During Lipedema Awareness Month, Dr. Karen Herbst sat down with Dr. Patrick Greaney, a double board-certified plastic and reconstructive surgeon specializing in lipedema, lymphedema, microsurgery, and complex reconstruction. The discussion explored current surgical approaches, the emerging role of GLP-1 medications, and exciting developments shaping the future of care.
Dr. Greaney reflected on how dramatically awareness of lipedema has improved over the past 15 years. More patients are arriving with a diagnosis, a greater understanding of the condition, and referrals from knowledgeable physical therapists. However, many patients still have not been introduced to foundational therapies such as compression, manual lymphatic drainage, and exercise.
Dr. Greaney emphasized that lipedema surgery is never “one-size-fits-all.” Surgical planning is individualized based on:
- Disease stage and severity
- Distribution and volume of affected tissue
- Patient age and overall health
- Existing medical conditions
- Functional limitations
While liposuction remains the primary surgical intervention, treatment often requires a staged approach, with some patients undergoing multiple procedures over several months to achieve optimal outcomes safely.
Fibrotic tissue is a significant component of lipedema and contributes to pain, heaviness, and impaired mobility. Dr. Greaney noted that a substantial portion of surgery is devoted to carefully breaking down and removing fibrotic tissue. Successful reduction of fibrosis can lead to meaningful improvements in movement and quality of life.
For patients who develop secondary lymphedema alongside lipedema, Dr.Greaney utilizes advanced diagnostic tools, including ICG (Indocyanine Green) lymphatic imaging and bioimpedance spectroscopy. When imaging identifies bypassable lymphatic obstruction, lymphovenous bypass (LVA) may be considered as part of a comprehensive treatment plan.
Dr. Greaney believes the future of lipedema and lymphedema care will combine:
- Advanced surgical techniques
- GLP-1 and peptide-based therapies
- Improved imaging technologies
- Better understanding of lymphatic biology
- Personalized, multidisciplinary treatment plans
His outlook is optimistic, particularly as new research continues to explore the intersection of inflammation, metabolism, adipose tissue, and lymphatic function.
Dr. Herbst noted Lympha Press’ commitment to the lipedema community, including advanced pneumatic compression therapy solutions and content to support both patients and clinicians. Find out more at lymphapress.com.
This Roundtable was originally recorded live on June 1, 2026. The views and opinions expressed in this program are those of the speakers and do not necessarily reflect the opinions or positions of Lympha Press. The content is for educational purposes only and not intended as medical advice.
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