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What is lipedema?
Lipedema, also known as lipomatosis of the leg or painful fat syndrome, consists of a disproportionate fatty deposit in the lower extremities. It generally extends from the hip to the ankles and is much more common in women than in men (in the latter case it would correspond to a serious hormonal alteration). A peculiarity of lipedema is that it is resistant to reduction through diet and exercise, which is why it is called “persistent fat.”
In 20% of the cases there is a family history of lipedema, although it is also associated with hormonal, microvascular and lymphatic disorders. It generally manifests itself during puberty, although it can appear at other times such as childbirth or menopause, always associated with hormonal changes.
Regardless of the person's body weight, the characteristics of the limbs are always the same. That is, even if the person is underweight or normal weight, below the waist they will look obese. At the same time, it is frequently accompanied by bruising, subcutaneous hemorrhages and pain that appears after pressing or palpating the tissue or in the absence of contact. It is frequently accompanied by joint pain, especially in the knees and lower back.
Lipedema and obesity
➡️ The women who present lipedema They have a higher risk of developing morbid obesity than those who do not have it. Obesity itself is a risk factor for lymphedema, which can exacerbate the condition. lipedema. Lymphedema, often confused with lipedema, is fluid retention in tissues that causes swelling due to congenital or acquired damage to the lymphatic system.
➡️ On the other hand, alterations in gait and knee pain resulting from lipedema reduce the desire and ability to walk, increasing levels of sedentary lifestyle, which is strongly associated with obesity. On the other hand, some studies suggest that women with lipedema have lower resting energy expenditure, which increases weight gain. Although healthy eating by itself is not enough to treat the disease, it is a factor that undoubtedly contributes favorably to it.
What types of lipedema exist?
There are 4 different types of lipedema and 3 different stages.
🔸 En la stage 1 The underlying fat is already increased and contains pearl-sized lumps. The characteristic of this stage is orange peel, which makes diagnosis difficult, since this type of skin is common in other diseases.
🔸 En la second stage The fat masses are larger, there may be dents in the skin and the presence of varicose veins.
🔸 En la third stage The skin may contain indentations and folds over fat. The fat masses are larger and have characteristic deforming fat lobes.
At any stage, lymphedema can occur and lead to a condition known as lipolymphedema, which is caused by obstruction of the lymphatic ducts.
Regarding the types of lipedema, the following are distinguished:
🔸 Type 1: Lipedema fat appears around the hips and buttocks.
🔸 Type 2: Fat appears from the waist to the knees and in the riding pants.
🔸 Type 3: Fat occurs from the hips to the ankles.
🔸 Type 4: Fat also occurs in the arms.
How is it diagnosed?
For him diagnosis lipedema, a precise examination must be performed in order to detect the clinical findings described below:
- Pain in legs or arms even when at rest, which may or may not increase with the practice of physical activity.
- Pain intense by applying pressure (not necessarily strong) on the affected area.
- Legs swollen and feeling of heaviness.
- Bruises in the legs that are not associated with blows.
- The fat of the legs or arms has a harder consistency than normal and sometimes lumps are observed.
- Negative response to diet and exercise physical.
It is also evaluated whether the appearance of symptoms coincides with stages of hormonal changes, such as puberty, pregnancy or the beginning of taking contraceptive pills. A family history of lipedema is also considered.
If necessary, complementary tests can be performed, for example, a lymphoganmography, which allows us to rule out concomitant pathologies such as lymphedema. In some cases, an ECHO-Doppler test of the lower limbs is performed to rule out the presence of significant varicose veins.
Which is the treatment?
🔘 Se necesita un enfoque múltiple para las mujeres con lipedema. El conservative treatment includes following a healthy eating plan in order to control (or reduce) body weight; physical exercise to increase metabolism and improve venous and lymphatic flow and muscle tone; complete decongestive therapy including manual lymphatic drainage; skin care to reduce dryness and cracks that increase the risk of infection (cellulitis).
🔘 El surgical treatment for lipedema is presented as an alternative interesting. Suction-assisted lipectomy (liposuction) aims to remove diseased adipose tissue and has shown an improvement in quality of life and reduction in pain in women with lipedema. The duration of this intervention will depend on the area to be operated on and the amount of fat to be extracted. The operation on average usually lasts between 2.5 to 3.5 hours, but it will depend on its difficulty.
Advantages and risks of treatment
🔹 Además de mejorar el dolor, el tratamiento quirúrgico permite aliviar los síntomas de pesadez en las piernas y mejora la circulación sanguínea y linfática, lo cual alivia la presión de los tejidos. Como resultado, el paciente adquiere una mayor flexibilidad y movilidad, se siente mejor a la hora de hacer deportes y, además, permite frenar el avance de la patología.
🔹 En general, los riesgos de la cirugía son bajos, más aún si la realiza un cirujano plástico especializado en el tema. El Doctor Weigand es especialista en tratamiento de Lipedema por lo que resolverá todas tus dudas.
