Lipedema Surgeon in Los Angeles
Lipedema is a chronic disorder of fat and connective tissue, including skin and cellulite, that can dramatically affect your quality of life. There are solutions for lipedema that go far beyond diet and exercise if you go to an experienced plastic surgeon who understands the underlying genetic and hormonal basis of lipedema. Unlike obesity, lipedema is caused by resistant fat cells that do not respond to normal changes in diet, exercise, and increased metabolism.
Our specialty is the treatment of lipedema using lymphatic sparing techniques that can help reduce inflammation, fat hypertrophy, and skin changes that are characteristic of lipedema. Our surgeons are board-certified in plastic surgery, venous and lymphatic medicine, and other specialties that can help you obtain expertise in Lipedema.
There are certain things that you should understand when seeking a plastic surgeon to help you with your lipedema. Dr. Karamanoukian has specialized in lipedema care and has developed lymphatic sparing techniques of liposuction to reduce the volume of fatty tissue and restore confidence in your body.
Characteristically, lipedema is a fatty deposition disorder in which abnormal amount of fat are deposited in the lower body and arms. This fat is unlike that attained with weight gain as it is more resistant to diet and exercise. Physicians often misdiagnose lipedema as obesity-related fat deposition when in reality these are two different entities that may sometimes overlap. Lipedema has characteristic patterns of growth and usually occurs in the hips, buttocks, thighs, legs, and arms while sparing the ankles and feet and hands.
What is Lipedema?
As lipedema worsens, the skin and soft tissue around the fat begins to change and begins to become more elastic and hypermobile. Increased compliance to tissue edema and skin stretching occurs. Many patients with lipedema have changes in their joints that may make them more flexible with increased risk of joint disorders and ambulatory problems. The skin may begin to change and become thickened and lumpy with bumps and irregularities felt on the surface. Once the fatty deposits become unregulated, nodularity and out pouchings of fat are more commonly seen on the lower body with an uneven skin contour.
History of Lipedema
Lipedema was first characterized as a disorder that was distinctively different than obesity in the 1940s, when physicians noticed that lipedema fat was associated with edema and was more resistant to normal patterns of metabolism. Surgeons, over the years, noted that there was a loss of elastic recoil in the skin and that this inherent problem was likely hormonal and genetic and influenced the amount of tissue edema within the skin and fatty tissue. We now think that lipedema is genetically-inherited with a preference for women in an autosomal dominant manner manner. Men with lipedema have been reported, but an underlying hormonal problem is usually apparent on clinical exam. What makes a lipedema so unique is that it is resistant to diet and exercise and is usually referred to as persistent fat with changes in skin contour and elasticity.
Incidence of Lipedema
For most patients trying to understand and come to terms with lipedema, they may be surprised to know that lipedema is quite common in the general population and estimates in several studies have shown that the prevalence of lipedema is approximately 10 to 16% of the adult female population. By extrapolating these numbers, lipedema is probably present in about 15 to 20 million people in the United States alone. You can study lipedema fat from so many different perspectives and clinicians remain challenged by the many different aspects of lipedema and connective tissue connections. Evidence shows that there is a predominant occurrence of lipedema in females because it often appears at times of hormonal changes such as childbirth, menopause, and puberty. During these periods, women begin to experience excessive deposits of fat with changes in skin texture and contour that appear to be nodular and lump-like.
Staging lipedema involves an assessment of skin quality and contour as well as the degree of fatty deposits. Stages one through four lipedema are characterized by progressive patterns of skin changes, contour irregularities, edema, and fatty deposits. As the stages of lipedema become more advanced, clinicians may notice more fluid in the fat areas and deformations of the tissue that may affect quality of life and ambulation.
Lipedema Types
Lipedema is also divided by type with clinicians categorizing anatomic distribution in order to more completely elucidate patterns of lipedema. Lipedema is usually seen in the lower body but spares the lower legs, ankles, and feet.
Staging of Lipedema
It's very important to classify the stages of lipedema in order to assess at the pace of lipedema changes with adulthood. Studies have shown that lipedema is relatively under-diagnosed by healthcare providers and is very often misdiagnosed as a lymphedema or obesity. Both of these conditions, lymphedema and obesity, can occur simultaneously with lipedema but our distinctly different.
Risk Factors for Lipedema
Clinicians also see patterns of lipedema development as early as puberty and adolescence. It is important to diagnose lipedema and children at an early stage so that they are not misdiagnosed as obesity and more appropriate treatment programs using conservative methods can be employed early. It is very rare to see lipedema in young male adolescents as it is usually hormonally driven based on estrogen and progesterone levels.
Diabetes and Lipedema
There are many parallel diagnoses that are of concern to clinicians treating lipedema patients. When compared to obesity, lipedema patients have a lower risk of diabetes when a comparison is made based on BMI. This does not mean that lipedema patients are not at risk of diabetes, but the risk of diabetes is considerably less when you compare BMI in patients with lipedema versus pure obesity.
Hypertension and Lipedema
Hypertension is also a risk factor with weight gain and obesity. When lymphedema patients were compared with BMI, it was found that lipedema patients have lower risk of hypertension in early disease when compared to patients with similar BMIs and obesity.
When looking at diabetes and hypertensive risk, it becomes more and more clear that lipedema is a distinct clinical entity that cannot be confused with obesity. When a comparison is made by BMI, patients with lipedema versus obesity have different risks of hypertension and diabetes. However, lipedema patients also have may have impairment in their normal daily function and this may considerably affect quality of life. Persistent fat patterns in the arms and legs may affect ones quality of life and lifestyle. Persistent fat in patients with lipedema may affect diet, lifestyle choices, exercise, fertility, ability to relate in social situations, clothing choices, and psychological well-being.
