What is lipedema?
O Lipedema is a chronic and progressive disease which is characterised 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.
Tende to be confused, often, with obesity, cellulite or swelling, As a result, many patients do not receive a correct and timely diagnosis of their condition and are therefore not treated properly for years.
Lipedema fat is known to have different characteristics to obesity, as it tends to form subcutaneous nodules and is painful, It also has an associated inflammatory component quite important. 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 seek out a professional specialising in lipedema so that you can benefit from the best advice for your case.
WHAT ARE THE CAUSES
LIPEDEMA?
Lipedema is a disease that has a strong genetic and hereditary predisposition, In other words, if a close family member has the condition, they 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 at puberty, pregnancy or menopause.
Symptoms
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 the excessive accumulation of fat in the extremities of the body;
• Pain and discomfort by touch and palpation;
- Feeling of tired and heavy legs and arms;
- Appearance of uneven skin texture, similar to cellulite, with fat nodules of different sizes;
- Frequent occurrence of haematomas;
- Decrease in mobility.
Classification 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
Types 3: hips, buttocks, thighs and legs
Type 4: arms
Type 5: legs
In turn, each type is categorised into different stages of severity. There are 4 stages that characterise the disease, depending on the increase in accumulated fat, the increase in pain/discomfort and changes in the skin:
Image credit: American Journal of Case Reports
Stadium 1The skin looks smooth and soft. Fat nodules are only noticeable on palpation.
Stadium 2Cellulite: the skin has an uneven texture, similar to cellulite, with fat nodules of different sizes appearing.
Stadium 3fatty nodules become larger, causing severe deformity of the limbs.
Stadium 4Lymphedema: obstruction of the lymphatic channels occurs, causing lymphedema in addition to lipedema: lipolymphedema.
Diagnosis Lipedema
The diagnosis of lipedema is based on the presence of certain clinical symptoms and in a detailed physical examination, in which the distribution of body fat in the four limbs is evaluated, as well as the presence of subcutaneous nodules, bruising, Lipedema can also cause pain on palpation of 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 treatments and causing a very negative impact on patients' lives, both physically and emotionally. Lipedema is often confused with lymphoedema, obesity or cellulite:
Lymphoedema - Although there may be similarities in swelling, lymphoedema occurs due to a blockage in the lymphatic system, while 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.
Realise a precise clinical diagnosis is essential to ensure proper and effective treatment. It is therefore very important that you seek out a professional specialising 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
Once lipedema has been diagnosed and its stage of severity has been assessed, the following is outlined individualised treatment plan 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 Nutritionlipedema patients 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 PhysiotherapySpecialised lymphatic drainage (pre- and post-operative) reduces oedema 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 required, 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.
Medical Specialists
About
Dr Marta Gouveia Duarte/ Plastic Surgery
DOCTORS' ASSOCIATION: registration no. 57817, specialising in Reconstructive and Aesthetic Plastic Surgery.
Graduated in Medicine from School of Health Sciences, University of Minho, where she completed her Master's thesis in Human Ageing.
He completed his speciality in Plastic, Reconstructive and Aesthetic Surgery at the Centro Hospitalar de Lisboa Central - Hospital de São José.
He collaborates in various research projects in NOVA Medical School.
About
Dr Sara Carvalho / Plastic Surgery
DOCTORS' ASSOCIATION: registration no. 60781, specialising in Reconstructive and Aesthetic Plastic Surgery.
Licensed by Lisbon Medical School. He completed his speciality in Reconstructive and Aesthetic Plastic Surgery at the Centro Hospitalar Lisboa Central - Hospital de São José.
She has taken various courses in aesthetic and reconstructive surgery of the breast and aesthetic surgery of the face.
She is currently a member of the clinical staff of the Reconstructive and Aesthetic Plastic Surgery service at the Centro Hospitalar Lisboa Central, where she excels in the areas of Breast Reconstruction, Body Contouring and Post-Bariatric Surgery, Paediatric Plastic Surgery, Trauma and Burn Surgery. She works as a hospital assistant, is a training supervisor and is responsible for Safe Surgery at the institution.
About
Dr Filipa Oliveira/ Plastic Surgery
DOCTORS' ASSOCIATION: registration no. 59147, specialising in Reconstructive and Aesthetic Plastic Surgery.
Graduated in Medicine from Faculty of Medicine, University of Porto, where she completed her master's thesis on paediatric scars.
She holds a doctorate in medicine from the University of Münster in Germany.
After completing her speciality, she became a Senior Graduate Assistant (Oberärztin) at the Fachklinik Hornheide and the University of Münster. She is currently collaborating on 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.
