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Evaluation and management of the fat leg syndrome.

Resource type
Authors/contributors
Title
Evaluation and management of the fat leg syndrome.
Abstract
LEARNING OBJECTIVES: After studying this article, the participant should be able to: 1. Discuss the initial evaluation of a patient presenting with lower extremity enlargement. 2. Distinguish underlying medical conditions causing lower extremity enlargement, including lymphedema and lipedema. 3. Discuss appropriate management and treatment for patients presenting with these conditions. BACKGROUND: Given the epidemic of obesity in the United States, many patients will consult the plastic surgeon with complaints of lower extremity enlargement secondary to "fat legs." In addition to cosmetic disfigurement, some patients may suffer from underlying medical conditions that are responsible for their symptoms. Knowledge of these other causes, including lymphedema and a disorder of abnormal fat deposition known as lipedema, ensures appropriate management and/or surgical treatment for affected patients. METHODS: Initial evaluation for lower extremity enlargement should include a discussion of pertinent medical history and a focused physical examination for findings that might indicate a pathologic underlying cause. When indicated, patients should undergo additional testing, including radiologic studies, to confirm their diagnoses. RESULTS: For those patients found to have lymphatic dysfunction, conservative management, such as massage therapy, use of compression garments, and limb elevation, should be initially recommended. Excisional or suction-assisted lipectomy may be considered in patients who fail conservative therapy. More extensive consultation with the plastic surgeon is recommended for patients seeking aesthetic improvement in contour and shape of large legs without a specified underlying abnormality. CONCLUSIONS: Patients with lower extremity enlargement may present to the plastic surgeon unsure of the specific cause of their deformity. A broad differential diagnosis exists for their presentation, which can be narrowed by using the common features and unique manifestations of the conditions.
Publication
Plastic and reconstructive surgery
Volume
119
Issue
1
Pages
9e-15e
Date
2007 Jan
Journal Abbr
Plast Reconstr Surg
Language
eng
ISSN
1529-4242 0032-1052
Extra
Place: United States
Citation
Warren, A. G., Janz, B. A., Borud, L. J., & Slavin, S. A. (2007). Evaluation and management of the fat leg syndrome. Plastic and Reconstructive Surgery, 119(1), 9e–15e. https://doi.org/10.1097/01.prs.0000244909.82805.dc