My 12 month Lipoedema Surgery Journey
Hi, I’m Bel Hardman and this is my story from Lipoedema diagnosis in 2020 to completion of 4 surgeries between December 2021 – December 2022.
The Diagnosis
Like many of us with Lipoedema, I was diagnosed later in life at the age of 49 in August 2020. I know the Lipoedema was triggered at puberty and then again at pregnancy. I grew up believing that it was a family trait that the women in our family just have bigger thighs. It annoyed me but you just accept it, especially when you learn dieting does not work for Lipoedema fat.
My diagnosis ultimately came about due to a knee injury I sustained in 2018 where I tore the ACL in my left knee. I spent 6 months unable to walk properly, put nearly a stone in weight on which was not ideal as I was already overweight, could not bend or straighten my knee and had no answers despite seeing multiple consultants. That was until I was blessed to find Dean Attwood, my now friend & business partner who, at the time was a Physical Therapist & Biomechanics Specialist. He helped me to both rehabilitate my injured knee and gain my mobility back.
Over the next 18 months through my knee rehabilitation I lost 55lb and gained an immense love of walking in nature and the gym. But my weight loss hit a wall and I started to question why I wasn’t losing any weight off my legs or arms. In Jan 2020 I started researching and just a few months later I’d self-diagnosed Lipoedema stage 2/type 4, it was definitely in my arms and I’d later learn in full arms. With my research I called my GP who I’m very blessed to have a wonderful rapport with. As we were in the midst of the pandemic I was put off as it was not urgent enough for a face to face appointment. I called back 3 months later and managed to get an appointment with one of the locums who thankfully knew all about Lipoedema.
I was incredibly blessed as I know many of you with Lipoedema have to fight to get your diagnosis and sadly it’s often tainted with medical gaslighting and fat shaming. The locum GP agreed, stage 2 / type 4. I know many of us experience differing emotions when we receive our official diagnosis, I guess I already knew in my heart so receiving a diagnosis was such a relief and I felt so much self-compassion, everything made sense and I knew I was not to blame entirely for the shape of my body or this condition.
The Decision – Complementary Therapies or Surgery
As I had started to research about Lipoedema eight months prior to receiving my official diagnosis, I had also looked into my options on how to manage this best for me and my future goals. I do appreciate surgery is not an option for everyone due to the cost, family or work commitments or other health issues. I did consider complementary therapies only and started with compressions however I was already doing many of these like regular exercise, dry brushing, eating an anti-inflammatory diet and restricting foods that cause me issues like gluten, dairy and refined sugars. I’d been following this lifestyle since 2015 when I was diagnosed with Fibromyalgia. It has served me and my health incredibly well as by late 2018 I’d reversed all Fibro symptoms.
Despite losing weight and taking care of myself I could still see the Lipoedema growing on the tops of my thighs which really concerned me. In addition to this was my age, at 50 in early 2021 and not yet menopausal I knew from speaking to many other ladies with Lipoedema that I would likely progress to stage 3 during menopause. This was concerning for me as I’d worked incredibly hard to gain and hold onto my mobility after reversing Fibro & rehabilitating my knee, I did not want to now risk losing my mobility to Lipoedema. It was for these reasons I decided surgery was the right choice for me.
Despite deciding on surgery, I do not view it as a cure, it’s simply a way to manage the Lipoedema. Current research tells us Lipoedema is a genetic based condition therefore I will need to continue with the complementary treatments I currently practice, including a healthy diet & lifestyle to ensure I do not trigger the Lipoedema. Now to find a surgeon.
Choosing a Surgeon
I’d spent about 20months researching into Lipoedema surgery, surgeons, differing methods of surgery and anaesthesia. This process was made so much easier thanks to the wonderful Maria Kokkinau Boege who runs the Global Lipoedema Awareness - Surgeries/Doctors group on Facebook. There are over 20,000 women worldwide with Lipoedema on this group which provides a wealth of information & support for those seeking surgery. Most important to my surgeon research was the Excel spreadsheet Maria has created which lists approved surgeons from around the world.
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I started by going through the Excel list, creating a short-list and researching the differing methods, WAL (Water Assisted Liposuction), PAL (Power Assisted Liposuction & Vaser along with locations, requirements and of course costs. I had considered two UK surgeons however due to my needs with full arms and the costs here, I decided to look at Europe. I was in talks with two and eventually consulted with Dr Johanna Schreiber from Berlin in Sept 2021. I think those of you who have chosen your surgeon just know when you click. Dr Schreiber was incredibly caring, patient, kind, skilled and has a passion for Lipoedema, not just surgery but education. |
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Her approach meant I would need 4 surgeries which was 1 more than I was advised by another clinic but it felt right for my stage and it felt very thorough. I was blessed that I was able to book my first surgery with Dr Schreiber for December 2021 as her diary was open due to recently returning from maternity leave. Planning for surgery begins.
