Evaluation and management of the fat leg syndrome - Lipedema

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Evaluation and management of the fat leg syndrome - Lipedema

Postby patoco » Sat Feb 03, 2007 4:51 pm

Evaluation and management of the fat leg syndrome.

Lymphedema and Lipedema

Plast Reconstr Surg. 2007 Jan;119(1):9e-15e

Warren AG,
Janz BA,
Borud LJ,
Slavin SA.

Harvard Medical School, Boston, MA, USA.

LEARNING OBJECTIVES: After studying this article, the participant should be able to: 1. Discuss the initial evaluation of a patient presenting with lower extremity enlargement. 2. Distinguish underlying medical conditions causing lower extremity enlargement, including lymphedema and lipedema. 3. Discuss appropriate management and treatment for patients presenting with these conditions.

BACKGROUND: Given the epidemic of obesity in the United States, many patients will consult the plastic surgeon with complaints of lower extremity enlargement secondary to "fat legs." In addition to cosmetic disfigurement, some patients may suffer from underlying medical conditions that are responsible for their symptoms. Knowledge of these other causes, including lymphedema and a disorder of abnormal fat deposition known as lipedema, ensures appropriate management and/or surgical treatment for affected patients.

METHODS: Initial evaluation for lower extremity enlargement should include a discussion of pertinent medical history and a focused physical examination for findings that might indicate a pathologic underlying cause. When indicated, patients should undergo additional testing, including radiologic studies, to confirm their diagnoses.

RESULTS: For those patients found to have lymphatic dysfunction, conservative management, such as massage therapy, use of compression garments, and limb elevation, should be initially recommended. Excisional or suction-assisted lipectomy may be considered in patients who fail conservative therapy. More extensive consultation with the plastic surgeon is recommended for patients seeking aesthetic improvement in contour and shape of large legs without a specified underlying abnormality.

CONCLUSIONS: Patients with lower extremity enlargement may present to the plastic surgeon unsure of the specific cause of their deformity. A broad differential diagnosis exists for their presentation, which can be narrowed by using the common features and unique manifestations of the conditions.

Lippincott, Williams & Wilkins


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Postby silkie » Mon Feb 05, 2007 2:25 am

Hi Pat,

I am really concerned with "plastic Surgery" and lipedema and lymphedema

I would like any woman love Normal legs hips, for the pain to stop

What about further damage to the lymphatics?

how often would you need to repeat liposuction as it does not cure mearly cleans out and re shapes for a time

We see so many disasters from botex going wrong, breast inplants,

gastric by passes etc. even tummy tucks going so disasterously wrong
We know of therapists that are not qualified practising MLD what qualifications do we look for for liposuction etc?

many cosmetic therapist do this procedure surely there are
guidlines for these practices?

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