Recognizing and treating lipoedema – what you need to know now

What is lipedema?

Lipoedema is a pathological fat distribution disorder that mainly affects women. The affected areas of the body are swollen and often hurt when touched. Mobility is also restricted as the disease progresses. Many women also suffer from the aesthetic appearance of the deformed volume growth.

This disease is often confused with obesity. Even those affected themselves are usually not initially aware that it is a disease that cannot be conquered by simply losing weight. It is particularly tricky for those affected who already know that they have lipoedema: They are often not seen as ill by those around them, but simply overweight and not taken seriously. This eats away at their self-confidence and takes a lot of energy.

A diagnosis by a specialist is therefore important. This is the only way to provide treatment.

Differentiation from lymphoedema

Lipoedema is often confused with lymphoedema. However, these are different diseases. Lymphoedema is an enlargement of the lymph vessels and lymph nodes caused by impaired lymph flow. Lipoedema is limited to fat deposits and usually only affects certain parts of the body. In turn, lipolymphoedema is a combination of lipoedema and lymphoedema.

How does lipedema develop?

The exact causes of lipoedema are not yet known, but it is thought to be due to a disorder of lymphatic drainage and a genetic predisposition. Hormonal factors, such as the use of hormonal contraceptives, pregnancy or puberty, may also contribute to its development.

Where can lipedema occur?

Lipedema mainly occurs on the legs and arms, but other parts of the body can also be affected.

In rare cases, painful fat deposits are also observed in the following areas:

• Face
• Belly
• Hip
• Buttocks

How do you recognize lipoedema?

The fat distribution disorder triggers a wide range of symptoms and cannot be eliminated with a change in diet or lots of exercise. Possible symptoms of lipoedema are as follows:

• Pressure pain, tightness and stabbing pain
• Hardening of the subcutaneous fatty tissue
• Persistent feeling of coldness in the limbs
• Feeling of heaviness in the corresponding part of the body
• uneven body proportions and even deformities
• Frequent occurrence of hematomas (bruises)
• Orange peel skin and cellulite as a known side effect
• Problems walking due to severely swollen fatty tissue (late stage)

These symptoms occur in most patients, although in rare cases lipoedema can also manifest itself without pain. The affected areas can be sensitive to pressure and only lead to pain in advanced stages. As doctors, we therefore take a variety of factors into account in order to reliably diagnose lipoedema.

The different stages of lipoedema

Lipedema is divided into three stages.

Lipoedema is a chronic and progressive disease. To classify the disease into stages, the visual appearance is assessed on the one hand and palpation findings on the other.

Lipoedema stage 1:
The skin is smooth, but the subcutaneous fatty tissue is thickened. Slight lumps are also palpable. There may already be a slight feeling of tension or pain in the affected areas.

Lipedema stage 2:

Symptoms of the first stage are more pronounced – dents and bumps are clearly visible, the lumps under the skin are coarser and clearly palpable. There may be pain when standing, initial restrictions in mobility and a change in body silhouette.

Lipedema stage 3:

The fat deposits are very clearly visible and cause a significant change in the body silhouette, the tissue is hard and large lobular pockets form on the skin. Movement restrictions and pain can increase and impair the quality of life. At this stage, there may also be a reduction in blood circulation and lymphatic drainage in the affected areas, resulting in swelling and oedema.

How do the types of lipoedema differ?

There are four classifications of lipedema:

Type 1 – Lipoedema occurs more frequently on the thighs and hips and resembles the classic “saddlebags”.

Type 2 – The accumulation of fat also increases in the knee area.

Type 3 – The entire legs are affected by lipedema.

Type 4 – The fat deposits increase on the arms.

In the further course of the disease, lipolymphedema may also develop, a disordered lymphatic drainage caused by lipedema that leads to lymphedema.

Which doctor diagnoses lipedema?

In principle, any doctor can diagnose lipoedema. However, as the condition is often confused with normal obesity, it requires sufficient experience on the part of the doctor. It is advisable to consult an expert. The diagnosis is usually made by a phlebologist (vein specialist), a dermatologist or a plastic surgeon. They will examine the affected areas of the body, analyze the symptoms and possibly carry out further examinations, such as the so-called pinch test.

Diagnosis is often difficult and time-consuming. It often takes a long time for sufferers to find out that they have lipoedema, as not all sufferers experience the symptoms to the same extent.

What treatment options are available?

One of the most important conservative treatment options for lipoedema is the use of compression stockings. These help to improve lymph flow and drain water from the affected tissues. Lymphatic drainage is also useful. This method improves the drainage of lymphatic fluid through gentle massage movements; building on this, complex physical decongestion therapy is possible. In some cases, alternative medicine such as acupuncture, homeopathy or herbal medicine can also alleviate the symptoms of lipoedema.

At present, however, only the removal of the diseased fat cells can bring about a real improvement.

Tips for everyday life with lipoedema

Lipoedema significantly restricts the quality of life. The following tips can help to alleviate symptoms and cope with the condition in everyday life:

Compression
Wear compression stockings or tights to support the fatty tissue and promote lymphatic drainage.

Take regular breaks
Avoid standing or sitting for long periods to reduce the feeling of pain.

Incorporate exercise into your daily routine
Do regular exercise and sport to promote blood circulation and tighten fatty tissue.

Be aware of temperature fluctuations
Avoid extreme heat or cold, as this can exacerbate the symptoms.

Avoid heavy lifting
Avoid excessive weight, as this can aggravate lipoedema.

With the right treatment and adjustments to everyday life, the progression of the disease can be slowed down and the symptoms alleviated. It is therefore important to consult a doctor at an early stage and initiate treatment.

How can lipedema be removed?

If conservative therapy does not sufficiently alleviate the symptoms, surgery may be advisable.

During lipoedema surgery (liposuction), the abnormal fat is removed from the affected area. At the DOCTOR NAURAS ABUAGELA practice, we have the expertise and experience to perform this type of surgery. For almost all patients, the operation marks the start of a new life. We look forward to accompanying you in this process, giving you back your self-confidence and helping you to regain a new body image.

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