Deep Oscillation Machine
Thinking about my post-surgery recovery I was keen to purchase a personal Deep Oscillation Machine. I’d already seen the benefits of D.O as I’d had 3 treatments over a 4 week period to my upper arms just before my diagnosis. I was surprised in that time I lost 3cm circumference in each arm. This further confirmed my belief I had Lipoedema but also just how effective the D.O is in moving lymph. I’d also received D.O treatments for my knee injury so was aware of its ability to assist with inflammation & bruising so I contacted Mary and arranged the purchase and follow up training with Julie. The D.O has been a worthwhile investment as it’s not just used by myself but my entire family uses it for strains and injuries. If purchasing is not an option, PhysioPod also hire these so do get in touch with Mary.
Planning – Travel
With 3 months to plan before my first surgery I again hit the Global Lipoedema Awareness - Surgeries/Doctors Facebook group to get advice from those who have travelled this path before me. Booking flights, airport assistance, what to take into the clinic and what to expect pre and post-surgery. For all flights we travelled with Ryanair and for 3 of the 4 surgeries we stayed in the same serviced apartment in Berlin. This was important to me as it had a full kitchen with washer / dryer allowing you and your companion to cook and cater for yourselves without the need to go out or order in.
Surgery One – December 2021 - Full Arms & Arm Lift
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I decided to get an arm lift performed at the same time as my liposuction. There are differing opinions on this but personally for me this was the right decision due to my age and the amount of weight I had already lost. I also did not want to have to undergo a 5th surgery just for the lift and it was obviously more cost effective to do them together. Recovery from this surgery was challenging, I struggle with low blood pressure at the best of times but post-surgery I really hit lows but Dr Schreiber and the clinic staff were so amazing and caring. The swelling was also quite high, especially surprising was how much my hands swelled. I had 2.8ltrs of Lipoedema fat removed from both arms and skin removal of 7cm width at the widest point, again confirming this was the best decision for me. I made the mistake of not booking airport assistance at Berlin after this surgery, considering the walk from check-in to boarding is about 20mins, I did not repeat that mistake again. |
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Surgery Two – February 2022 - Lower Legs
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I was really keen for this next surgery as I had incredibly firm lower legs and suffered sock cuffing on my upper ankles. Surgery went very well. I had 5.1lts removed and could instantly see the benefits. True to form I suffered with very low blood pressure and needed to stay in the clinic a further night. For me personally the recovery from lower legs was the easiest physically however I did suffer a complication on return which had me in A&E |
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just 5 days later because my haemoglobin levels had dropped from 137 pre surgery to 60. I was given two EPOs (Erythropoietin Injections) and an Iron Infusion to kick start red blood cell production. Thankfully these treatments worked and I was sent home the next day. Within 5 weeks my haemoglobin was up to 148, so no long-term issues.
After I reported my complication to Dr Schreiber she phoned me immediately after consulting with her team including the anaesthetist and spent time calming my concerns and discussing in great detail options with regards my future care. I was concerned as my next planned surgery was May 2022 so we decided together to cancel that, and what was due to be my 4th surgery in July became my 3rd and we booked the 4th surgery for December 2022. I was so much happier with this new plan as I truly felt I needed a longer recovery time.
Surgery Three – July 2022 - Front Upper Legs, Mons Pubis, Belly & Hips
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Having extended the date to give myself more recovery I was in such a better state physically & emotionally for this surgery. My thighs were showing the classic forward Lipoedema bulge and the right side was looking a little larger so I was so excited for this surgery and the subsequent results. There was also a huge mental relief knowing that after this surgery I would be 75% completed on this journey. Dr Schreiber was so calming and always put me at ease. In this surgery I had 5lts removed and could see instant results in |
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my thighs and belly. Again, my blood pressure dropped to a new low of 77/44 and I had to be kept on bed rest and had an extra night in the clinic. I personally have never had issues with excessive pain, however with this surgery my upper thighs were proving the most painful of all my recoveries. That said I’ve only ever needed Paracetamol but I will say surgery, compressions, travel and general recovery is very uncomfortable. My best advice is don’t expect to be comfortable, and expect everything to take 4 times as long as it normally would. You just need to be patient with yourself and this process, but it will be worth it.
Surgery Four – December 2022 - Back Upper Legs, Hips, Chin + Revisions
This being my final surgery felt very emotional. Dr Schreiber was now working with a new clinic, the Meoclinic in Berlin which is like a 5* hotel. I had a 1hr 45min pre surgery consult the day before my Monday surgery with Dr Schreiber which was wonderful, it was so relaxed and all my questions were answered. Being my final surgery, Dr Schreiber said we need to look at all my concerns and possible revisions to ensure I’m completely happy with the outcome. So in my revisions I had a little liposuction on my belly, midriff & bra bulge and Dr Schreiber suggested some revision to my upper & lower knees which I welcomed as pre surgery my knees were one of my biggest concerns, especially as I love walking. I also needed some scar revision on my arm lift which currently at 5 weeks post-surgery looks and feels amazing. I had a total of 3.8lts removed in this surgery and could feel the difference immediately and I’m looking forward to improvements as swelling reduces.
