Lipedema

Physical
and emotional stress

Lipedema is a pathological fat distribution disorder that causes pain and tightness in the arms and legs and predominantly affects women. Experts in medicine and research currently believe that lipedema develops as a consequence of a hormonal change such as puberty, pregnancy or perimenopause. Lipedema can be inherited from either parent. Lipedema develops during puberty in 85 % of cases, that is, at a time of life associated not just with physical changes but also many emotional upheavals. And in the middle of all this, painful and visible changes develop in the legs that nothing can shift or improve.

What is lipedema?

Lipedema is a chronic, often hereditary, uncontrolled growth and enlargement of the fat cells in the arms, buttocks and legs that is possibly triggered by female hormones.

Lipedema is a pathological fat distribution disorder that causes pain and tightness and predominantly affects women. Three lipedema stages and four types of lipedema are differentiated. Three lipedema stages and four types of lipedema are differentiated.

Causes of lipedema

Specialists currently believe that one of the primary causes of lipedema is a hormonal change: The female hormone oestrogen leads to growth and enlargement of the fat cells.

Lipedema has to date only been scientifically verified to develop in the legs and arms. In 97 % of cases the legs are most often affected, particularly the thighs. But lipedema can also occur on the buttocks and hips.

In 31 % of all cases the typical signs of lipedema can also be seen on the arms of patients. The arms initially often do not have any symptoms and also do not need to be treated. If and when the arms become symptomatic over time cannot be predicted.

Symptoms
of lipedema

Lipedema symptoms are often difficult to classify because of how they appear and their similarity to the symptoms of other disorders.

Getting a diagnosis of lipedema is often a drawn out and difficult struggle because the symptoms are experienced by patients in very different ways and are often confused with those of other diseases. What is important is that affected patients have access to a doctor who has experience with lipedema. Many practices now offer specialist consultations. The initial diagnosis can often be made by a phlebologist.

Symptoms similar to those experienced with lipedema may occur with diseases such as fibromyalgia, chronic musculoskeletal pain, polyneuropathy or even chronic venous insufficiency. These include:

pain and tightness in the legs and arms
feeling of heaviness in the legs and arms
exhaustion and lethargy

For a specific diagnosis, it is essential to have a personal physical examination in addition to the symptoms described above. There are currently no instrument-based diagnostics available that can confirm lipedema. Ultrasound in particular can only give minor indications but never evidence of the presence of lipedema.

Internal symptoms

External symptoms

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Tthe typical symptoms of lipedemia include:

physical proportions that do not match the rest of the body (greatly enlarged, column-like legs with a slim upper body)
symmetrical fat deposits on the legs and/or arms
tendency to bruise easily
pain and tightness in the legs and arms
pain in the legs and arms if pressure is applied or they are touched
Attempts to lose weight have little or no effect on the size of the arms and legs.

External symptoms

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Internal symptoms

Stages
and types

Lipedema is a chronic, progressive fat distribution disorder. It is classified into three stages and four types.

The severity is classified by the treating doctor using the appearance of the skin and palpation.

The three stages of lipedema

Stage 1: Surface of the skin is smooth, subcutaneous fatty tissue is thickened, fat structure has small nodules

Stage 2: Surface of the skin is uneven, there are indentations and bulges, fat structure has large nodules

Stage 3: Tissue is rough and hard, large lobes of skin form

The four types of lipedema

While staging lipedema considers the appearance of the skin and the tissue, which parts of the body are affected becomes relevant when classifying the types of lipedema.

Type 1: The subcutaneous fat accumulates mainly around the buttocks and hips. The result is the ‘riding breeches’ look.

Type 2: Lipedema extends to the knees. More fat accumulates on the insides of the knees.

Type 3: The disease extends from the hips to the ankles. The feet are not affected.

Type 4: The lipedema now also affects the arms. Wrists and hands are not affected.

Therapy /
treatment

Liposuction as part of a lipedema operation is the only lasting treatment for lipedema.

Systematically and competently performed lipedema surgery achieves outstanding results with very few complications. As a pioneer in the surgical treatment of lipedema, the LipoClinic is a worldwide leader, successfully performing more than 2,500 operations every year.

So that the tissue is decongested and best prepared for the liposuction performed as part of the lipedema surgery, it is extremely important that patients continuously wear a flat-knit compression garment for six to eight weeks before the operation. If the tissue is very congested, targeted manual lymphatic drainage (MLD) should also be performed before the operation. MLD is also important in the follow-up care to counteract the swelling that typically occurs after surgery. The flat-knit compression garment must also be continuously worn after the liposuction. It helps with reducing the swelling, knits the layers of loosened tissue together again and ensures better contouring thanks to the compression.

