I’m currently traveling, but I’ve found some down time somewhere between Nevada and Utah to answer some questions that someone asked in a blog post comment.
How old are you?
I’m currently 38 years old (turn 39 on Dec 10th) and I was first diagnosed with Lipedema in the fall of 2015 when I was 36 years old. So I spent a long time spinning my tail trying to figure out why the hell I couldn’t lose weight.
Where did you go for your surgery?
Since I live in the Netherlands (I’m actually duel American/Dutch and grew up in WA state USA) I choose a surgeon in the Netherlands. His name is Dr. Boonen and he operates in his Rotterdam clinic.
I was eyeballing some of the German surgeons when I had a consultation with Dr. Boonen and after consultation I knew he was the surgeon for me. He’s frank (and super “dutch” direct), doesn’t sugar coat anything, and really has the best for his patients in mind.
What’s better? TAL or WAL liposuction?
Ok, first lets talk about the difference between TAL (tumescent assisted liposuction) and WAL (water assisted liposuction). They’re BOTH tumescent based liposuction.
With TAL, the surgeon infiltrates the area he/she is working on completely with tumescent fluid and then does liposuction after the local anesthesia has set. This can be accompanied by tools such as a vibrating cannula (what my surgeon likes using). As with the actual liposuction varying from surgeon to surgeon, the method of infiltration can also vary.
Some surgeons like running all sorts of lines into the area they’re going to work on, making your body look like a cyborg. My surgeon uses the same cannula that he uses for liposuction, which also vibrates as he infiltrates so that it helps break up the fat.
Now, I haven’t had WAL but from my understanding there’s much less tumescent fluid pumped into the area (with TAL, it’s like a balloon). Then the surgeon uses a cannula that shoots a water stream into the limb to help break up the fat.
So the question becomes, which is better?
In my opinion, based on 2 years of research and reading over a hundred different outcomes (including my own experience), it seems that TAL performed by a surgeon who will do the entire calf/thigh at once (circumferential liposuction) gives the best outcome.
Which is more lymph sparing? WAL or TAL?
And that leads into this question, which is more lymph sparing. Personally, I think both types of liposuction are safe. There are ladies getting good results with both. However, WAL surgeons typically seem to be more focused on the pain relief and regaining mobility aspect vs. any sort of cosmetic result.
Also, in the right hands, both are “lymph sparing.” What really matters the most is having a surgeon that understands the body, understands where the huge lymph nodes are (you can never save them all since we have them all over the body), and understands just how aggressive they can be. Going to an experienced surgeon is so, so, so important so you can get the best care and the best possible outcome.
In the end, only you can decide on what type of surgery to choose and the surgeon you want to use. However, if you’re USA based, you might want to check how much surgeons cost in the EU (it’s actually much cheaper in Germany than the USA or UK) and then price air fare and hotel and see if you’d have to pay as much for a US based surgeon.
Of course, IF you can get your insurance to pay for it (and there are some cases of US ladies being successful), then you’ll have to choose in the states.
Regardless, my advice is to talk to whomever you can who has used the surgeon before you so you can ask questions and learn if the surgeon you’re thinking of is the surgeon for you.
PetraAnn
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pwtra, I had tumescent lipo. I can tell you that I did not have a bloody mess. I was out during the procedure. When I woke up the lymph therapist was doing Mld on open wounds. I never experienced anybif the pain ir all that leaking.
by the way, I had a tummy tuck done 2 years before my lipo on legs. I went to a Dr. in North New Jersey whom I loved. I had a breast lift and tummy tuck . I was very pleased. Is your abdominal fat from lipodema or obesity? Remember I am a nurse and not saying hurtful words. I continued with MLD for 2months 3xs a week after my legs. I was told to 2 weeks. I like to be thorough!!
The tumescent lipo I had was local only as anesthesia is not recommended for lipedema patients (I know a lot of surgeons do it so they can get out more, but I’ve also seen a lot more complaints about complications and the 3 common elements are general anesthesia, a lot of fat taken at once, and the wounds stitched).
The main reason the lipo was a mess is my surgeon doesn’t stitch the wounds. This allows the fluid to drain out and keeps swelling down. Those that are stitched seem to have less leakage and mess afterwards but like I said, more complications (again, this is just my observation after reading and talking to a lot of women the past 2 years).
The abdominal fat is pretty much all lipedema fat. The only place I can lose weight is my upper chest, breasts, neck back and face and there’s not much fat there. In fact I had my upper stomach rapidly grow in a period of 1.5 years after major burn out levels of stress, which now tells me it’s lipedema since when I’m stressed I exercise more and eat less.
Hi just a question about your lipo with Dr. Boonen. On his website the price list refers to per leg. Is it possible to have calves then thighs done or would I have to walk around with one slim and one fat leg? I live in Ireland so travelling to NL would be an easy option for me especially since I have an American expat friend living in NL for support 🙂
Hi Lorna,
It really depends on how much fat there is to take out.
For myself personally, I was a late stage 2 / early stage 3 so my legs were pretty big. My calves were almost 21.5 inches in circumference at their biggest and my thighs 36 at their biggest. So for my safety and so he could remove the most fat possible he split it up into a total of 3 surgeries. Both calves together then my left thigh and finally my right.
Meanwhile there was a dutch lady who posted on a group (as a patient of Dr. Boonen) towards the end of last year who had the same amount of fat taken out of her thighs together in 1 surgery as in 2. I kind of got a little miffed that I had to do my thighs in 2 and she got it in 1, then I realized after the swelling went down at about 8 months on both thighs, I have very well built and massive leg muscles from all my cycling and lifting weights (they measure 28.5 inches, might be 29 by now due to all of the leg presses and squats I’ve been doing). So it made it look like there was more fat than there really was.
Looking back, having each leg done separately wasn’t such a horrible thing. If you’re healing well and there’s no complications, he will do every surgery 6 weeks apart. By the time you get to 6 weeks, it’s just becoming noticeable that you have one huge leg and one much smaller. I think I had mine done with either 8 or 10 weeks a part because there was some concerts I wanted to go to. By then it was really noticeable but I personally don’t care what anyone thinks. If I did, I’d have done it at the 6 week mark but the concerts were more important!
When it comes down to it, the decisions Dr. Boonen makes about the surgery is always coming back to the safety of the patient. It’s not about a money grab (if he does it in one go you’d be paying 2x the cost of legs anyways) or to humiliate you in public. It’s all about getting as much fat out as possible in one go without having to resort to putting you under general anesthesia which he is adamant about not being safe.
Feel free to ask me any questions if you can’t find the answer here, the email is petra@whatislipedema.com.
Hi Petra
I live in South Africa..how do I go about making contact with Dr Boone..do I Email and send some pics of my legs and arms..does he do Skype consultations ?
Thank you so much for the info
https://www.polikliniekdeblaak.nl/
You’ll want to call or write them and see if they’re willing to see you! So far I don’t think his office has taken anyone outside of the EU. If they won’t, there are surgeons in Germany who are more set up for “surgery tourism”.