Lipedema Protocol
Lipedema Surgical Protocol in New York and New Jersey
One of the most common questions we receive is how do you organize, structure and schedule the surgery.
Lipedema Surgery planning is different from any other surgery. Insurance companies have very strict guidelines on lipedema surgery. Some of those guidelines are publicly available and some of them are not. Our first priority is patient. The first surgery we perform should address the areas of the greatest concern. Some patients are concerned mostly about their arms, others about the abdomens, the third group may be mostly concerned about the lower legs or knees specifically.
This is usually the first surgery that we schedule. Then we devise and develop comprehensive surgical plan that simultaneously addresses is patients concerns in the most efficient manner.
The surgeries are spaced to provide the patient enough time to recover and to be within the guidelines of the specific insurance carrier.
Should the patient choose not to proceed with insurance coverage and have the surgery paid for through their own funds, we do have more flexibility.
Which areas do we do you treat first?
Usually the first areas that we treat are the areas of greatest concern to the patient.How many surgeries do I need?
This is not easy question to answer. Depending on the amount of excessive Lipedema tissue, the number of locations, age, overall health and many other factors, the number of surgeries may vary from 1 to 5 or more.How often can I have my surgeries done?
That depends on how fast you were able to recover, how fast the swelling goes away, how old you are, what is your Health status, number off health related conditions that might hinder your recovery, etc.
However, on average we space the procedures every three months.
Should I have weight loss surgery or Lipedema surgery first?
The expected answer would be weight loss surgery first. However, the answer is not that simple.
The decision is based not on amount of overall fat or BMI but on the amount of visceral fat.
Usually it is determined by one of our metabolic specialists.
If the patient has significant amount of excessive weight which is located outside of the areas affected by lipedema, we recommend weight loss surgery and then will perform Lipedema surgery after the weight is stable. It is about six months or a year after the surgery.
However, many patients come in with high BMI but they do not have significant amount of visceral fat or they already had bariatric surgery. In this case were able to perform Lipedema surgery.
Is BMI a factor in Lipedema surgery?
Traditionally high BMI is associated with higher risk of complications. On average Patients with BMI over 40 have 100% risks of complication. In most cases we see minor complications, such as fluid collection, seroma, separation of the wound, need for revision, Etc.
We also understand that reaching normal BMI is impossible in most of our Lipedema patients. We educate them on proper preparation for surgery, management of the risks and possible complications and we design the surgery to minimize risk factors and complications.