Do I have lipedema?

You can use this initial lipedema test to check if you may be affected by lipedema. Complete the check here.

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Do you have any questions about lipedema?

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Psychological Impacts

Many patients with lipedema suffer not only from the physical complaints such as pain and swelling, but also from psychological stress such as feelings of shame, depression, lack of understanding from others and reduced self-confidence. In order to ensure sustainable treatment success, it is important that the psychological conditions are also taken into account in the therapy. To ensure a successful outcome for the treatment in the long term, it is important that psychological conditions are also considered in the therapy.

Inner heaviness

Lipedema patients often experience a heavy and tired feeling in their legs and/or arms due to the pathological accumulation of fatty tissue. This heavy feeling can lead to reduced levels of movement and limit the physical activity of patients.

Pressure pain

Pressure pain can occur in lipedema because of the irregular distribution of fatty tissue and inflammation beneath the skin. The increased growth of fat cells places pressure on the surrounding tissue and nerves, which can lead to pain and feelings of tightness.

Stabbing pain

Stabbing pain in lipedema can occur because of tissue stress, inflammation, nerve irritation or accompanying medical conditions such as venous disorders or lymphedema. Stabbing pain can also occur when resting or sitting/standing for long periods.

Proportions don’t match

Lipedema patients often have physical proportions that are not harmonised across their whole body. They typically have a slim upper body while their legs and/or arms are considerably larger because of the symmetrical fat deposits.

Jumps in caliber

A common feature of advanced lipedema are obvious jumps in size with fat deposits forming around the wrists or ankles. This leads to a noticeable difference in the circumference between the arms/legs and the slimmer hands/feet, which creates what are known as ‘fat cuffs’ or ‘bracelets’.

Bruising

Due to the abnormal fat distribution, patients with lipedema tend to have more permeable capillary walls, which means that tissues can bruise more easily in response to minor injuries or if slight pressure is applied to the affected areas.

Psychologische Auswirkungen

Viele Patientinnen mit Lipödem leiden nicht nur unter den körperlichen Beschwerden wie Schmerzen und Schwellungen, sondern auch unter psychischen Belastungen wie Schamgefühl, Depressionen, Unverständnis anderer und einem verminderten Selbstbewusstsein. Um einen nachhaltigen Behandlungserfolg zu gewährleisten, ist es wichtig, dass auch die psychologischen Bedingungen in der Therapie Beachtung finden.

Innere Schwere

Lipödem-Patientinnen leiden oft unter einem schweren und müden Gefühl in den Beinen und/oder Armen aufgrund der krankhaften Ansammlung von Fettgewebe. Dieses Schweregefühl kann zu einer Einschränkung des Bewegungsumfangs führen und die körperliche Aktivität der Patientinnen einschränken.

Druckschmerz

Druckschmerzen können bei Lipödem aufgrund der ungleichmäßigen Verteilung von Fettgewebe und Entzündungen unter der Haut auftreten. Das vermehrte Wachstum von Fettzellen übt Druck auf das umliegende Gewebe und Nerven aus, was zu Schmerzen und Spannungsgefühlen führen kann.

Stechender Schmerz

Stechende Schmerzen beim Lipödem können aufgrund von Gewebebelastung, Entzündungen, Nervenreizungen oder Begleiterkrankungen wie Venenerkrankungen und Lymphödemen entstehen. Auch in Ruhezuständen, bei längerem Stehen oder Sitzen können stechende Schmerzen auftreten.

Proportionen passen nicht

Lipödem-Patientinnen weisen häufig körperliche Proportionen auf, die nicht im Einklang mit dem Rest ihres Körpers stehen. Typischerweise haben sie einen schlanken Oberkörper, während ihre Beine und/oder Arme aufgrund der symmetrischen Fettablagerungen deutlich vergrößert sind.

Kalibersprünge

Ein häufiges Merkmal des fortgeschrittenen Lipödems sind sogenannte “Kalibersprünge”, bei denen sich Fettablagerungen um die Hand- oder Fußknöchel herum bilden. Dies führt zu einem auffälligen Unterschied im Umfang zwischen den Armen/Beinen und den schmaleren Händen/Füßen, was oft als “Fettkragen” oder „Fettmuff“ bezeichnet wird.

Blaue Flecken

Aufgrund der gestörten Fettverteilung neigen Patientinnen mit Lipödem zu einer erhöhten Durchlässigkeit der Kapillarwände, was zu leichten Blutergüssen und blauen Flecken bei geringfügigen Verletzungen oder Druck auf betroffene Bereiche führen kann.

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Physical and emotional stress