An increased awareness of lipoedema has led to more patients seeking surgical treatment. Lipoedema is a challenge to manage surgically and usually involves a staged approach. I will discuss my approach to make a challenging surgical problem surmountable with practical tips and how I mitigate the risk of complications and manage expectations.
Lipoedema is a progressive, painful condition affecting the legs, arms, lower abdomen and buttocks of around 10% of women. The fat deposits are metabolically resistant to traditional methods of weight loss. Left unchecked it can limit mobility and has significant morbidity. Lipoedema is not a recognised medical condition in Australia. Management is multi-disciplinary and conservative measures need to be employed prior to water assisted liposuction, which is recommended. I share my 10 year experience and recommendations in treating this common condition.
Galaflex mesh is a biopolymer - poly-4-hydrobutyrate - P4HB that dissolves over a 18-24 month period leaving an internal bra collagen scar. It is reported to have a lower complication rate than ADM. it does not yet have TGA approval and needs case by case approval. I have been using it now for 3 years in both primary and revision cases. I present a balanced view, my current indications for use and some technical tips I’ve learnt from its use.