The types of surgery for lipedema! Liposuction? Renuvion? Laser? Bodytite? Cruroplasty? Take the lipedema self-assessment questionnaire: https://bio.amato.io/auto Get to know Dr. Fernando Amato's channel: https://www.youtube.com/channel/UCJ_9… Check out the channel's exclusive playlist for Plastic Surgery: https://youtube.com/playlist?list=PLg… Follow Dr. Fernando on Instagram: @meu.plastico.pro Visit Dr. Fernando's Website: www.plastico.pro Watch the recommended video of the CHANNEL now: https://bio.amato.io/indicado Watch this video on how to care for the drain during the post-operative period: https://www.youtube.com/watch?v=mnGmQ… Also watch this video about Hematoma: https://www.youtube.com/watch?v=xY6sN… https://www.youtube.com/watch?v=56AaG… #institutoamato #Cirurgiaplastica #lipoaspiracao #Protesedemama #abdominoplastia

What are the types of surgery
to treat Lipedema?

Almost everyone already knows from the internet and
social media that the surgical treatment

for Lipedema is
liposuction. Is it truly

only liposuction? Liposuction is an old,
minimally invasive technique for the

mechanical removal of fat from the body,
removal of superficial fat from the body. In

Lipedema, it is performed with a tumescent technique,
that is, a large amount of liquid is injected:

physiological saline with adrenaline and anesthetic.

This liquid helps to
better loosen the fat;

it causes vasoconstriction in the vessels, which means
less bleeding, and ultimately protects the area.

And some auxiliary device is almost always used,
such as vibration assistance, like

vibrolipo, there's vibrofit.

The advantage of these devices is to help
loosen these fibroses, and to not require excessive arm movement in

liposuction, as in classic liposuction,

which facilitates certain positions for the surgeon,
especially when approaching the leg, which is

harder to find a position for.

There are some cannulas that can
perform better than traditional ones,

but it can depend on the experience of the team, and that is truly

important. There can be several access points
on the skin, on the leg, which can be useful. These are

the small holes we use to
introduce the cannula and perform liposuction, and

this will depend on the location of the fat.

But the surgical treatment
is not always this!

If they haven't told you, it's not just liposuction.

Patients with very advanced
Lipedema,

they have a lot of excess skin and may
need a dermolipectomy,

which is the resection of skin, skin and fat,
dermolipectomy, we resect the skin in a block

with the Lipedema. In the thighs,

we call it cruroplasty and in the arm
brachioplasty, and it may still be

necessary in other areas of the body, such as
the leg. In this surgery, it is even possible to

resect Lipedema nodules,
which are fat balls.

Often these balls are hardened
in their center with necrosis, a

calcification. In some cases with little
excess skin, sometimes we even use a

laser, some type of laser to associate with the
procedure, with the most commonly used frequency being

980.

But with the 980 characteristic, it destroys more
fat, causes lipolysis, we aspirate and

we can still achieve
some skin retraction.

We end up using it on the
medial thigh and arm.

There is also the 1210 laser
which can also be used,

it does not destroy the fat, it loosens
the fat, it is less destructive, but it also allows

this aspiration of the fat

after the laser has been passed. Both lasers
are options to cause this local stimulation

of collagen, improving this skin laxity,
improving local skin quality,

reducing skin flaccidity.

There are others such as devices like Renuvion,
which is a plasma jet, and Bodytite, which are also

alternatives for skin retraction and
causing local biostimulation of

collagen. However, because it is an inflammatory disease,
all these options must be

evaluated and used with great caution,
as the mechanism of collagen stimulation

involves a local inflammatory process. This could
even be a risk in a theoretically inflamed patient

to trigger Lipedema.

When we use these devices, we observe that
since we removed the diseased fat, it does not stimulate,

but we must always evaluate the location and

sometimes, for example, using an
extremely aggressive device,

for example, on the leg in the most distal part
of the leg, could even damage lymphatic vessels

and impair lymphatic return,
causing more leg edema, a leg that

did not have lymphedema but had lipedema
could evolve into lymphedema

if it has these lesions of the lymphatic vessels.
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