What is lipedema?
Lipedema is a chronic and progressive disease characterized by an abnormal distribution of fat in the thighs, legs and hips. In some cases it can also affect the arms. This disease occurs bilaterally and symmetrically and mainly affects women.
It often tends to be confused with obesity, cellulite or swelling, which leads to many patients not having a correct and timely diagnosis for their condition and thus not being treated properly for years.
Lipedema fat is known to have different characteristics to obesity, as it tends to form subcutaneous nodules and is painful, while also having a very important inflammatory component associated with it. In addition to inflammation, genetic, metabolic and hormonal changes are also involved. Due to this hormonal influence, it is very common for symptoms to appear or worsen during puberty, pregnancy or the menopause.
It is therefore very important that you see a professional specializing in lipedema so that you can benefit from the best advice for your case.
WHAT CAUSES
OF LIPEDEMA?
Lipedema is a disease that has a strong genetic and hereditary predisposition, meaning that if a close member of your family has the condition, you are more likely to develop it.
In addition, there are some factors that can contribute to the development of lipedema, such as significant hormonal changes during puberty, pregnancy or the menopause.
Syntoma
Lipedema is a chronic disease, i.e. there is no cure, but it must be controlled to prevent it from progressing and the symptoms of the disease from increasing. The main symptoms of lipedema are
– Body disproportion due to excessive accumulation of fat in the extremities of the body;
– Pain and discomfort on touch and palpation;
– Feeling of tired and heavy legs and arms;
– Appearance of skin with an irregular texture, similar to cellulite, with fat nodules of different sizes;
– Frequent bruising;
– Decreased mobility.
Classification of lipedema
Lipedema can be classified into 5 types, according to the areas of the body involved:
Type 1: hips and buttocks
Type 2: hips, buttocks and thighs
Type 3: hips, buttocks, thighs and legs
Type 4: arms
Type 5: legs
In turn, each type is classified into different stages of severity. There are 4 stages that characterize the disease, according to the increase in accumulated fat, the increase in pain/discomfort and changes in the skin:
Image credit: American Journal of Case Reports
Stage 1: the skin looks smooth and soft. The fat nodules are only noticeable on palpation.
Stage 2: the skin has an uneven texture, similar to cellulite, and fat nodules of different sizes are apparent.
Stage 3: the fat nodules become larger, causing severe deformity of the limbs.
Stage 4: obstruction of the lymphatic channels occurs, causing lymphedema in addition to lipedema: lipolymphedema.
Lipedema diagnosis
The diagnosis of lipedema is based on the presence of certain clinical symptoms and a detailed physical examination, which assesses the distribution of body fat in the four limbs as well as the presence of subcutaneous nodules, ecchymoses and pain on palpation in the affected areas, among other characteristic findings of this pathology. It should be noted that lipedema never affects the hands or feet.
This disease is sometimes misdiagnosed, leading to ineffective treatment and causing a very negative impact on patients’ lives, both physically and emotionally. Lipedema is often confused with lymphedema, obesity or cellulite:
Lymphedema – Although there may be similarities in swelling, lymphedema occurs due to a blockage in the lymphatic system, whereas lipedema occurs due to a disproportionate accumulation of fat in the body.
Obesity – Obesity and lipedema are two different conditions and respond to different treatments. While an obese person responds to appropriate weight loss treatment and sees improvements in their condition, a person with lipedema will not achieve significant improvements with weight loss alone, but rather with a therapy plan appropriate to their condition.
Cellulite – While cellulite results from the deposition of fat under the skin, lipedema involves a disproportionate accumulation of fat nodules, which can vary in size.
Making an accurate clinical diagnosis is fundamental to ensuring appropriate and effective treatment. It is therefore very important that you seek out a professional specializing in lipedema so that a correct and timely diagnosis can be made and, from there, the treatment that best suits your particular case can begin.
Treatment
After diagnosing lipedema and assessing its stage of severity, an individualized treatment plan is designed for each patient.
Treatment involves a combination of surgical and non-surgical strategies and is based on a multidisciplinary approach, including Functional Nutrition, Dermatofunctional Physiotherapy and Plastic and Reconstructive Surgery.
Functional Nutrition: patients with lipedema have an underlying inflammatory process in the body, so it is essential to implement an anti-inflammatory diet. In patients with obesity (although this is a distinct pathology from lipedema) it is beneficial to reduce excess weight, as this will lead to a better quality of life. Physical activity is also important, as it will act as an anti-inflammatory by increasing blood flow and will lead to benefits in terms of the patient’s mobility and weight control.
Dermatofunctional physiotherapy: Specialized lymphatic drainage (pre- and post-operative) reduces edema and promotes lymphatic circulation, making it an essential resource in the treatment of patients with lipedema.
Liposuction: Liposuction is an invasive surgical procedure that removes fat from lipedema in the affected areas of the body. It involves inserting a cannula under the skin and suctioning out the accumulated fat. Lipedema-specific liposuction appears to be highly effective when all other conservative treatments have failed. More than one session may be necessary, depending on the amount of accumulated fat present.
With the right treatment, it is possible to delay the progression of the disease and significantly improve its symptoms in order to improve the patient’s quality of life.
Specialist Doctors
About
Dr. Marta Gouveia Duarte / Plastic Surgery
Member of The Portuguese Medical Association, Nº 57817
Graduated in Medicine from the School of Health Sciences of the University of Minho, where she completed her Master’s thesis in Human Aging.
She concluded her specialty in Plastic, Reconstructive, and Aesthetic Surgery at the Centro Hospitalar de Lisboa Central – Hospital de São José.
Collaborates in several research projects at NOVA Medical School.
About
Dr. Filipa Oliveira/ Plastic Surgery
PORTUGUESE MEDICAL ASSOCIATION: registration Nº. 59147, specialist in Reconstructive and Aesthetic Plastic Surgery.
Graduated in Medicine from the Faculty of Medicine of the University of Porto, where she completed her Master’s thesis on pediatric scars.
PhD in Medicine from the University of Münster in Germany.
After completing her specialty, she became a Senior Graduate Assistant (Oberärztin) at the Fachklinik Hornheide and the University of Münster. She is currently involved in various research projects at the University of Münster, where she is supervising doctoral students. She is also a regular correspondent for scientific and leisure magazines in Germany.