It is important that a healthy lipedema journey through life includes healthier choices in terms of diet, exercise, social behavior, and well-being. Lipedema is an autosomal dominant connective tissue disorder which cannot be changed in terms of a genetic profile. However, healthy lifestyle changes can improve one's well-being as they proceed through life with lipedema. It is also important to seek and experience lipedema expert such as Dr. Raffy Karamanoukian, a top lipedema surgeon in Los Angeles, who can recommend a healthy treatment program they can reduce the burden of the lipedema.
Diet and Exercise
It is known that lipedema fat is resistant to diet and exercise that is above and beyond the metabolic compliance of fat with obesity. Some clinicians feel that the lipedema fat cannot be reduced with diet and exercise which makes lifestyle decisions a difficult choice for patients with lipedema. It would not be wise to have an unrestricted diet and avoid exercise, but these two patterns of behavior, healthy diet and increased aerobic exercise, should be part of a healthy lifestyle change with lipedema. Failure to lose weight with dieting may predispose a lipedema patient to obesity and increase cardiovascular risk.
Chronic Pain
Patients with lipedema often live with chronic pain that is distinctly related to inflammation in the fat. These patients may be diagnosed with chronic pain issues or fibromyalgia when in fact they have inflammation related to the fat. This may be also related to joint pain due to ligamentous changes and gravity-dependent weight on the joints. Hyper mobility and weight gain may have progressive degenerative effects on the body. Pain management is important for lipedema patients and our office can suggest an appropriate pain management protocol.
Hypermobility of Joints and Joint Pain
Hypermobility is a very common problem in patients with lipedema as the joints can suffer from degenerative changes in the ligaments, tendons, and cartilage. This is related to the connective tissue disorder inherent in lipedema as well as increases in weight stressors on the joints. This hypermobility is apparent in the skin, joints, spine, and even in the cardiovascular system. We see many changes related to the dilation of veins, dysfunction of capillaries, dysfunction of lymphatic tissue, and the development of varicose veins in the ankles legs and thighs.
Varicose Veins and Lipedema
Dr. Karamanoukian may also refer you to the Santa Monica Vein Center which specializes in the management of varicose veins and venous insufficiency. Patients with lipedema may have severe varicose vein issues including bulging varicose veins, venous hypertension, swelling in the legs, loss of lymphatic flow, thick skin, Lipodermatosclerosis, vein ulcers, and poor wound healing.
If you have obesity coinciding with lipedema, Dr. Karamanoukian may suggest a weight loss regimen that may reduce non-lipedema fat. This is usually done with diet and exercise and may require a more regimented protocol based on current weight loss techniques.
Depression and Lipedema
There are psychological implications of weight gain and lipedema, particularly if they are related to a decrease in mobility, lifestyle changes, and psychosocial stressors. Patients with lipedema may have feelings of anxiety, depression, discrimination, lack of compassion, and feelings of isolation from family and friends which may lead to social avoidance, withdrawal from social circles, and social isolation. As you can see, treatment of lipedema in our Los Angeles plastic surgery office is important to avoid lifestyle stressors that may further exacerbate a genetically unavoidable connective tissue problem.
Patients with lipedema must realize that there are plenty of resources available among medical physicians, expert plastic surgeons, therapists, and weight loss experts who can help manage the implications of lipedema. Medical support is an important tool in the early management of lipedema and may help facilitate lifestyle changes and conservative management choices that can reduce the burden of the lipedema. This may coincide with Sports Medicine recommendations which may reduce the burden of lipedema on the joints and musculoskeletal system. We would recommend compression stockings for patients who have increased swelling in the lower legs that is gravity-dependent and caused by reduced lymphatic flow. Lymphatic drainage with manual therapy or sequential therapy may also reduce the swelling inherent with lipedema.
Dermatology and Lipedema
Skin care is an important aspect of lipedema, especially in the latter stages of lipedema development. Thickened skin, skin that is a damaged and chronically inflamed, poor wound healing, hyperemic skin that is prone to infection and cellulitis may all be present. The approach of the surgeons at Kare Plastic Surgery is to employ many of the cosmetic dermatology recommendations available in our office by licensed clinicians.
We recommend that patient's undergo frequent skin checks to improve overall dermatologic health. capillary fragility is also an important aspect of lipedema and may cause broken blood vessels, spider veins, and the early development of varicose veins.
Top Los Angeles Lipedema Surgeon
Your overall health is very important to us at Kare Plastic Surgery and if you are living with lipedema, it is important to be treated early with frequent doctor visits to assess the severity of the lipedema and the implications for your overall health. Our plastic surgery office is located in Santa Monica and serves the greater Los Angeles area where we see patients with lipedema from all over the country.
We are an experienced lipedema treatment center located in the heart of Los Angeles with two board-certified surgeons who are well equipped to handle the difficult challenges of lipedema. When you come into our office for a consultation, we will address the lymphatic ramifications of lymphedema, the lifestyle impairing changes in health, the development of varicose veins and venous insufficiency, the excess fat related to lipedema in the lower legs and arms, and the mobility issues related to hypermobility and joint deformations. We will work alongside specialists in the field of lymphedema, venous insufficiency, and sports medicine to help you regain your health and lifestyle. Living with lipedema can be made easier with progressive lifestyle changes and lymphatic-sparing liposuction that can reduce the burden of lipedema fat in your legs.