Lymphedem and Plastic Surgery

Hello everyone!! I hope you all had a great weekend and a great day today!! 
I hate to bug you guys and pick your brains, but you all have been so helpful in the past I wanted to see if anybody has anything on this subject.

Lymphedema and excess skin.

I have loss over 150lbs and have kept it off for 5 years. However back in 2007, when my weight was stabilizing, my legs started to swell out of no where. I went from doctor to doctor with no explanation and had every blood test, and acronym test you can find only to be told that nothing was wrong. But then I went to another Dr. outside of my network, he said that I had lymphedema because my blood pressure was high and that I need to take meds to control it. He sent me to a physical therapist, who massaged me and wrapped me for a week and in combination with that and the meds I immediately dropped 15-19lbs of fluid with in 2 weeks. I've been on the meds for the duration since then.

But I just noticed that I don't swell unless I don't get enough sleep and also it popped in my mind that I'm carrying around the weight in skin on a 5ft 5in frame of a whole other (plus-sized) person and would think that would have an effect on my circulatory system too. 
 I only posted this on this board to see if anyone had the same problem and were able to get insurance to approve plastic surgery because of this.

As usual your time, thoughts and suggestions are greatly appreciated,
Marie

Hi mantionette,

Plastic surgery in general puts a person at risk for lymphedema. Most surgeons post-op should provide compression garments for arms lifts etc. If you're just going for a tuck mostly you should be fine, at least I think so. The real answer is to get a consultation and address it with the surgeon. If he/she tries to bypass the subject I would find another surgeon.

Any kind of surgery that occurs around your lymp nodes and possibly damages them will put you at risk for lymphedema so it's imperative they address that.

Good luck,
Scott

Thanks Scott. Sorry it took so long for me to respond, it"s been a little hetic lately. I will follow up with my plastic surgeon but I think that it will go well as long as my primary Dr. stays involved from what I'm told.

Thanks for your help, Marie.

I will have to have plastics too when I have met my goal. My lymphedema Dr. is very supportive and  has told me to have the excess skin removed from my stomach and legs and arms to relieve the pressure on the lymphatic system down stream and prevent skin irritations that can cause infection.Not sure how much insurance will pay but know that breast reduction and pannectomy can be covered especially if you have irritations. So take pictures .  Inteerstingly my Dr. said as the fat goes so will the fluid and it is.I'm down 3 compression hose sizes in 6 mo.

Thanks for getting back with me on my issue Nanna Jean. And I want to say grats for you dropping those sizes< it does help. And you know I find it interesting that your Dr. said that about the plastic surgery being able to relieve some of the pressure off of the lymphatic system. I too believe in that greatly. I will bring this up with my plastic surgeon as well as my primary care physician as well. I will keep you posted as things progress in this for me. I'm going to request you as a friend if that's okay and keep the info line open.

Thanks for the insight and keep up your success, Marie

Good Luck Marie, I too was shocked at Dr. Moosa'scomment the first time I met him  I've had 4 surgeries on my stomach . Two vertical C Sections and the others  laproscopic. Usually you would avoid any further damage to the lymphatic system. Within a week of Aetna learning I had Lymphedema they approved revision from lapband to RNY.  The Dr. has been so pleased with my progress . He has shown me how to message in the shower my arms and legs to get better  shrinkage of the expanded tissue. Again he emphasized the need for me to stay hydrated and dry the folds completely to avoid rashes that cause cellulitis. I think if you have enough documentation they would know it would be cheaper to remove the skin versus the expense of infections and further treatment.

So it *is* possible to remove the excess skin from the legs after reaching goal from WLS?  I've often wondered that, as I have a pretty severe case of cellulitis in both my lower legs.

Thanks,
Helly

I have had great success wearing a compression garment I bought at the OH convention in Rye New York last October.  The company is call Lipo Express.  I got several custom long leg garments (Model 1610 with extended legs), I have been wearing them 24/7, and only remove it to shower and then put on a fresh one.  It is necessary to wash them after each use in order to avoid cellulitus.  Since wearing the garment I lost 40# of fluid and can now wear regular support hosiery to control the swelling. 

PS: My vascular doctor said that any cutting of the legs could cause a major non reversible flare up of the lymphedema as well as an acute case of cellulitis that could be very hard to stabilize.  Any plastic surgery needs to be done by someone with a lot of experience with lymphedema.  If they produce references of other lymphedema patients, find another surgeon.