Lipedema: The Silent Revolution of a Hidden Condition Through Surgery

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Lipedema: The Silent Revolution of a Hidden Condition Through Surgery

Assoc. Prof. Dr. Övünç Akdemir explains: A new era in lipedema with microsurgery-friendly surgical techniques

Lipedema is a condition estimated to affect up to 10% of women, but it is often mistaken for simple obesity or considered a purely cosmetic concern. Typically emerging during hormonal shifts such as puberty, pregnancy, or menopause, this condition is characterized by painful fat accumulation, primarily in the legs, hips, and sometimes the arms. In advanced stages, lipedema can significantly impair daily life. Unfortunately, it still goes unrecognized by many and is frequently misdiagnosed, leading to years of inappropriate treatments.

Assoc. Prof. Dr. Övünç Akdemir, Chair of the Department of Plastic, Reconstructive and Aesthetic Surgery at Istanbul Aydın University, has been successfully applying both scientific and surgical approaches in the treatment of lipedema for years. We spoke with him about this invisible disease—from diagnosis to surgery, hospital procedures, and microsurgical principles aimed at preserving microcirculation.

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What is Lipedema? How is it Distinguished from Lipodystrophy?

Lipedema is characterized by symmetrical fat accumulation in the legs that does not respond to diet or exercise. Unlike obesity, the upper body remains unaffected; and unlike lymphedema, the swelling does not subside in the morning and typically spares the feet. Many patients report complaints like, “My pants don’t fit my legs, but the waist is loose.”

The disease often presents with pain, easy bruising, tenderness, and psychosocial effects such as depression. It is commonly classified from Type I to Type V, with Type I affecting only the hips and Type V involving the entire limbs.

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First Step in Treatment: Awareness and Accurate Diagnosis

According to Dr. Akdemir, the biggest hurdle in treatment is the delay in diagnosis:

> “Many patients come to us after years of visiting dietitians, undergoing treatments at lymphedema clinics, or trying cosmetic procedures. However, with the correct diagnosis—especially when using microsurgery-friendly techniques—we can achieve highly effective outcomes.”

Diagnosis typically involves ultrasonography, photoanalysis systems, clinical examination, and sometimes tissue biopsies. Metabolic evaluations and hormone profiling are also important components.

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Surgical Approach: Liposuction Techniques that Respect Microcirculation

Traditional liposuction methods fall short in the treatment of lipedema. At this point, “microcirculation-friendly” techniques become essential. The methods employed by Dr. Akdemir include tumescent local anesthesia, vibration-assisted liposuction (PAL), water-assisted liposuction (WAL), and modified techniques using fine cannulas that minimize tissue trauma.

> “Our goal is not just to remove fat but to preserve lymphatic drainage and vascular structures, reduce interstitial edema, and restore proportional body contour.”

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Surgery and Recovery: Key Considerations

Lipedema surgery typically lasts between 2 to 6 hours and may be performed in a single session or staged depending on disease extent. Postoperative care includes lymphatic drainage massages, compression garments, and a special diet low in salt and carbohydrates.

Swelling and bruising, common in the early days after surgery, generally subside within a month. Final contour changes usually settle between 3 to 6 months.

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Are Non-Surgical Alternatives Effective?

Non-surgical treatments such as manual lymph drainage, pressotherapy, cold laser, vacuum therapy, and mesotherapy are commonly used. However, Dr. Akdemir emphasizes that these methods offer only temporary relief and are effective mostly in early stages. Permanent contour correction typically requires surgery.

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Patient Selection and Risk Management

Not all patients are suitable for surgery. Conditions such as heart failure, advanced lymphedema, or clotting disorders must be carefully assessed. Patient education on weight control and physical activity is also critical for minimizing postoperative complications.

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Integrating Microsurgical Innovations

In advanced cases of lipedema where the lymphatic system is severely affected, lymphatic microsurgery techniques such as lymphovenous anastomosis (LVA) or vascularized lymph node transfer (VLNT) may be considered. With his microsurgical background, Dr. Akdemir applies these interventions successfully in selected patients.

> “Our microsurgical expertise allows us to approach this disease with great precision. The goal is not just fat removal, but holistic body restoration.”

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Conclusion: Lipedema No Longer Needs to Be Hidden

Lipedema is a significant public health issue with both medical and social implications. However, with accurate diagnosis and multidisciplinary treatment, this condition is finally coming to light. Thanks to the leadership of Assoc. Prof. Dr. Övünç Akdemir, awareness and scientific advancement in this field are gaining momentum in Turkey.

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Contact and Information

📞 WhatsApp: +90 532 204 31 39

🌐 Website: www.ovuncakdemir.com.tr

📸 Instagram: @ovak.clinic