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lipedema consultation

5 things you should know about the lipedema consultation


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You think you have lipedema and you want to meet Dr Nicolas Zwillinger, but you have questions about this first consultation. This article: “5 things to know about the lipedema consultation” will help answer them.

1. Course of the lipedema consultation

When you arrive at the practice, we will ask you to fill in a questionnaire that will allow us to collect information about your symptoms and their intensity.

Doctor Nicolas Zwillinger will then receive you in his office, where he will ask you about yourself and your medical history, and more specifically about the elements that make you think of lipedema.

The surgeon will then proceed to the clinical examination, he will observe the disproportion between the different parts of your body (lower and/or upper limbs in relation to your trunk). He will palpate the areas that may be affected and will ask you how you feel when pressing these areas.

Photos will then be taken in a standing position (front, back and each profile), which will allow us to follow the evolution of the affected areas following the WAL liposuccion WAL surgery.

Following all these steps, the diagnosis of lipoedema can be confirmed or made and the surgeon will indicate the areas affected by lipedema. There are in fact 5 types of lipoedema:

  • Lipedema type I: Hips/buttocks.
  • Type of lipedema II: From the buttocks to the knees (included).
  • Lipedema type III: Buttocks to ankles (included).
  • Lipedema type IV: Arms.
  • Lipedema type V: Calves only

The WAL liposuction technique will then be explained to you in detail and you will be able to ask any questions you may have about this condition or about the surgical treatment of it.

At the end of your consultation, you will be discussed with Dr. Zwillinger’s secretaries and you will be given an estimate.

2. Examinations before or after the consultation

We recommend that you have an ultrasound Doppler examination of the affected areas in the 6 months prior to your consultation, as this will provide information on your vascular network which may be altered by the presence of lipedema. If this examination has not been carried out before your visit to the practice, we will give you a prescription at the end of your appointment.

If Dr. Nicolas Zwillinger deems it necessary, you will also be given a prescription for a lymphoscintigraphy. This examination, which is carried out in nuclear medicine centres, allows the visualisation of your lymphatic system before a possible intervention. 

However, it is important to note that a vascular or lymphatic system deficiency does not necessarily mean that an operation is not possible.

If you have a history of anaemia, a prescription for a blood test is also given to you.

3. The particular case of video-consultation

In cases where a consultation at Dr. Nicolas Zwillinger’s office, located in the 16th arrondissement of Paris, is not possible, we offer video-consultation. This solution is quite possible in the case of lipedema.

It is strongly advised to carry out this remote consultation using a computer and not a smartphone, the quality of the video is essential. You will need to have a sufficient internet connection and be in a quiet place where you can put on your underwear to show the surgeon the affected areas.

If this is not possible, we advise you to take photos beforehand.

These photos must respect certain criteria:

  • On a plain background
  • With good quality lighting 
  • A shot from your feet to your waist (or your whole body if your arms are affected)
  • Positions: front, back, both sides, arms outstretched if the upper limbs are affected

These photos can be shared during your lipedema consultation via Doctolib or sent by email before the consultation.

The different stages of the consultation will be respected, the estimate and the administrative information will be sent to you by email at the end of your appointment.

4. Follow-up appointments

It is possible to consult Dr. Nicolas Zwillinger again following this first appointment. This second appointment can take place at the office or by video, and will not be charged.

It will allow you to answer any additional questions you may have and to discuss with the surgeon any additional examinations you may need.

5. Post-operative appointment

Following the operation we recommend an appointment 1 month, 3 months and 6 months after the operation, in order to monitor your recovery and the results. These consultations can take place at the office or by video-consultation.

This article reviews the different stages of the lipedema consultation, in order to answer the questions of people affected by this pathology. If you would like to learn more, do not hesitate to come back to us.

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