Diagnosing Lipedema

To an untrained clinician, lipedema may be very similar to obesity and fat cells, but there are fundamental differences that are poorly understood by most physicians. Lipedema characteristics go far beyond the traditional fatty deposits seen with non-inflammatory disorders and this is why new research guidelines in lipedema have classified this problem as more of a connective tissue disease rather than purely a disease of fatty metabolism.

Dr. Raffy Karamanoukian and Dr. Hratch Karamanoukian are two double board-certified surgeons who specialize in the management of patients with lipedema. We find that the diagnosis can be made by a well-trained eye, a thorough medical history, and a solid clinical examination. Many patients with lipedema have concurrent problems with obesity, metabolic problems, inflammation, and chronic fatigue and chronic pain. In fact, many of these same patients have connective tissue problems that make losing weight very difficult. 

Some of the telltale signs of lipedema are found in the clinical examination, and others during your medical history. There are no specific blood tests for lipedema, but we may routinely order specific tests that can identify chronic inflammation in the body. A diagnostic ultrasound may also be important to evaluate your legs for concurrent vein problems that can worsen lipedema. 

Consultations In-Office

Consultations begin with an examination and assessment of your specific problems. A physical examination may be followed by a duplex ultrasound of the legs and assessment of lymphatic circulation. These visits are generally informative for the surgeons and for patients, as there are clear differences in choosing the right procedure for your specific needs. Our surgeons will examine the severity of the lipedema and also determine whether your condition warrants a surgical procedure. We will work very closely with a team of experts to manage your vein problems, circulatory problems, and even the chronic fatigue. 

Common areas to undergo our surgeon-specific SLIM protocol include the following: 
  • Arms
  • Buttocks
  • Thighs
  • Hips
  • Legs
  • Knees
A duplex ultrasound is especially important for patients who exhibit vein disease or problems with their lower leg circulation. It is important to understand how these two diseases interplay in order to more effectively treat each one. 

Virtual Consultations: 

These consultations are informative and allow a patient to pre-select the right procedure for their needs. Our center is multi-disciplinary and we see patients from all over the nation. If you are concerned about specific areas of lipedema, a virtual consultation with Dr. Karamanoukian can help you determine the right intervals of treatment. Our specialization allows us to follow the SLIM Protocol, developed by Dr. Hratch and Dr. Raffy Karamanoukian. This allows for the treatment of lipedema and the inflammation caused by chronic venous insufficiency and concomitant inflammatory connective tissue problems. 

Our office will facilitate a virtual consultation with photos and video consultation to go over specific questions.