Some patients with lipedema experience localized sagging of the skin on the arms and/or thighs, and wonder whether the liposuction technique used by Dr Zwillinger is sufficient, or whether it should be combined with a facelift.
The skin on the inner thighs and arms is thin and its elastic fibers fragile. It is therefore rapidly degraded by natural aging or significant weight variations, particularly following bariatric surgery(sleeve, gastric band…).
This deterioration in skin quality is often resented, and the demand for repair is therefore high.
In the case of excess skin associated with lipedema, WAL liposuction should be combined with a facelift technique. This will effectively reduce fatty infiltration, remove excess skin and securely suspend the remaining skin for effective tightening. We recommend that you make an appointment with Dr. Nicolas Zwillinger to determine whether this combination is right for you.
What do WAL liposuction alone and facelift liposuction have in common?
Reviews :
Pre-operative (blood test, Doppler ultrasound and lymphoscintigraphy in some cases) and post-operative (blood test at D+7 and Doppler ultrasound at D+15) examinations remain the same. Lymphatic drainage of the operated areas is also recommended, although a minimum of 15 to 20 days should be allowed before the first session to avoid overloading the scars in the case of upper and lower limb facelifts.
Post-operative compression:
Compression sleeves must be worn during arm lifts (brachioplasty) combined with surgical treatment of lipedema by liposuction:
- day and night for a minimum of 2 weeks, ideally 4 weeks
then
- day or night for 2 additional weeks
In the case of a thigh lift (cruroplasty) combined with surgical treatment of lipedema by liposuction, the post-operative panty should be worn following the same protocol as for the “arm” area, in combination with class 3 compression tights for the first 10 days.
Compression is an essential element in the post-operative surgical treatment of lipedema, 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 facelift?
WAL liposuction of the lower limbs can be performed under spinal or general anesthesia, while cruroplasty is performed under general anesthesia. In fact, the operating time is longer when these two techniques are combined:
- 1h30 to 2h on average for WAL liposuction of the lower limbs
- 2h30 to 3h on average for WAL liposuction combined with curoplasty
Following the operation, walking is a little more difficult with cruroplasty. You need to be patient, and get up gradually. We advise patients to take their time and be well looked after in the first few days. It’s best to plan your first night at the clinic.
The scars left by WAL liposuction are small and inconspicuous, whereas thigh and arm lifts leave larger scars.
In the case of brachioplasty, the procedure lasts an average of 1? to 2 hours, and like liposuction of the upper limbs alone, it is performed under general anesthesia.
How to care for cruroplasty or brachioplasty scars?
It is important to have post-operative care (dressings) performed by a nurse once a day for 2 to 3 weeks. We advise patients to shower daily, without compression or dressing, from the day after surgery, if they feel able to do so. If not, they can wait 48 to 72 hours after surgery. Once the discharge has stopped, it is important to apply a healing cream (cicalfate, cicaplast…) to the scars, until they are completely healed. This can take 6 months to 1 year.
During the first 6 months, sun exposure should be avoided, and the area should be protected by wearing clothing, ideally, or at least by applying maximum UV protection (to be repeated every 2 hours).
To reduce surgical scars, it is possible to use the Fraxel laser. It is advisable to consult the dermo-aesthetician at Dr. Nicolas Zwillinger’s practice, in order to carry out a flash test and determine whether this technique is possible in your case. The first session should ideally take place 2 to 3 weeks after surgery, and be repeated once a month for 3 months. For further information on the Fraxel laser technique, please make an appointment.
In conclusion, lifting certain areas affected by lipedema (thighs or arms) may be necessary, due to poor skin elasticity or significant weight variation. In some respects, this procedure is considered “heavier”, but in the end it’s not that different from WAL liposuction alone.
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