Preoperative Routine Cold-water Immersion for Lipedema Reduction Surgery

Abstract

Routine cold-water immersion (CWI) is typically suggested to reduce inflammation, a hallmark property of lipedema. Lipedema is a connective tissue disorder with a genetic component that presents with a disproportionate distribution of nodules in the extremities. This case report explores the impact of routine CWI on the effectiveness of lipedema reduction surgery (LRS) and manual lipedema extraction, as part of the SMiLE technique (softening, mobilization, liposuction, and extraction). A 59-year-old woman with lipedema presented for LRS of the anterior legs. In the prior 5 months, the patient engaged in daily CWI. During LRS, there was a remarkable amount of lipedema nodules readily extracted compared with a typical patient. The patient's 5 months of routine CWI resulted in improved quality of life and decreased lipedema symptoms, and may have contributed to the quantity and ease of nodule extraction during LRS.

Fig. 1.

Images showing the patient’s legs before and after surgery. A, Before lipedema reduction surgery using the manual lipedema extraction technique. B, Six weeks postsurgery, after significant lipedema tissue removal, which had previously caused increased leg size and heaviness.

Fig. 2.

Images showing the patient’s left leg before and after liposuction and manual lipedema extraction. A, The patient’s leg immediately before. B, Images of the patient's left leg immediately after, demonstrating tissue reduction.