Lipedema complicated by lymphedema of the abdominal wall and lower limbs

We describe a 52 year-old woman in whom lymphedema primarily of the abdomin al wall was superimposed on lipedema resulting in an abdomen of enormous di mensions with marked impairment of ambulation. Treatment consisted of preop erative compression of the legs by an external pneumatic device (Lympha-Pre ss) followed by excision of the lymphedematous abdominal fat pad in conjunc tion with "debulking" of the right leg. The patient illustrates the extreme s of lipedema complicated by lymphedema and the technical difficulties asso ciated with its management.