Description

Lipedema Liposuction of the Legs and Hips After Bariatric Surgery: 56-Year-Old Woman

Before Treatment

This 56-year-old woman came to board-certified plastic surgeon Dr. John Larson in Newport Beach, California, after years of struggling with disproportionate fat in her legs and hips that did not respond to diet, exercise, or weight-loss surgery. She had gastric banding in 2013 and a gastric sleeve in 2017. Both helped her lose weight in other areas of her body, but her legs, hips, lower abdomen, and arms stayed enlarged.

This pattern is one of the hallmarks of lipedema. Lipedema is a chronic fat disorder, affecting mostly women, in which abnormal fat builds up symmetrically in the legs, hips, and often the arms. Diet, exercise, and bariatric surgery reduce ordinary fat, but lipedema fat largely resists them. That is why many patients, like her, still carry heavy, painful legs even after major weight loss.

Her main concerns:

• Lipedema of both legs, from the thighs through the ankles, and the hips
• Pain and heaviness in her legs
• Swelling and easy bruising in the affected areas
• Limited mobility
• Additional lipedema of the arms

Her Surgical Journey

We began her treatment with her legs, using power-assisted liposuction to remove the lipedema tissue along the full length of each leg and through the hips in a single operation.

• Full-leg lipedema liposuction. Power-assisted liposuction of both lower extremities and hips, treating the hips, thighs, knees, calves, and ankles for a smoother, more proportionate contour.

She has since completed her next stage: arm liposuction, an arm lift, a forearm lift, and removal of excess underarm skin (not pictured). Her plan includes a future stage that returns to her lower body for additional liposuction with a thigh and calf lift, and that addresses her abdomen.

How She’s Doing Now

She is doing very well nearly three months after surgery (photos taken just under 3 months post-op), and the change in the size and shape of her legs and hips is already clear. Her contours will continue to refine as swelling resolves over the coming months.

• Improvement in pain and heaviness in her legs
• Improvement in swelling
• Improved mobility
• Slimmer, more proportionate legs from thigh to ankle
• Smoother contours through the hips, thighs, knees, and calves
• Looking ahead to a future stage for her legs and abdomen

Her first stage treated the lipedema that years of weight-loss efforts couldn’t touch, giving her lighter, more comfortable legs.

Common Questions About This Case

Why didn’t weight-loss surgery reduce her legs?
 Lipedema fat behaves differently from ordinary fat and largely resists diet, exercise, and bariatric surgery. This patient lost weight elsewhere after gastric banding and a gastric sleeve, but her legs and hips stayed enlarged until her lipedema was treated surgically.

Can lipedema surgery be done after bariatric surgery?
 Yes. Many lipedema patients have had weight-loss surgery first. This patient had gastric banding and a gastric sleeve years before coming to us, and we planned her lipedema care in stages, beginning with her legs and hips.

Does lipedema leg liposuction always require a thigh or calf lift?
 Not always. Whether skin removal is needed depends on skin quality and how much tissue is removed. This patient’s first stage was liposuction alone. Her plan includes a future thigh and calf lift, along with additional liposuction, to address remaining tissue and loose skin.

How long does it take to see results after lipedema leg surgery?
 This patient’s photos were taken just under three months after surgery, and the change is already clear. Contours typically continue to improve for several more months as swelling resolves.

Surgery performed by John Larson, MD, board-certified plastic surgeon, Larson Plastic Surgery & Medical Aesthetics, Newport Beach, CA. Individual results vary.

56-year-old with lipedema, nearly 3 months after full-leg and hip power-assisted liposuction. Slimmer, smoother, more proportionate legs, with improvement in pain, heaviness, swelling, and mobility. Arms completed in her next stage, with a thigh and calf lift and abdominal surgery planned!