced cases, generally 3-4 surgeries are needed. Dr. Larson will work with you to determine your treatment plan and the number of operations you will need.
A: Prior to your lipedema surgery with Dr. Larson, you’ll embark on a collaborative journey to optimize your health and prepare for a successful outcome. During your initial consultation, Dr. Larson will meticulously assess your condition and craft a personalized treatment plan. This may involve pre-operative tests like blood work and imaging to ensure you’re a good candidate for surgery. Dr. Larson will review your medical clearance and answer any questions you may have. Our team will provide specific instructions on medications, compression garments, and dietary adjustments to optimize your health before surgery. We understand surgery can cause you to feel anxious, so don’t hesitate to reach out with any questions or concerns. By working together, we can ensure you feel prepared and confident on your path to lipedema relief.
A: Larger lipedema operations with Dr. Larson are performed in an accredited surgery center or hospital setting to prioritize your safety and comfort. General anesthesia will typically be used to keep you pain-free throughout the procedure. Dr. Larson utilizes advanced liposuction techniques to gently remove excess fat while meticulously preserving healthy structures. Depending on the extent of lipedema, skin removal may also be performed to achieve the desired outcome. The entire surgical team is highly experienced in lipedema treatment and works collaboratively to ensure a successful procedure.
A: Recovery after lipedema surgery is an important part of the healing process. You can expect some initial swelling, bruising, and discomfort, which can be managed with medication and proper care. Our team will provide you with detailed post-operative instructions, including pain management strategies, proper use of compression garments, protocols to care for your surgical site, and dietary recommendations to promote healing. Regular follow-up appointments with Dr. Larson are crucial to monitor your progress and ensure optimal results. Physical therapy may also be recommended to improve mobility and reduce swelling. Remember, our staff is available to answer any questions and address any concerns you may have throughout your recovery journey.
A: Individual recovery time will vary from patient to patient and depending on the operation performed, but it generally takes 1-2 weeks to recover. After the first week, patients typically feel progressively better each day. After the initial recovery period, you will continue to have swelling which will subside over the course of several months. At that point you will be ready for your next stage of surgery.
A: The best practices after lipedema surgery include getting rest, taking short walks as soon as possible, wearing compression garments, taking medications as prescribed, drinking plenty of fluids, and avoiding foods that can cause inflammation such as added sugars, refined grains, and high sodium foods. While not required, some patients elect to also complete hyperbaric oxygen therapy and/or manual lymphatic drainage (MLD) massages post-operatively.
A: To make the process as convenient as possible for our out-of-town patients, we will typically schedule a virtual appointment to review important pre-operative information weeks before your operation. Any pre-operative clearance requirements such as labs or imaging can also be completed in your home town. We then schedule an in-person pre-operative appointment 1-2 days before your operation to meet with Dr. Larson and finalize the plan. After your operation, you’ll stay in town until your 1 week post-operative visit with Dr. Larson. Patients commonly leave for home after this appointment. In total, patients are usually in town for about a week.
Dr. Larson uses a specialized liposuction technique called Power Assisted Liposuction (PAL). Before starting the liposuction phase, Dr. Larson first injects the areas being treated with a solution of sterile injectable saline, epinephrine to reduce bleeding, and lidocaine to provide pain relief. This solution is referred to as tumescent solution. After injecting the tumescent solution, Dr. Larson makes small incisions and inserts a thin metal tube called a cannula. This cannula is connected to a powered handle that provides rapid vibrational movement to the cannula to gently break up fat deposits and make them easier to remove. This power-assisted technique is a gentler, more efficient approach that enables Dr. Larson to remove more fat in less time, with less trauma to the tissues compared to traditional liposuction. Ultimately, this translates into less bruising and discomfort, a quicker recovery, and enhanced results.
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Next Steps
While there are many benefits to lipedema surgery, the decision to know if it is right for you is not always an easy one. Dr. Larson and his staff are ready to answer any questions or provide further information so you can make the best decision towards improving your quality of life.
If you’re ready to take the next steps in your lipedema journey, we encourage you to book a consultation today.
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