Some patients with lipedema experience localized skin laxity on the arms and/or thighs and wonder whether the liposuction technique used by Dr. Nicolas Zwillinger can be sufficient or whether it should be combined with a lift.
The skin on the inner thighs and arms is thin and its elastic brittle fibers. It is therefore rapidly degraded by natural aging or significant weight variations, particularly following bariatric surgery (sleeve, gastric band, etc.).
This deterioration of the skin quality is often badly experienced and the demand for repair is therefore, important.
In the case of excess skin associated with lipedema, WAL liposuction should be combined with the facelift technique. This will effectively reduce the fatty infiltration and remove the excess skin and firmly suspend the remaining skin in order to effectively tighten it. We recommend that you make an appointment with Dr. Nicolas Zwillinger to determine whether this combination is necessary in your case.
What do WAL liposuction alone or in combination with a lift have in common?
The pre-operative examinations (blood test, Doppler ultrasound and lymphoscintigraphy in certain cases) and post-operative examinations (blood test at D+7 and Doppler ultrasound at D+15) remain the same. It is also recommended to have lymphatic drainage of the operated areas performed, with a minimum of 15 to 20 days before the first session is respected in order not to put too much strain on the scars in the case of lifting of the lower and upper limbs.
Post-operative compression :
During the operation for a lifting of the arm (brachioplasty) combined with surgical treatment of lipedema by liposuction, compression sleeves should be worn:
- day and night for at least 2 weeks (ideally 4 weeks)
- day or night for 2 additional weeks
Concerning the lifting of the thigh (cruroplasty) associated with the surgical treatment of lipedema by liposuction, it is necessary to wear the post-operative SPANX following the same protocol as for the “arm” area, combining the wearing of class 3 compression tights during the first 10 days.
Compression is an essential element in the post-operative treatment of lipoedema, as it allows the skin to retract properly over the operated areas.
What are the differences between WAL liposuction alone or in combination with a lift?
During a WAL liposuction operation on the lower limbs, the operation can take place under spinal or general anesthesia. In the case of the addition of cruroplasty the operation takes place under general anesthesia. Indeed, the operating time is longer when combining these two techniques:
- 1h30 to 2h on average for a WAL liposuction of the lower limbs
- 2h30 to 3h on average for a WAL liposuction associated with a cruroplasty
Following the cruroplasty, walking is a little more difficult. You have to be patient and get up gradually. We advise patients to take their time and to be well supported during the first few days. It is preferable to plan the first night at the clinic.
The scars left by WAL liposuction are small and not very visible, whereas thigh and arm lifts leave larger scars.
In the case of brachioplasty, the procedure lasts an average of 1.5 to 2 hours, and like the upper limb liposuction procedure alone, it is performed under general anesthesia.
How to care for cruroplasty or brachioplasty scars?
It is important to have a nurse do the post-operative care (dressings) once a day for 2 to 3 weeks. We advise patients to remove all compression bands and/or adhesive bandages when taking a shower, which is allowed from the day after the operation, if they feel able to do so. Otherwise it is possible to wait 48 to 72 hours after the operation. Once the discharge has stopped, it is important to apply a healing cream (cicalfate, cicaplast…) to all the scars until they are completely healed, which can take 6 months to 1 year.
During the first 6 months, exposure to the sun should be avoided. The area should ideally be protected either by wearing clothes over the area or by applying a maximum UV protection (to be repeated every 2 hours).
In order to reduce surgical scars, it is possible to have to resort to the Fraxel laser. It is advisable to consult the derma-aesthetician, present at Dr Nicolas Zwillinger’s practice, in order to carry out a flash test and thus determine whether this technique is possible in your case. The first session should ideally take place 2 to 3 weeks after the operation and be repeated once a month for 3 months. For further information about the Fraxel laser technique, please make an appointment.
In conclusion, lifting of certain areas affected by lipedema (thighs or arms) may be necessary, this may be due to poor elasticity of your skin or a significant change in weight. This procedure is in some respects considered more “enduring” but in the end it is not that different from liposuction surgery WAL