Lipedema Surgery

What is lipedema?

Lipedema is a chronic medical condition characterized by the symmetric enlargement of the legs due to deposits of fat beneath the skin. It primarily affects women and is often misdiagnosed as simple obesity or lymphedema. It can also occasionally affect the arms.

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Characteristics of Lipedema:

  1. Fat Distribution: Abnormal accumulation of fat, primarily in the legs and sometimes the arms, but sparing the feet and hands, creating a "bracelet" effect at the ankles and wrists.
  2. Pain and Bruising: The affected areas are often tender or painful and may bruise easily.
  3. Progressive Nature: Lipedema is a progressive condition, meaning it worsens over time, especially without treatment. It often develops or worsens at puberty, during pregnancy, after gynecologic surgery, or around the time of menopause, which suggests a hormonal component to the disease.
  4. Symmetry: It usually affects both sides of the body symmetrically.
  5. Non-Pitting: Unlike lymphedema, lipedema is typically non-pitting, meaning it does not leave a dent when you press the skin.

Stages of Lipedema

Lipedema progresses through various stages characterized by increasing amounts of abnormally distributed fat and other changes in the skin and tissue. They are generally classified as:

Stage 1

The skin is smooth, but there is an increased amount of evenly distributed fat.

Stage 2

The skin becomes uneven, with fatty bulges, and there may be the development of lipomas (benign fatty tumors).

Stage 3

Large protruding fatty lobules lead to substantial deformity, and mobility can become increasingly limited.

Stages of lipidema


Diagnosing lipedema can be challenging because it is not widely recognized, and it shares characteristics with other conditions like obesity and lymphedema. A careful physical examination, patient history, and sometimes additional testing such as lymphoscintigraphy can help in diagnosing lipedema.


Insurance and Lipedema

A lot of insurance companies will cover lipedema, but the coverage will require a lot of discussion with the insurnace company as compared to other surgeries. This is because they will often deny coverage based on the labeling of the procedure as "cosmetic" and based on the relative recent introduction of lipedema as a recognized disease. For this, we recommend patients use a specialized patient-advocacy group that will take their case and help them submit to insurance. This is the most successful way to ensure that insurance covers the high costs of surgery. more information on the patient advocacy group, , can be found:

We will work with your insurance company after your get the services of to try to get your insurance covered. We cannot do it without their expertise, so we cannot directly obtain authorization for you unless you work with a professional advocate. We also accept self pay patients but we highly recommend, if you have insurance, to see if you can get coverage first.


Dr. Khalifeh and Lipedema

Dr. Khalifeh has been performing liposuction for many years, before lipedema became recognized. he often got patients with extremity pain and difficulty walking who he treated with liposuction over the years, and now he is committed to providing this helpful therapy to more lipedema patients. He attends conferences on the subject to provide patients with a high level of expertise. He offers both awake (smaller volume/staged treatments) and asleep in hospital (higher volume) treatments.

Dr. Khalifeh will be attending the First World Congress on Lipedema in Potsdam, Germany as he was invited there by the growing colleagues around the country that treat lipedema and who are involved in research on the subject.