What Is Lipedema?
Lipedema is a condition that causes excess fat to accumulate in an irregular manner beneath the skin. Lipedema typically affects the thighs, calves, and buttocks. The upper arms may also be impacted. The hands and feet are usually unaffected by the condition.
Women are mostly affected, up to 11 percent of women may have lipedema. There are, however, a few reports of it occurring in males. Although it starts as a cosmetic issue, it eventually has the potential to lead to pain and other issues. It is possible to confuse lymphedema (swelling due to accumulation of lymphatic fluid) or common obesity with lipedema. However, lymphedema can develop as a result of lipedema. Due to low public awareness of the condition, lipedema can also cause emotional distress in addition to physical discomfort.
What Are the Types of Lipedema?
Medical professionals divide lipedema into five categories based on where it occurs in the body.
-
Type I: The fat accumulates between the belly button and the hips. It frequently covers the buttocks and pelvis.
-
Type II: The fat accumulates below the knees and around the pelvis.
-
Type III: The fat starts at the pelvis and extends to the ankles. This stage can result in an obvious fat cuff at the ankle.
-
Type IV: The fat extends from the wrists to the shoulders.
-
Type V: The calves are primarily where the fat is located.
Some individuals have a mix of types, most frequently Types II and IV or Types III and IV. Type V is very uncommon.
What Causes Lipedema?
There is no known cause for lipedema. However, the condition can be inherited and runs in families. The condition almost exclusively affects females and typically begins or gets worse during puberty, pregnancy, or menopause. This indicates that hormones are probably involved. Although obesity does not directly cause lipedema, it is present in more than half of patients. Dieting may result in weight loss in the upper body without affecting the lipedematous regions.
What Are the Signs and Symptoms of Lipedema?
Lipedema signs and symptoms include:
-
Accumulation of fat in the upper arms, thighs, calves, and sometimes the buttocks. Support stockings, elevating the legs, and diuretics do not affect the affected areas. In most cases, there is no swelling in the hands or feet unless the patient has lymphedema or chronic venous insufficiency.
-
Pain.
-
Lipedema can hinder the patient’s ability to walk as the condition worsens.
-
As the lower body swells, many lipedema patients experience emotional symptoms like embarrassment, anxiety, and depression.
-
As more fat builds up over time, it may eventually block the lymphatic system. As a result, lymph fluid accumulates. Secondary lymphedema or lipo-lymphedema are two terms for the condition.
How Is Lipedema Diagnosed?
Clinical examination results and a patient's unique symptoms help doctors identify lipedema. They might inquire about a person's symptoms and health background. They might inquire about a person's family's medical history as well. An ultrasound or an MRI (magnetic resonance imaging) scan are examples of imaging methods that a medical professional might recommend to rule out other conditions with comparable symptoms.
To identify lipedema, medical professionals use the criteria listed below:
-
Symmetrical fat deposits on both legs are a sign of lipedema, which almost exclusively affects women.
-
Cuff-like appearance due to minimal fat deposits on the hands and feet.
-
Discomfort and sensitivity to touch.
-
A sensation of tension and weight in the impacted limbs.
-
Symptoms that get worse throughout the day.
-
Cool skin.
-
Quick bruising.
-
The affected limbs still have disproportionate swelling even when a person loses weight.
-
Hardly any pitting edema.
-
Telangiectasias are tiny, broken blood vessels that appear on the skin's surface around fat deposits.
A negative Stemmer's sign, in which the skin fold between the second and third toes can be pinched and lifted, is another sign of lipedema. Conversely, the skin fold cannot be pinched and lifted in the presence of a positive Stemmer's sign, which denotes advanced lipedema or lymphedema, typically stage four or possibly stage three.
How Is Lipedema Treated?
Lipedema treatment frequently focuses on treating the symptoms, stopping further progression, and enhancing mobility and quality of life. The type and extent of treatment will vary depending on how far along the lipedema is and how much distress it causes. Both conservative and intensive treatments are possible.
Options for conservative treatment include:
-
Manual Lymphatic Drainage: A massage that uses light, rhythmic pumping motions to encourage lymphatic fluid to move past obstructions and into healthy vessels that can drain into the venous system. This lessens discomfort and guards against fibrosis.
-
Compression: The application of stretch bandages, panties, or spandex shorts to the swollen legs increases tissue pressure and reduces fluid retention.
-
Exercise Therapy and Physiotherapy: Water exerts little pressure on joints and promotes lymphatic drainage; water exercise is particularly beneficial.
-
Psychosocial Counseling: Counseling can assist in coping with the illness's effects and related conditions, such as eating disorders.
-
Weight Management and Dietary Advice: Lipedema is a serious condition that can lead to morbid obesity in those with it. However, anti-inflammatory diets might be beneficial.
-
Thorough Skin and Nail Care: It reduces the risk of wounds and infection during lipedema.
-
Patient Education: People with lipedema can better manage their condition, make wise decisions, and seek support when necessary by becoming knowledgeable about the condition and its treatments.
Liposuction may be an option if conservative treatments fail to relieve the lipedema and lower the quality of life. The lipedema fat can be eliminated through liposuction, particularly tumescent liposuction, and water-assisted liposuction. A hollow tube is inserted beneath the skin to suction the fat tissue. Depending on the amount of abnormal fat, multiple sessions might be required.
Before considering liposuction, the doctor will assess several factors. Liposuction is ineffective in severe cases of lipedema, especially when lymphedema is also present. Debulking surgery might be necessary. Dermato-fibro-lipectomy is the term used for this.
Conclusion
In addition to causing physical symptoms, lipedema can be uncomfortable, painful, and distressing, affecting one's emotional well-being and quality of life. Although lipedema cannot be cured, it can manage the symptoms, slow the condition's progression, and enhance general health, all of which may impact lipedema. Early diagnosis is crucial because this is the time when lipedema can be treated more successfully and conservatively. The outlook is good with a multidisciplinary treatment team.
