Lipedema (Painful Fat Syndrome) in Beverly Hills, CA

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About Lipedema



Many patients travel from around the world to see board-certified Beverly Hills, CA 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, an upper 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 had gastric bypass surgery to no avail. The main reason is that they have been misdiagnosed as obese and not properly diagnosed with lipedema.

Lipedema, also referred to the as painful fat syndrome, affects approximately one in nine women in the United States with more than 300 million women 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, which progressively causes pain, swelling, and tenderness in the areas that are enlarged.

Symptoms of lipedema

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

  • Onset lipedema during puberty, pregnancy, or menopause (hormonal changes)
  • Lipedema is symmetrical (on both sides of the affected area)
  • Column-like legs
  • Pain with movement, being touched, or at rest
  • Hypersensitivity to touch
  • Accumulated fat on the hips and buttocks, to the knees, or even down to the ankles
  • A thickened ankle that appears like a "cuff" between leg and foot
  • Fat pads above, below, and/or inside the knees (which 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
  • A "cuff" appearance at the wrist with a thickened ring
  • Disproportionate arm fat that hangs creating a "bat-wing" deformity
  • Since lipedema has a connective tissue disorder component, joint hypermobility can be seen
  • The 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
  • Skin that bruises easily
  • Negative Stemmer sign (a thickened skin fold at the base of the second toe or second finger that is characteristic for lymphedema)
  • Lower skin temperature in the extremities
  • Fatigue
  • Rubbery texture to the skin
  • Can be triggered by or worsen following a surgery with a general anesthesia
  • Diets and other weight loss techniques are ineffective

Stages of lipedema

Here is an overview of the four stages of lipedema:

Stage I 

  • Smooth skin

  • Swelling of the legs that improves with elevation and compression

Stage II 

  • Skin becomes more cobblestone-like in appearance

  • May feel lipomas

  • Swelling of the legs gets worse when standing and does not resolve as easily

Stage III 

  • Tissue becomes hardened and fibrotic

  • Swelling usually present

  • Skin and fat accumulation that overhangs

Stage IV (lipo-lymphedema)

  • Fibrosclerosis with possible elephantiasis

  • Swelling almost always present

  • Overhanging fat and skin

Lipedema Treatment

The more definitive treatment for lipedema is to remove the lipedematous fat using Lymphatic Sparing Liposuction. 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.s


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 liposuction, which stands for:

  • Separation-This allows for gently infiltrating water that will protect and separate the more fragile lymphatics and blood vessels. 
  • Aspiration- Dr Schwartz removes the lipedema fat gently with blunt cannulas following along the lymphatics which spares them.
  • Fat Equalization- Once the lipedema fat is removed with advanced water assisted lymphatic sparing liposuction, the area is then further released without suction to ensure a smooth contour and better healing process.

Techniques such as this and others 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.


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 at Fat Disorders Research Society (FDRS) on the fact that compression after surgery is a mainstay long-term treatment. When Dr. Schwartz tightens the area by removing the skin, the technique can effectively create a similar effect to the skin as what a compression can do. After surgery, compression garments will fit more properly. Dr. Schwartz has developed a technique known as a Body LipoLift®, which utilizes liposuction and other techniques to spare even the dermal lymphatics while removing and tightening the skin. A Body LipoLift® can be used as part of a thigh lift, arm lift, panniculectomy, and/or body lift.


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 lipedema treatment, fat reduction procedures and skin tightening at the same time to reduce the number of surgeries and overall recovery at his Beverly Hills and Dubai office. 

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Lipedema is treatable with the precision, protocols, and procedures of an experienced surgeon. Board-certified Beverly Hills plastic surgeon Dr. Jaime Schwartz is a renowned leader in safe lipedema care.

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