Living with lipedema can mean years of discomfort, unanswered questions, or being told that changes in your body are simply related to weight. Care should start with something different: listening.
At InHands, licensed occupational therapists with specialized lymphatic training provide individualized lipedema therapy from our Los Gatos clinic, serving patients throughout San Jose, Silicon Valley and the greater Bay Area. Some patients come to us looking for help managing symptoms. Others have been asked to complete conservative therapy before lipedema surgery. Some are preparing for or recovering from a procedure. Wherever you are in that process, we start by understanding what you need.
Lipedema (also spelled lipoedema) is a chronic connective tissue disorder characterized by an abnormal accumulation and distribution of fat and connective tissue, most commonly affecting the legs, hips, buttocks and sometimes the arms. It occurs predominantly in women and may be associated with tenderness, pain, easy bruising, heaviness, swelling and changes in mobility or function.
Lipedema is not simply excess weight, and it presents differently from one person to another. So does the support that is appropriate. That is why we don't begin with a package or a predetermined number of appointments. We begin with an assessment.
Lipedema and lymphedema are different conditions, although a person can experience both.
Lipedema: Lipedema is a chronic connective tissue disorder involving an abnormal accumulation and distribution of fat and connective tissue, commonly affecting the lower body and sometimes the arms.
Lymphedema: Lymphedema involves an accumulation of lymphatic fluid related to impairment of the lymphatic system.
When clinically identifiable lymphedema develops in someone who also has lipedema, it may be referred to as lipolymphedema. Knowing the difference matters because the appropriate care may be different. If your symptoms suggest that additional medical evaluation is appropriate, we'll tell you.
No conservative therapy removes lipedema tissue or cures the underlying condition. We believe it is important to be clear about that. Conservative care can still be valuable. Depending on your symptoms, therapy may help address swelling, heaviness, discomfort, tissue restriction, mobility, compression needs and other functional concerns. Your care may include:
Care should have a reason behind it.
Your first visit is about 90 minutes and gives us time to understand what has been happening and what you hope to accomplish.
Your therapist will review your medical history, symptoms, diagnosis if you have one, previous treatment, compression use, functional concerns and goals. When appropriate, they may also evaluate swelling, tissue changes, movement, mobility and compression needs.
Then we talk about what comes next. That may mean conservative therapy to help manage symptoms, helping you prepare for surgery, or developing a postoperative plan. Sometimes it means recommending that you see a physician or another specialist before beginning therapy.
We won't recommend treatment simply because we offer it.
There isn't one standard treatment plan for lipedema. Your care at InHands is built around your symptoms, goals and medical plan, and it may change as your needs change.
Manual lymphatic drainage, or MLD, is a specialized hands-on technique used to support lymphatic flow. For some patients, MLD may be part of a broader conservative care plan, particularly when swelling or lymphatic involvement is present. It is not appropriate or necessary for every patient.
Compression may help manage symptoms for some people with lipedema, but finding the right garment and level of compression matters. Our therapists can provide compression education and help with garment selection or fitting when appropriate.
Treatment may also address tissue restriction, mobility, strength and other functional concerns. As occupational therapists, we look at how you are functioning as a whole rather than treating one symptom in isolation.
The care you receive between appointments matters too. We want you to understand what you can do at home, how to use compression appropriately, how movement may fit into your plan and when a change in symptoms deserves further evaluation.
Some surgeons and insurance plans ask patients to complete and document conservative management before lipedema reduction surgery. Those requirements vary. One patient may hear that they need a certain number of lymphatic therapy sessions. Another may be asked to complete several months of conservative management, use compression or meet entirely different criteria.
If your surgeon or insurance company has given you written requirements, bring them to your assessment. We'll review them with you, determine which services we can appropriately provide, and develop a plan based on your clinical needs.
When appropriate, preoperative care may include therapy, compression support, movement guidance, education, documentation of your visits and communication with your surgeon's office.
InHands cannot guarantee insurance coverage or authorization for surgery. Completing a specific number of appointments does not guarantee approval.
Planning lipedema surgery? Let's plan the care around it.
Not everyone does. There is no universal rule requiring every person with lipedema to complete 20 lymphatic drainage sessions before surgery.
Requirements may come from your surgeon, insurance carrier or individual health plan. Some insurers require documentation showing that conservative management has been attempted for a specified period of time before considering coverage for lipedema reduction surgery.
