Lipedema (Painful Fat Syndrome) – Beverly Hills, CA*

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About Lipedema

 Many patients travel from around the world to see Board Certified Beverly Hills Plastic Surgeon Dr. Jaime Schwartz for his expertise in body contouring procedures that he has developed such as Breast LipoLift® and Body LipoLift®. Some of these patients especially women can have disproportionately large thighs, calves, ankles, a buttock shelf as well as large arms that seem to extend to the wrist.  Most of these women will tell you they have tried dieting their entire lives and some have even undergone gastric bypass  to no avail.  The main reason is that they have been misdiagnosed as obese and not properly diagnosed with Lipedema.

Lipedema, also referred to as painful fat syndrome, affects approximately 1 in 9 women in the United States with over 300 million worldwide. It is characterized by excessive fat deposits developing under the skin in irregular ways, typically around the hips, thighs, calves, and arms. While some patients and doctors may simply misdiagnosis this condition as obesity, lipedema is a disorder that is resistant to diet and exercise and progressively causes pain, swelling, and tenderness in the areas that are affected

Symptoms of lipedema

Symptoms will vary widely depending on the patient and their stage , but some of the common signs are:

  • Onset during puberty, pregnancy or menopause (hormonal changes)
  • Both Legs Symmetrically Affected
  • Column-like Legs
  • Pain with movement, being touched or at rest
  • Hypersensitivity to touch
  • Fat that accumulates from the hips and buttocks to the knees or even down to the ankles.
  • When around the ankles it can form a thickened “cuff”.
  • Knees with fat pads above, below and inside
  • The knee fat pads may stress the joints and cause pain or abnormal walking movements
  • Fat accumulation in the upper arm that can be seen extending to the forearm
  • Near the wrist the fat can “cuff” creating a thickened ring.
  • Disproportionate Arm fat that hangs creating a “bat-wing” deformity
  • Since lipedema has a connective tissue disorder component, joint hyper mobility can be seen.
  • Skin has a spongy consistency that overtime loses elasticity
  • Non-Pitting Edema that can become lipo-lymphedema
  • However, pitting edema can occur while standing for long periods of time
  • Easy Bruisability
  • Negative Stemmer Sign. Stemmers sign is a thickened thickened skin fold at the base of the second toe or second finger that is characteristic for lymphedema. When this tissue cannot be lifted but can only be grasped as a lump of tissue it is positive.
  • Lower Skin Temperature in the extremities
  • Fatigue
  • Skin can be “rubbery”
  • Has also been seen to begin or worsen following general anesthesia surgery
  • Diets and other weight loss techniques are ineffective

Stages of lipedema

Stage 1 Lipedema

  • Smooth Skin

  • Swelling of the legs that improves with elevation and compression

Stage 2 Lipedema

  • Skin becomes more cobblestone-like

  • May feel lipomas

  • Swelling of the legs gets worse when standing and doesn’t resolve as easily

Stage 3 Lipedema

  • Tissue becomes hardened and fibrotic

  • Swelling usually present

  • Skin and fat accumulation that overhangs

Stage 4 Lipedema (Lipo-Lymphedema)

  • Fibrosclerosis with possible Elephantiasis

  • Swelling almost always present

  • Overhanging fat and skin

Lipedema Treatment

Noninvasive methods are generally used in conjunction with surgical intervention. Certain medication to reduce inflammation, a healthy diet, regular exercise, compression garments, breathing techniques, and other treatments that are designed to increase circulation, blood flow, and drainage in the lymphatic system can be used. Some popular methods include dry brushing, which involves passing a brush over the skin to help alleviate pressure, vibration devices, and pneumatic compression pumps, which both work to improve blood and lymphatic flow. 

  • Liposuction: SAFE Liposuction and WAL Liposuction 

Lymphatic Sparing Liposuction Is the main treatment for lipedema. Dr. Schwartz utilizes specialized techniques to releases the pressure and congestion gently so as to spare lymphatics while debulking the lipedematous fat.  One of Dr Schwartz’s preferred methods is SAFE lipo which stands for





Techniques such as this and others like Water Assisted Liposuction (WAL) allow Dr Schwartz to gently separate the fat to be removed so that all other structures such as nerves, blood vessels and lymphatics are left behind. Since it allows his more fragile lipedema patients to recover and heal better, he also employs this technique for all body contouring and liposuction patients he treats. Dr Schwartz believes in treating the worst areas first so that the congestion can be relieved and allow swelling in other areas to be relieved. 

  • Body LipoLift®:  Extreme Lymphatic Sparing Surgical Thigh Lift, Arm Lift, Panniculectomy and Body Lift

Once liposuction has been completed to reduce the fat tissue, a surgical skin reduction may aid in decreasing the lipedematous fat to recur.  Dr Schwartz has lectured on the fact that compression after surgery is a mainstay long term treatment. When Dr Schwartz tightens the area by removing the skin it can effectively create a similar effect to compression garments as well as allowing compression garments to fit more properly.  Dr Schwartz has developed a 1 STAGE technique known as Body LipoLift® which utilizes liposuction and other techniques to SPARE even the DERMAL LYMPHATICS while removing and tightening the skin. 


Board Certified Beverly Hills Plastic Surgeon Dr Jaime Schwartz has developed protocols with “Gentle Anesthesia” so that most patients can go out to dinner the next night and return to work in a few days. These protocols and techniques allow for 1 stage lipedema fat reduction procedures and skin tightening at the same time to reduce the amount of surgeries and overall recovery. 

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Lipedema is treatable with the proper precision, protocols and procedures. Board Certified Beverly Hills Plastic Surgeon Dr Jaime Schwartz is one of the thought-leaders on safe Lipedema care.

*Individual results are not guaranteed and may vary from person to person. Images may contain models.