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Do you remove Dercums lipomas or larger fatty lipomas?

I do remove both Dercums lipomas and fatty lipomas of any size via either direct excision or liposuction.

Is there a BMI limit for performing liposuction for lipedema?

BMI limits are hard to apply in lipedema. I evaluate your overall health and decide case by case.

Are there certain patients that you will not perform surgery?

I will not operate on patients with life-threatening health complications, who have an untreated mental illness, or on patients who I do not deem to have realistic expectations from surgery.

Can you perform liposuction on a person that is being treated with blood thinner due to past blood clots?

I do not advise this. In small areas, I can. In larger areas, this can prove quite painful and dangerous.

Do you perform liposuction on a person that has Lipo-Lymphedema?

This depends on the severity of the lymphedema and the damage to the skin. I will often request other specialist opinions if I am in doubt.

Do you prefer the patient to take care of their vein disease and/or be assessed for vein disease prior to liposuction?

Yes, venous disease, if present, should be evaluated and treated to avoid bleeding complications.

Does lipedema skin retract? How long do you advise to wait to see if there is extraction?

I feel that in most cases, the skin does retract. Even more so than in patients without lipedema. This is best with post-operative compression and the use of other modalities such as Renuvion. It takes up to a year to see the final result, but the bulk of the result can be seen typically in 4-6 months.

Do you use BodyTite or something similar for tightening skin?

I use Renuvion, formerly known as J-Plasma. This technology helps tighten the fibro-septal skin bands while sparing the lymphatics. This results in a net tightening effect on the skin and can hopefully help reduce the need for long scars with a thigh lift or arm lift.

Do you leave the incision drain open or do you stitch up each person?

I remove excess fluid by manual massage after surgery. Then I close the incision to avoid a very messy post-operative couple of days. Preserving the lymphatics should allow the excess fluid to be naturally resorbed. Occasionally I will place drains.

What physical activities can be done after surgery?

Walk the day of surgery and every day after. Whatever does not cause excess discomfort, depending on the site of surgery.

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