What is Lipedema?
Lipedema is a disease that almost entirely affects women, characterized by symmetrical excessive fat accumulation in specific areas of the body. Fat accumulates in the affected legs, hips, and, less frequently, in the arms. Swelling accompanies the fat tissue, and over time, symptoms such as tenderness to touch and pain appear. Lipedema does not regress spontaneously, and unfortunately, there is no known effective medical treatment. Those with lipedema often do not realize they are ill and think they have conditions like cellulite or obesity. This delays the diagnosis and treatment of the disease.
Symptoms of Lipedema:
Symptoms of lipedema may vary depending on the degree and duration of the disease; however, the following symptoms are generally observed:
- Symmetrical Fat Accumulation: Lipedema is characterized by excessive fat accumulation in certain regions of the body. The most commonly affected areas are the legs, hips, and sometimes the arms, while the upper part of the body is usually not affected.
- Pain and Sensitivity: Pain and sensitivity are often observed in the affected areas. Especially when touched, sensitivity and pain can arise in these regions.
- Edema: In patients with lipedema, alongside fat tissue, swelling (edema) due to fluid accumulation can also develop. This leads to a thicker appearance of the legs, and swelling is particularly more pronounced in the evening.
- Skin Irregularities: Individuals with lipedema may exhibit rough patches, a wavy appearance, or cellulite-like appearances on the affected skin surface.
- Worsening Symptoms Over Time: If lipedema is not treated, the severity of the disease may increase over time, and deformities may become more pronounced. This can lead to limitations in daily activities.
What Causes Lipedema?
It is known that genetic and hormonal factors play a role in the emergence of lipedema. Although the pathophysiology of lipedema is not clearly understood, factors such as food allergies, consumption of hormone-containing foods, microbiological agents, and lifestyle may also contribute to the widespread occurrence of the disease; however, scientific studies are needed to establish these factors.
- Genetic Factors: Lipedema is considered to be a hereditary disease. If there is a family history of lipedema, the risk of developing the disease is higher than in the normal population. This suggests a connection between the disease and genetic transmission.
- Hormonal Changes: Hormonal changes play a significant role in the onset of lipedema. Periods such as puberty, pregnancy, and menopause can trigger the emergence of the disease. The excessive effect of the female hormone estrogen may cause fat tissue to accumulate in specific areas.
- Lymphatic System Disorders: The frequent occurrence of edema with lipedema indicates that the lymphatic system may be affected. Improper distribution of lymph fluid in the body can lead to swelling and the formation of edema.
- High Weight or Obesity: While lipedema is generally observed in individuals with excessive weight, obesity and lipedema are different diseases. Obesity only refers to excessive fat accumulation, while in lipedema, fat accumulation typically concentrates in specific areas, causes pain, and is accompanied by edema.
Diagnosis of Lipedema:
The diagnosis of lipedema is made based on physical examination and the patient’s history. There is no specific diagnostic test in the medical literature that leads to a diagnosis of lipedema. Lipedema typically presents itself with symmetrical fat accumulation in the lower part of the body, allowing a specialist doctor to diagnose it through examination.
Stages of Lipedema
Lipedema is a progressive disease and is divided into different stages.
Stage 1: Initial Period
In this stage, the skin surface is smooth or slightly rough, but the fat tissue beneath the skin is slightly thickened. An abnormal distribution of fat cells has begun, but no significant irregularity is noticeable. Mild swelling may increase by the end of the day, but it generally decreases with rest.
Stage 2: Tissue Damage and Irregular Appearance
The skin surface now has a softer, wavy, or irregular structure. There may be hardening in the fat tissue, and small nodules may be felt. The tendency to bruise increases, and the tissues become more sensitive to touch. The sensation of edema is more pronounced and may increase during the day.
Stage 3: Marked Fat Accumulation and Deformity
At this stage, fat accumulation becomes more pronounced, and the skin surface exhibits serious irregularities. Legs and arms thicken, and sometimes large fat masses can form. Mobility begins to decrease, and the tissues harden and become more painful. The risk of developing lymphedema increases.
