From Dr. McCluskey:
The most challenging aspect of lipedema care is the initial diagnosis. Many patients come for consultation and are genuinely confused by the term lipedema. Many have struggled with disproportionally large legs and arms, or they’ve been referred by a vein or lymphatic specialist, and they’ve been introduced to this new and unusual word, Lipedema.
I was honestly confused by the term when I first heard it 10+ years ago – of all fat related diseases that I studied in medical school, lipedema was never mentioned. I worked with many world renown plastic surgeons during medical school and residency and never heard the term lipedema or saw a patient diagnosed with lipedema. I first learned about lipedema from my own patients, and this led me to do extensive research in the medical literature for information, studies, and resources on lipedema and lipedema liposuction.
The original term as first described in 1940 was Lipoedema, but has been shortened to Lipedema in conventional speech. Lipo, or Lip meaning fat, and Edema meaning swelling or fluid. In a patient with edema, one may see swelling in one or both legs and this edema is often described as “pitting” which means that when the swollen area is pressed with the fingers, an impression is left. With lipedema there is no pitting but the appearance can be similar to a patient with edema in the sense that the lower legs are disproportionally larger than normal.
Adding to the confusion, the word Lipedema is far too similar to the word lymphedema, and in fairness the two conditions share some similarities. But lipedema and lymphedema are also very different. I will define these in further detail in the ensuing sections. The important point is that diagnosing and treating lipedema can be challenging, and the first challenge to overcome is the confusing terminology. Lipedema has a specific set of diagnostic criteria, types, and stages that I will list and carefully define. I want this site to be educational for those trying to understand why they have disproportionally large legs and/or arms, that are often tender to touch or bruise easily. I want this site to serve as a reference when you have questions about lipedema or need further information about diagnosis and treatment.
My first encounter with a lipedema patient was with a CRNA who approached me at the hospital and asked if I could look at photos of her legs. I was somewhat familiar with lipedema and I instantly recognized from the photos that she suffered from Stage III Lipedema. She said her legs were painful and tender and they bruised easily. She had lost 30-40 pounds but it did not change the appearance or tenderness in her legs. We received a referral from her primary care doctor and completed an extensive lipedema workup for insurance purposes. I developed a 3 stage plan for lipedema liposuction for her legs beginning with both calves and ankles circumferentially. The second stage of surgery was her anterior thighs and the final stage was her posterior thighs. With each stage I removed multiple liters of fat and fluid and I could see an incredible difference almost immediately. It was a remarkable transformation and she experienced significant relief from her pain and discomfort.
My mission in treating edema is not just about enhancing appearance; it’s about restoring function and improving quality of life. This unique intersection of cosmetic and functional plastic surgery is what makes this field so fulfilling. My patients leave feeling significantly better—both inside and out. That’s why I have chosen to specialize in the treatment of lipedema, lymphatic disorders, and fatty tissue disorders. Understanding the diagnosis of lipedema is crucial, as it allows for the identification of the various stages and types, ensuring that all non-surgical and surgical options are thoroughly discussed.