Some patients present with significant lipodystrophies in the thighs, calves and ankles which swell more and more. Weight loss treatments do nothing.
Our treatment is first an assessment:
A specific biology in micronutrition is mandatory to understand insulin resistance witch can cause obesity, and the ionic and protein losses that cause edemas, and the hormonal problems.
LymphoMRI to look for water infiltration and possible lymph node and/or lymphatic vessels hypoplasia.
Treatment :
The treatment is long term and is multidisciplinary.
- Micronutrition
- Liposculture, but, given the massive absorption of water, it is not recommended to do it under lipojet. On the other hand, in the event of hypoplasia, it will be done with the direct vision of the lymphatic channels after an injection of fluoresceine which will be captured by a lazer and which will allow the cannulas to be guided in safe areas to avoid destruction of lymphatic vessels.
- Lymphovenous derivations in case of ankle stasis
- Lymph node autotransplants in the knee or inguinal region, depending on MRI imaging.
Conclusion :
It is obvious that this pathology is far from simple, is multifactorial, and that the first diagnosis is essential. A simple liposuction will never solve the problem in the long term.
