When  Coverlipedema.com first started working with lipedema patients in 2018, we did not know who treated the disease. A Google search then and even now reveals many “lipedema experts” whose only proper surgical training is a few weeks in Germany and on the job treating lipedema patients. This concerned us especially as we started talking to more highly trained and experienced plastic surgeons, including Dr. Karol Gutowski, who has treated fat disorders like lipedema for almost 20 years. We soon became convinced that a plastic surgeon was the best choice for lipedema surgery.

Plastic surgeons have the highest level of surgical training.

The medical training of plastic surgeons is one of the most rigorous in medicine. After four years of medical school, the additional training of plastic surgery residency is one of the most exclusive specialties that accepts only top graduates. It’s typically six years long and features comprehensive, integrated general and plastic surgery training. Additional training called fellowships can be done in areas such as microsurgery, hands, or body contouring. There is no other medical training that so well prepares a surgeon for the surgical treatment of lipedema than plastic surgery.

Non-plastic surgeons do not receive the same level of surgical training

In comparison, a medicine-based residency done by dermatologists, internal medicine, vascular specialists, OB/GYNs, and emergency room doctors is typically a four years residency that does not focus on surgical skills unrelated to their specialty. Plastic surgeons who have watched videos of non-plastic surgeons doing lipedema surgery, including some who have treated thousands of patients, have raised concerns about the quality of their skin excisions and their ability to maintain a sterile surgical field. Any physician who does not pursue the extensive training of a plastic surgeon is just not well prepared to be a lipedema surgeon.

There is no substitute for the training and experience of plastic surgeons

To be clear, the knowledge, confidence, and experience of residency, fellowship, and practice in cutting into a human body of a plastic surgeon make them more qualified to perform safe and effective lipedema surgery. The basis of plastic surgery training is reconstructing the body following the removal of disease. After their training, they continue to undergo vigorous oversight of their skills and continued education by the American Board of Plastic Surgery. Due to this board’s tenets, no plastic surgeon will remove more than five liters without overnight monitoring in an accredited or licensed facility.

It takes a special plastic surgeon to treat lipedema

Of course, we do not believe every plastic surgeon should treat lipedema. Of the 6,000 plastic surgeons in the United States, probably only a few hundred would be skillful and willing. We have found that university-based surgeons who treat cancer or lymphedema are less interested in lipedema cases and can be either over or under-aggressive. They do not have the body contouring background in liposuction that more aesthetic plastic surgeons do, especially those who have done post-weight-loss surgery. We also have seen them try to remove lipedema by large skin excisions leaving giant scars. If we do work with university-based surgeon, we prefer ones who do not make cancer the focus so their practice and have plenty of body contouring and weight loss surgery experience. We prefer to work with plastic surgeons in private practice or work at a hospital who are interested in lipedema and who have experience in large-volume liposuction and body contouring surgery. We also prefer to work with surgeons whose practice is generally successful, so they don’t have to treat lipedema as a business.