Yet again I hit a new low for my blood pressure at 64/28, the Meoclinic doctors & nurses were very caring and strongly suggested I have a bottle of Coke to improve my blood pressure. Now I mentioned earlier that I went refined sugar free for my health so I think it’s been 10+ years since I’ve had a Coke, not my first choice but I drank it and my BP was up at 107/53 the next day. So, Coke for medicinal purposes, who knew! Again 2 nights at the clinic then back to our apartment for the next 36hrs before the flight home.
Recovery Overview
My recovery time for most of the surgeries was around 2-4 weeks to get back to my normal routine. Post-surgery swelling has taken up to 4 months to completely reduce so compressions and movement are key. Post-surgery recovery is absolutely a team effort so I must thank those who have helped me in this process. Sue Hansard from First Lymph Care who took care of me from Nov 2021 to Oct 2022 and Tina Portman from House of Treatments, both use Deep Oscillation in their treatments. MLD post-surgery is vital and the time and cost for this treatment must be added in because there is no point having surgery and not taking care of yourself afterwards. My compression nurse Mel Cotterill from the lymphedema clinic at Katherine House Hospice has also been so helpful. Of course my family and friends have helped immensely both physically & emotionally, I am forever grateful for their support as a good support network assists in your recovery.
As I type this I am 5 weeks post my final surgery and am doing really well. Bruising has gone, I’m still tender especially when sitting and swelling is still evident. This was by far the easiest surgery as I was the most coherent and mobile of all the surgeries. I do feel this is in part to feeling an element of relief that I have completed this process and mentally & emotionally I feel so much more relaxed knowing that for 2023, my body & my health are fully back in my hands.
In hindsight I believe I was heading towards stage 3 and looking back on my pre surgery pictures I feel I may have been developing lipo-lymphedema in my right leg, so I’m even more grateful I chose surgery.
Current Improvements & 2023 Health Goals
The physical benefits have been noticeable since the very first surgery. My arms and legs are so much lighter, I don’t physically tire just drying and styling my hair. Walking is easier and with less bulk around my knees my gait feels more fluid and most important, no more pain in my legs. I also noticed after both surgery 3 & 4 this further freed up fluid from around my ankles. This was also evident with the chin liposuction I just had done in my 4th surgery, it was more about the blockage of lymph than the actual quantity of Lipoedema that was removed.
In terms of measurements I have seen the following reductions –
Ankles – 5cm
Calves – 8cm
Upper Knee – 11cm
Thighs – 9cm
Belly – 6cm
Wrists – 1cm
Forearms – 3cm
Upper Arms – 7cm
Total of 16.7Ltrs of Lipoedema removed
My main motivation for surgery was my mobility so in 2023 my aim is to get back walking, I’m blessed to live near an 'Area of Outstanding Natural Beauty'. I also aim to get back to the gym hopefully in the next 2 weeks to start strength training and my ultimate goal this year is to climb Snowdon. I’d be more than happy to report back here in 6 months with an update as I know my measurements will improve once swelling has reduced and my fitness has increased. I will then be able to share full before & after pictures.
Resources for Lipoedema
I’m really keen to raise awareness of Lipoedema to help others manage it in the best way possible for themselves. My goal is to create a website which aims to list many resources for those with Lipoedema around health, diagnosis, surgery, new research and for sharing your stories. If you would like to know more or would like to share your story please contact me here.
Since starting my Instagram pages I’ve met so many wonderful strong women with Lipoedema and I’ve seen how it’s affected so many of us, not just physically but mentally and emotionally. It is for this reason I’m using my personal experience & skills as a Life Coach to create a Self-Acceptance & Love Programme to support Lippy Ladies to embrace self-acceptance, self-love and much more. This is a 12 week group programme and I am offering the first cohort launch group to the Lipoedema community completely free of charge. There are limited places so if you feel you would benefit from this programme please get in touch with me here for more details.
If anyone has questions about Lipoedema, health or surgery please feel free to ask, I’m always happy to help.
Lastly I wish to mention that my wonderful surgeon Dr Johanna Schreiber will be hosting a Lipoedema Info Event in London late April, (dates to be announced). This is not just about surgery, it’s about education & support with the aim to bring together therapists, compression experts and more. Please get in touch with me here if you wish to receive more details.
Follow me on Instagram - @lipedema.facts & @healfibromyalgia
Written by Bel Hardman
Stress, Burnout & Resilience Coach at
and
Owner and Director of Integral Workplace Wellness - a Mental Health Support & Training Company that specialises in Staff & Business support for SME’s - www.integralworkplacewellness.com
