Arm Lifts and Bilateral Symmetric Lipomatosis

Cosmetic Question: I had an arm lift but the fat came back. I didn’t gain weight. What did the surgeon do wrong?

Cosmetic Answer:

Your surgeon may not have done anything wrong – you may have a condition called Bilateral Symmetric Lipomatosis (BSL, also called Madelung’s Disease).

In BSL, lipomas (fatty tumors) occur in specific body areas and are difficult to remove completely so they typically regrow. The most common areas are the upper back and the arms. In women, the fat does not appear in the neck. There is no test for BSL that can be done before surgery, although surgeons’ familiar with BSL will recognize the possibility that you may have it, if you have fatty tumors in both the upper back and the arms.

A second operation may be worthwhile. At times, the fatty tumor is completely removed and does not return, but it is unpredictable. The arms are more difficult to correct with a second operation than the upper back, because of the fat growing around important nerves and arteries.

BSL occurs in adult men and women, usually of European descent. It was well known in Europe long before it was recognized in the USA, but it is now part of modern medical students’ instruction. The cause is presumably genetic, and there is no outside cause known.

Until you know the diagnosis though, it can be extremely frustrating! Ask your surgeon to research the disease for you or see a plastic surgeon familiar with BSL.

We offer all cosmetic office and surgical procedures and cosmetic dermatology.

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Copyright E Morgan July 2014