If you have been told that you need 20 sessions, bring the requirement with you. We'll help you understand what it asks for, what falls within our scope of practice and how we can appropriately support your care.
We won't recommend unnecessary appointments simply to reach a number.
Postoperative recovery is a core part of what we do at InHands, and your needs may change considerably as you heal. Our therapists include several Certified Cosmetic Surgery Therapists (CCST) with specific training in postoperative care.
When cleared by your surgeon and clinically appropriate, your care may include:
We follow your healing, your clinical presentation and your surgeon's preferences rather than applying the same timeline to every patient.
If you are traveling outside the Bay Area for lipedema surgery, we encourage you to arrange your local postoperative care before your procedure. That gives us time to understand your surgeon's preferences and have a plan waiting for you when you return home.
Lipedema can involve pain, swelling, connective tissue changes and functional limitations, and in some patients the lymphatic system is involved too. That deserves clinical care.
At InHands, lipedema and lymphatic care is provided by licensed occupational therapists. Each of our therapists also holds additional certification in lymphatic or postoperative therapy, such as Certified Lymphedema Therapist (CLT), Certified Cosmetic Surgery Therapist (CCST) or Manual Lymphatic Drainage (MLD) training.
Occupational therapists are trained to look beyond a single symptom. They assess how you move, function and manage daily life, adjust care as your needs change, work with compression, and recognize when something should be referred back to a physician.
When choosing someone for lipedema or lymphatic care, ask two questions:
Are they a licensed healthcare professional?
What specialized lymphatic training do they have?
You can read about each therapist's background on our Our Providers page.
Lipedema doesn't always fit neatly into one specialty. Depending on your needs, your care may involve a physician experienced in lipedema, vascular or lymphatic specialists, a surgeon, occupational or physical therapists, compression specialists or other healthcare professionals.
We don't try to replace those providers. We work alongside them. With your authorization, we can communicate with your physician or surgeon so that conservative therapy, surgical preparation and postoperative recovery feel like connected parts of the same plan.
You may be looking for help managing symptoms. You may have been handed a list of insurance requirements. You may be researching surgery, or you may already have a procedure scheduled and suddenly realize you need a recovery plan.
You don't need to know exactly what kind of therapy you need before you call us. That's part of our job. We'll start by understanding where you are, what you have been told and what you need from us. Then we'll help you determine the next step.
Lipedema Therapy in Los Gatos, Serving San Jose & Silicon Valley
Schedule a Lipedema Assessment | 408-827-4267 | 100 Los Gatos-Saratoga Rd.
It can be helpful for some patients, particularly when swelling or lymphatic involvement is present. Manual lymphatic drainage may be used as one part of a broader conservative care plan. It does not remove lipedema tissue or cure the condition.
No. Lipedema presents differently from person to person. The type and frequency of therapy should be based on your symptoms, clinical presentation and goals.
Conservative care may include compression, manual therapy, movement or therapeutic exercise, education and strategies for managing symptoms at home. An appropriate plan should be individualized.
There is no standard number that is appropriate for everyone. Treatment frequency should reflect your clinical needs and goals as well as any requirements from your surgeon or insurance plan.
Not necessarily. See "Do I Need 20 Lymphatic Sessions Before Lipedema Surgery?" above, and bring any written requirements to your assessment.
Some insurance plans do. Requirements vary by insurer and individual policy and may change over time. Verify your specific coverage and medical-necessity requirements directly with your insurance company.
We're not contracted with insurance companies, but we're happy to provide an invoice or treatment notes you can submit to your insurance for possible reimbursement. Many patients also use their HSA or FSA. We offer financing through Cherry as well, so you can spread payments out over time. Let us know if you'd like help with any of these.
No. Lipedema is diagnosed by a physician or other qualified medical provider. If you don't have a diagnosis, we can help you find a physician who evaluates lipedema. Our therapists can still assess your symptoms and function to determine whether therapy may be appropriate.
Yes. When appropriate, our therapists can provide compression education and assist with garment selection or fitting based on your individual needs.
Yes. With your permission, we can communicate with your surgeon or medical team regarding therapy, surgical preparation and postoperative care.
Yes. Postoperative care is a core part of InHands. Timing and frequency are individualized based on your procedure, your healing and your surgeon's preferences.
InHands provides lipedema and lymphatic therapy at our clinic in Los Gatos, serving patients from San Jose, Campbell, Saratoga, Los Gatos, Silicon Valley and throughout the greater Bay Area.