Stage 4: Advanced Tissue Damage and Accompaniment of Lymphedema
In this stage, lipedema may now merge with lymphedema and can lead to severe tissue damage. The legs become excessively heavy, harden, and mobility restrictions become more pronounced. Abnormalities in fat tissue become more apparent, and treatment becomes difficult.
Treatment Methods for Lipedema:
There is no treatment that can completely correct and eliminate lipedema, but there are various alternatives available to manage the symptoms of the disease and improve the quality of life:
- Diet and Exercise:
– Exercise and a healthy diet are important in managing lipedema, as they can prevent the progression of the disease and improve the patient’s overall health. However, it should be noted that individuals with lipedema have a very low likelihood of losing weight through diet and exercise, as the fat tissue stored in lipedema is resistant to melting.
– Low-impact activities like cardio exercises, walking, and swimming may help alleviate swelling.
- Compression (Wearing Compression Stockings, etc.) Therapy:
– Using compression garments (corsets, stockings) can be effective in managing swelling and edema in lipedema. These garments apply pressure to the affected areas and can reduce swelling by preventing fluid accumulation.
- Lymphatic Drainage Massage:
– Lymphatic drainage massage helps redistribute lymph fluid properly in the body. In individuals with lipedema, it can prevent fluid accumulation and reduce edema.
- Medication Treatment:
- There are no specific medications for the treatment of lipedema, but drugs aimed at reducing edema or painkillers may be used. Some suggest treatments to reduce the effects of estrogen; however, considering the possible side effects, it is preferable to avoid such treatments.
- Liposuction (Fat Removal Surgery):
- In individuals with moderate to advanced stages of lipedema, the surgical removal of fat accumulations is necessary. Liposuction is a surgical procedure performed to remove fat tissue from the body in lipedema patients. This treatment can improve the course of the disease and alleviate symptoms, but it does not completely eliminate the condition.
The power-assisted liposuction method is currently the most effective known treatment for removing diseased tissue in lipedema. This technique involves using specialized medical devices designed for fat removal, allowing for a faster procedure, reducing surgery duration, minimizing blood loss, and providing skin-tightening effects. Plastic and aesthetic surgeons may choose different devices based on their experience, patient outcomes, and personal observations. Power-assisted liposuction enhances both the patient’s and the surgeon’s comfort during the procedure and increases patient satisfaction with the surgery results.
Liposuction can be performed in both early and advanced stages of lipedema. Over time, affected areas tend to develop waviness, a cellulite-like appearance, sagging, and thinning of the skin, leading to a deterioration in tissue quality. The biggest advantage of early surgery is that it helps slow the progression of the disease and prevent skin deformities before they develop.
In advanced lipedema cases, aggressive liposuction is essential to remove as much fat as possible. However, it is crucial to ensure that the amount of fat removed in a single operation does not exceed 10% of the patient’s body weight. If more fat removal is needed, it is safer to conduct the procedure in multiple sessions rather than in a single surgery, as removing excessive fat at once can place extreme stress on the body and increase the risk of severe complications.
After extensive fat removal in the legs and arms, skin sagging may occur. In such cases, arm or thigh lift surgery can be performed simultaneously with liposuction, or the skin’s recovery can be observed by wearing a compression garment for an extended period before deciding on additional procedures. Based on our experience, in early-stage patients with relatively good skin quality, a significant amount of fat can be removed without the need for additional skin-tightening surgeries.
For lipedema patients, liposuction surgery typically lasts between 2 to 6 hours, depending on the stage and extent of the disease. The patient may need to stay in the hospital for one or two nights. Due to the extensive nature of the procedure, blood transfusions are often required. After surgery, compression garments or specially designed pressure stockings should be worn for about two months. Although a strict diet and lymphatic drainage massages are not mandatory in the early postoperative period, they are recommended.
Originally posted 2025-01-10 12:24:20.