What is Lipedema?

Lipedema is a congenital disorder in which excess fatty tissue accumulates symmetrically on the body, most often and noticeably on the legs, with advanced cases experiencing accumulation on the hips, buttocks, arms, and sometimes the torso, sparing the hands and feet. It is classified as a rare adipose tissue disorder (RAD) and a connective tissue disorder, and possibly an autoimmune and/or vascular disorder. It involves excess tenderness and pain upon pressure, limb heaviness, minimal edema (except in Lipolymphedema) or hypertrophy/hyperplasia of fat cells with a negative Stemmer's sign, vascular fragility (leading to conditions such as Chronic Venous Insufficiency) causing easy bruising and petechiae, temperature sensitivity, and the accumulated fat remaining despite adequate diet and exercise measures. It later stages, tissue fibrosis, lipomas, Lymphedema, cellulitis, osteoarthritis, and potential immobility become more likely. Some patients with Lipedema have connective tissue disorders such as Ehler's Danlos or other hypermobile spectrum disorders, and may be more likely to have autoimmune disorders. Some estimates put Lipedema effecting 10-20% of the female population. Very rarely, males can show signs of Lipedema.

Medically, it is sometimes known as adiposalgia, adipoalgesia, adiposis dolorosa, lipalgia, lipomatosis dolorosa, lipohypertrophy dolorosa, lipodystrophy, painful column leg, or painful fat syndrome. It is often misdiagnosed as obesity despite many Lipedema patients not having a finding of metabolic syndrome. In parts of Europe and Australia, Lipedema is known as Lipoedema. In some Germanic languages, it's called Lipödem or Lipöedem,

Lipedema is in a family of rare adipose tissue disorders that includes Familial Multiple Lipomatosis (FML), Multiple Symmetric Lipomatosis (MSL), Madelung's Disease, Dercum's Disease (adiposis dolorosa), and Lipomatosis. These conditions may present similarly to Lipedema, though angiolomas and lipomas are more common and may be found in other areas of the body not commonly associated with Lipedema. A proper diagnosis is important to distinguish between these disorders, though it's possible to have multiple adipose tissue disorders.

Treating Lipedema

Lipedema cannot be cured at this time. It is typically managed through conservative treatments, but if those fail to achieve pain relief or stop the progression of the disease, more invasive methods may be necessary to restore health, quality of life, and prevent immobility.

Decongestive therapy

Decongestive therapy aims to remove edema from the affected limbs. This may be by Manual Lymphatic Drainage Massage by a trained physical therapist, a home use pneumatic lymphatic compression pump such as a Flexitouch or Lymphapress, wrapping, or compression garments. It is most effective in patients with Lipolymphedema or Lymphedema.

Deep tissue massage may be helpful in Lipedema patients by reducing pain and preventing or breaking up areas of fibrosis, especially post-liposuction. Some methods include quadrivas therapy, astym therapy, graston technique, thai massage, shockwave therapy, and meridian massage.

Diet & Exercise

While proper diet and exercise can't reduce Lipedema tissue, it can help prevent Lipedema progression and spread. It will also prevent other medical conditions.

Weight Loss Surgery

For Lipedema patients who also have lifestyle-induced obesity, losing weight is very important to prevent comorbidities. Weight loss surgery may be a good option for Lipedema patients who are also obese. A lower BMI may also make liposuction a safer option.

Liposuction

Liposuction for Lipedema is not a cosmetic or plastic surgery procedure. It is performed by a knowledgeable surgeon, typically using waterjet assisted liposuction (WAL) or tumescent liposuction . It is performed carefully to spare the lymph system from further strain or damage. While not a cure, it is the only method effective in reducing pain, limb heaviness, fat cell hypertrophy/hyperplasia, vascular complaints, bruising, and progression and spread of Lipedema. It can also help prevent fibrosis, Lymphedema, osteoarthritis, and immobility.

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