Lipedema surgery: Questions answered by Dr. Josef Hadeed, MD, FACS
Dr. Josef Hadeed is a double board-certified plastic surgeon in Beverly Hills, California and Miami, Florida, and a verified practice in the Lipedema Central directory.
What do you wish patients had done before they walked in your door?
I wish patients would have gotten a real diagnosis and more answers to their questions earlier. However, the medical community often dismisses their concerns, so oftentimes there is a delayed diagnosis by the time they walk in the door and they present at later stages, which adds to the technical challenges of surgery.
What should a patient understand about insurance and paying for lipedema surgery before they start?
Insurance approval unfortunately remains difficult, even with documented symptoms and pictures showing the severity of the condition. What makes the approval process even more difficult and frustrating is the lack of a uniform standard between insurers. Some carriers view any liposuction as cosmetic-only, and other insurers want guarantees that the patient will continue with conservative treatments after surgery.
What makes someone a good candidate for lipedema surgery?
A good candidate for lipedema surgery is someone who has tried prior conservative treatments such as manual lymphatic drainage and compression garments, has realistic expectations that the surgery isn't a cure but rather a method to reduce symptoms, and is committed to the recovery and maintenance process.
What is the biggest misconception about lipedema in the medical community?
I think the biggest misconception is that lipedema is just obesity fat, and that it can be treated with lifestyle changes, diet, and exercise. In fact, part of the frustration that women experience is that they are told to "just lose weight" and are often dismissed for years by the medical community before they can get appropriate treatment.
What separates a surgeon who treats lipedema from one who does liposuction?
Liposuction for cosmetic reasons involves soft fatty tissue, whereas liposuction for lipedema involves treating tissue that is fibrotic, fragile, and vascular. The goal of cosmetic liposuction is an improved appearance to the treated area. The goal of lipedema liposuction is not only an improved appearance, but symptom reduction and functional improvement. A good lipedema surgeon will not debulk the extremity, but rather sculpt it.
Answers provided in writing by Dr. Josef Hadeed on September 17, 2026, and published with his permission. Dr. Josef Hadeed’s listing: Dr. Josef Hadeed on Lipedema Central.