Lymphedema & Lipedema

What Are Lymphedema and Lipedema?

Lymphedema

A chronic condition where lymph fluid builds up, causing swelling, discomfort, and skin changes. It often occurs after:

  • Cancer treatment (lymph node removal).
  • Surgery or trauma damaging lymph vessels.
  • Infections (e.g., cellulitis).
  • Genetic disorders (primary lymphedema).

    Lipedema

    A fat disorder that causes abnormal fat deposits in the legs, thighs, and arms, often leading to:

    • Painful, swollen legs (even with diet/exercise).
    • Easy bruising.
    • Disproportionate lower body (smaller waist, larger legs).
    Rick Pittman, MD, FAAD

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    Dr. Rick Pittman, MD, is a board-certified specialist in venous and lymphatic medicine and one of the Pacific Northwest’s most respected vein experts. With 40+ years of experience and 50,000+ procedures performed, Dr. Pittman has transformed the lives of thousands of patients through minimally invasive, highly effective treatments.

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    Symptoms of Lymphedema & Lipedema

    Symptom Lymphedema Lipedema
    Swelling Starts in feet/ankles, progresses upward Starts in hips/thighs, spares feet
    Pain/Tenderness Mild to severe Often painful to touch
    Skin Texture Thick, hardened (fibrosis) Soft, dimpled (“orange peel”)
    Bruising Rare Frequent
    Symmetry Often one-sided Usually symmetrical
    Response to Diet/Exercise No improvement No improvement

    Causes & Risk Factors

    Lymphedema

    • Primary lymphedema (genetic, present at birth or develops later).
    • Secondary lymphedema (caused by damage to lymph nodes/vessels):
      • Cancer surgery (e.g., mastectomy, lymph node removal).
      • Radiation therapy.
      • Infections (e.g., cellulitis).
      • Trauma or injury.

    Lipedema

    • Genetics (runs in families).
    • Hormonal changes (often starts during puberty, pregnancy, or menopause).
    • Female sex (rarely affects men).

    Treatment Options

    While there is no cure for lymphedema or lipedema, we offer effective treatments to manage symptoms, reduce swelling, and improve quality of life.

    1. Compression Therapy
      • How it works: Graduated compression garments (20-40 mmHg) reduce swelling and improve lymph flow.
      • Best for: Early-stage lymphedema, maintenance therapy.
      • Insurance Coverage: Covered under the 2024 Lymphedema Treatment Act (3 sets of daytime garments every 6 months, 2 sets of nighttime garments every 2 years).
    1. Pneumatic Compression Devices
      • How it works: A sequential compression pump massages the legs to move lymph fluid.
      • Best for: Moderate to severe lymphedema, lipedema.
      • Insurance Coverage: Covered by most insurers as Durable Medical Equipment (DME).
    1. Manual Lymphatic Drainage (MLD)
      • How it works: A gentle massage technique performed by a certified therapist to stimulate lymph flow.
      • Best for: Mild to moderate lymphedema, post-surgical swelling.
      • Insurance Coverage: Sometimes covered (check with your provider).
    1. Liposuction for Lipedema
      • How it works: Tumescent liposuction removes abnormal fat deposits while preserving lymph vessels.
      • Best for: Advanced lipedema (when compression alone isn’t enough).
      • Insurance Coverage: Rarely covered (considered cosmetic).
    1. Skin Care & Infection Prevention
      • How it works: Moisturizing, gentle cleansing, and wound care to prevent infections (e.g., cellulitis).
      • Best for: All stages of lymphedema/lipedema.

    When to See a Vein Specialist

    Schedule a consultation if you experience:

    • Persistent swelling in your legs, arms, or abdomen.
    • Pain or heaviness that interferes with daily activities.
    • Skin changes (thickening, hardening, or infections).
    • Difficulty fitting into clothes due to disproportionate fat deposits.
    • Frustration with diet/exercise not improving your symptoms.

    Insurance Coverage for Lymphedema & Lipedema

    Thanks to the 2024 Lymphedema Treatment Act, Medicare and most insurers now cover:

    • 3 sets of daytime compression garments every 6 months.
    • 2 sets of nighttime garments every 2 years.
    • Pneumatic compression devices (as Durable Medical Equipment).

    Lipedema treatments (e.g., compression, liposuction) may not be covered unless complications (e.g., lymphedema) arise.
    Questions about coverage? Call us—we’ll help you navigate your benefits.

    Next Steps

    Schedule a consultation

    with our lymphedema specialists

    Undergo a thorough evaluation

    (including measurements and imaging if needed).

    Receive a personalized treatment plan

    to manage your symptoms.

    Ready to take the first step?

    Call Us to book your appointment today!