How many medical appointments are required before lipedema surgery?
As part of the surgical treatment of your lipedema using WAL liposuction, at least four medical appointments are necessary:
- With plastic surgeon Dr. Nicolas Zwillinger.
- With the angiologist for Doppler ultrasound of the lower limbs.
- With the nuclear medicine physician for lymphoscintigraphy of the lower limbs.
- With the anesthesiologist for the preoperative appointment.
Appointments with Dr. Zwillinger
The appointment with Dr.Nicolas Zwillinger (in person or virtually via Doctolib) is a clinical examination that allows for the diagnosis of lipedema and the identification of the affected areas. He will explain what lipedema is, its consequences, and its treatment methods, including theWAL liposuction technique.
He will give you all the information you need about the operation and its aftermath. You can ask any questions you may have during this appointment, but also afterwards by email or phone. You can request another appointment at any time if you need further explanation.
Other medical appointments to schedule before lipoedema surgery
The appointment with the angiologist
The angiologist participates in the diagnosis of lipedema, particularly through Doppler ultrasound. If you have significant varicose veins, you will need to consult a phlebologist (a specialist in the treatment of varicose veins) and have them treated before lipedema surgery.
During this appointment, the angiologist will ask you about your medical history, any vein surgery you may have had, current treatments, previous pregnancies, and whether anyone in your family also suffers from vascular diseases.
This is followed by a clinical examination that focuses particularly on the legs, involving observation and palpation, especially of the peripheral pulses (at the popliteal artery, dorsal artery of the foot, femoral artery, etc.). After this, the angiologist will decide whether an ultrasound and/or Doppler ultrasound is necessary.
We work in particular withDr. Cazaubon, who specializes in vascular medicine (angiology). She will see you at her Vascular Exploration Center in Paris (16th arrondissement).
Thanks to her experience gained in the largest hospital departments in Paris (Bichat, La Pitié, Ambroise Paré), and in her region (Hôpital Américain de Neuilly, Clinique du Val d'Or in St Cloud), she offers you the most modern vascular examination methods best suited to vascular diseases (arteries of the neck and limbs, veins, and lymphatics), with a recent specialization in the examination of large legs, particularly lipedema.
Secretary General of the French Society of Angiology for over 20 years, she has built up a network of correspondents from all specialties, not only in Paris, but also outside mainland France and in so-called "developing" countries.
With a multidisciplinary background (cardiology and angiology) in particular, she opted for a comprehensive approach to treating vascular disorders.
Available and easily reachable, she handles emergencies (phlebitis in particular) as well as long-term follow-up care.
An update on venous Doppler ultrasound
Doppler ultrasound is performed using ultrasound waves and a probe that is moved over the limbs being examined. This technique has many advantages: it is completely painless, harmless, and non-invasive.
Therefore, it can be recommended at any age and repeated as many times as necessary, which is very useful for monitoring the progression of lipedema and the impact of treatments. Similarly, it can identify and define the location of venous thrombosis, as well as the size of the clot obstructing the vein. This is very useful if you suffer from lipedema, which is often associated with an increased risk of thrombosis.
Your appointment with the nuclear medicine physician for your lymphoscintigraphy
Lymphoscintigraphy is a method that allows for detailed analysis of your lymphatic system and thus determines drainage function in the upper and lower limbs.
In other words, in the case of edema, the examination can determine whether the cause is lymphatic or not. In the case of lipedema in particular, the examination also makes it possible to assess the area where lymphatic flow is impacted, regardless of the cause. It should be noted that for this examination, there is no need to fast or stop taking your medication, as is required for other examinations.
This examination makes it possible to differentiatebetween lipoedemaand lymphoedema.
In the case of lipedema, excess fat accumulates in the affected limbs (lower limbs and arms) and does not disappear with daily exercise or a special diet. This excess abnormal fat results in swelling of the legs and arms.
In the case of lymphedema, the lymphatic vessels no longer drain lymph efficiently, causing it to accumulate in the tissues beneath the skin. Swelling then appears on one leg or arm, unlike lipedema, which causes symmetrical swelling in the affected limbs. Unilateral swelling is therefore a sign of lymphedema.
In very advanced stages of lipedema, the disease can develop into lipolymphedema. The lymphatic system then malfunctions bilaterally.
In some milder cases of lipoedema, it may still be associated with moderate lymphatic insufficiency.
The appointment with the anesthesiologist
This should take place one month before your procedure. During this appointment, the anesthesiologist will explain all the stages of the operation and give you the necessary instructions to ensure that the anesthesia goes smoothly. They will also review your medical and family history. In some cases, they may prescribe additional tests (blood tests, electrocardiogram, etc.).
We work in particular withDr. Gloulou, ananesthesiologistand intensive care physician trained in general anesthesia and the care of patients in surgical intensive care. He completed his university studies and then trained at a hospital. He worked as a hospital practitioner for several years at a university hospital. For the past few years, he has been working in the private sector, exclusively performing cosmetic and plastic surgery, notably at the Clinique de l'Etoile.
You will see the surgeon again just before the operation to go over everything with you and mark the areas to be operated on with a felt-tip pen.
This article has detailed the various medical appointments you will need to attend before your surgery, so that you can learn more about the different preoperative stages.