Sturdy Woman

Earlier this year I asked you to send me your questions and you did! This week I am back to answer some of the many questions I received about surgery for lipedema. I have to admit this is a post I never imagined that I would do because I primarily focus on conservative treatments, but I want to be responsive to what matters to you, Sturdy Reader, since you’re the whole reason I do this. Read or watch below as I answer questions like, have I had lipedema surgery? What is lipedema surgery? Can weight loss or bariatric surgery help lipedema? Can lipedema come back after surgery?

Remember, I’m not a doctor, surgeon, or nutritionist. I’m just a woman like you who has lipedema, lymphedema, and venous insufficiency. My goal with this post is to help point you to resources that will help you decide if lipedema surgery is the right path for you.

Have a question you’d like me to answer about lipedema? Submit it in the Sturdy Woman survey and I might just address it in a future video!

Have I had lipedema surgery?

This is an easy one, Sturdy Reader. No, I have not had any surgery for my lipedema. Like many of you, when I was diagnosed (yes, I was diagnosed by a doctor) I was told that there was nothing I could do except surgery. Paying tens of thousands of dollars out of pocket seemed impossible. I have a lot of student loan debt from my master’s degree, I live in an expensive city, and someday I’d like to be able to buy a house. So I learned everything I could about conservative treatments and… changed my entire life. Looking to treat lipedema without surgery? You can see my before and after pictures and read more about my 100+ pound weight loss and symptom reversal here. If you prefer to watch, check out my Conservative Treatment for Lipedema playlist on YouTube. At this point, I’m really satisfied with my progress and don’t think I’d pursue surgery even if I could afford it.

Do you recommend surgery for lipedema?

It doesn’t matter what I think! Whether or not to have surgery is an extremely personal decision. I recommend you spend some quiet time with yourself thinking about your goals for surgery and what you hope to get out of it. Some people are hoping to reduce pain. Others have large, heavy legs and are hoping to improve their mobility. Still others are uncomfortable with their physical appearance and changing it would improve their quality of life. Whatever your reason, knowing what you hope to get out of surgery will help you find the right surgeon for you – they are all different! – and set realistic expectations for your results. Ultimately, only you can decide whether or not liposuction for lipedema is worth it.

Is lipedema surgery covered by insurance?

This is a shifting and dynamic situation. Liposuction, literally removing the lipedema nodules and unhealthy tissue, is the most common procedure but it is traditionally seen as a purely cosmetic procedure. This means, at least in the United States, it hasn’t been covered by insurance. However, over the past few years, women have started taking insurance companies to court for denying their surgery… and winning! To explore whether your insurance company might cover your treatment, a simple Google search will return a lot of information. The lipedema surgeons and doctors are also very clued into this and should be able to give you good advice about pursuing coverage.

How do I find a good lipedema surgeon?

Educate yourself! There are two great places to start learning more about the different surgeons who do lipedema liposuction and the experiences of their patients. We all know by now that fellow patients are often one of our best resources for lipedema information. Believe it or not, Facebook is a great place to find them. Multiple groups with 50,000+ members are extremely active. People post-surgery before and after photos regularly and discuss their experiences with specific doctors. Many of the doctors are also active on social media and you may find them operating their own groups or YouTube channels.

My second suggestion is to check out the Fat Disorders Resource Society conference. I attended the 2023 conference in Atlanta and many of the top United States-based surgeons were there advertising their practices, presenting their techniques, and sharing patient stories. All the presentations from the 2023 conference are available for free on the FDRS YouTube channel. You’ll literally see all the gory details, so be ready! FDRS is a hybrid conference where doctors, researchers, and patients present, so you can also watch patient stories. There are both good and bad stories about surgery and it will help you assess whether it is a journey you want to take.

The 2024 FDRS conference will be held April 19-21 in St. Louis, Missouri. It’s a fun weekend to connect with other patients and learn more about the latest research on lipedema, Dercums disease, and other fat disorders. The great thing about the conference being held in St. Louis is that St. Louis is a hub for Southwest Airlines and they have one of the most friendly policies for passengers of size. They allow you to purchase two seats if you need more space and get reimbursed for the second one after your trip is finished. I successfully used this in 2021 when I was still much larger. Read more about Southwest’s Passenger of Size policy here. You can also attend the FDRS conference virtually and participate live in the networking and question and answer sessions.

Is lipedema surgery permanent? Can lipedema come back after surgery?

At the 2023 FDRS conference, someone asked the panel of surgeons this question pretty directly and the answer was more or less unanimous. While liposuction can physically remove the lipedema nodules and unhealthy fat tissue, it can’t fix the underlying mechanisms that caused it to form in the first place. Think sluggish lymphatic system, inflammation, weak connective tissue, and the whole constellation of things that makes lipedema so challenging to diagnose and treat. Don’t be surprised if, after surgery, your surgeon recommends some lifestyle changes to maintain your progress.

What about lipedema and bariatric surgery? Can weight loss surgery help lipedema?

This is another great thing to ask about in the Facebook groups. Many of the women I know who have had bariatric surgery report that they had weight loss in their non-lipedema areas but that their legs and arms remained stubbornly large. That said, I have heard of lipedema surgeons using bariatric surgery with patients to help reduce some of their body mass before doing liposuction. That’s going to be a very personal conversation between you and your surgeon, however,.

What are the other types of surgery for lipedema?

Besides liposuction and bariatric surgery, you’ll hear people talking about having skin removal surgery for lipedema. This is often after they have lost a large amount of weight, either through another surgery or through keto. Remember, I’ve lost more than 100 pounds and other women have used keto and fasting to lose twice that much. Given that we already have loose connective tissue, of bodies are prone to having a lot of saggy skin and skin removal surgery can help tighten everything up.

Have you had surgery for lipedema? Do you have more questions?

To the extent you are comfortable, please share your experience with lipedema surgery below (note the comments on YouTube tend to be more active than on the blog). Have more questions about surgery or anything else? Send them anonymously through the Sturdy Woman survey!