Cause, Symptoms, & Treatment of Lipedema

Lipedema is a disease that affects the body’s subcutaneous fat cells and most prominently develops in the extremities. Dr. Hine and Dr. Allen of the Rochester first recognized this disease at the Minnesota Mayo Clinic in 1940. Furthermore, scientists have continued to study it closely since that time. In addition, awareness associated with Lipedema is on the rise. Moreover, it’s widely understood that the benefits of early diagnosis and treatment are vast for patients suffering from this condition.

With that said, scientists are still researching the singular underlying cause of Lipedema. They agreed that it’s linked to a genetic disorder that is far more frequent in woman than men. Additionally, the two men who have been diagnosed with Lipedema had hormonal abnormalities. Certainly, lipedema is sometimes affected by hormonal changes linked to pregnancy or menopause but rarely occurs before puberty. Fat cell accumulations become noticeable in specific and very different areas of the body. This has led physicians to divide Lipedema into five separate types or Lipedema stages.

In short, type I lipedema presents in the buttocks and type II lipedema presents in the hips, thighs, and buttocks. Furthermore, type III lipedema presents in the highs, thighs, and calves and type IV lipedema presents in the arms. Lastly, type V lipedema is exclusively noticeable in the calves. In addition, all types of Lipedema require serious observation and treatment. However, on an aesthetic level, many patients have a difficult time accepting the disproportionate figure the disease creates. As a result of that, significant deposits of fat linger in the extremities. Occasionally, Lipedema presents in the lower abdomen or back of some female patients.

Lipedema vs. Lymphedema

Consequently, it’s common for patients to confuse Lipedema and Lymphedema which are separate yet linked medical conditions. More advanced stages of Lipedema can cause a secondary Lymphedema condition. Here, the lymph fluid is left in the extremities as well. As a result, this condition is recognized as Lipo-Lymphedema and it can be dangerous if the patient doesn’t receive treatment. For that reason, the link between Lipedema and Lymphedema is why professionals continue to investigate this disease.

Lipedema Overview

• • Type I – Occurs in the buttocks
  • Type II – Occurs in the hips, thighs, and buttocks
  • Type III – Occurs in the hips, thighs, and calves
  • Type IV – Occurs in the arms
  • Type V – Occurs in the calves

 Lipedema Symptoms

Most patients that are diagnosed with Lipedema first notice signs of the disease presenting as disproportionate areas of fat accumulation. Interestingly enough, this fat accumulation doesn’t blend with the rest of the body. Hence, even a rather slim individual who suffers from Lipedema may notice pronounced areas of fat. For instance, these areas of fat usually occur around their arms, thighs, hips or ankles. Over time, the size differences become more evident with some patients facing size disparities. These size disparities could be as bad as of up to 10 clothing sizes between their top and bottom halves.

*Actual Patient: Individual Results May Vary

Also, as the disease progresses there is a tendency for these fat deposits to become a source of pain for patients. While healthy fat cells are soft in texture, deposits that accumulate with Lipedema take on a firm and nodular texture. This causes swelling and discomfort. If the patient doesn’t get treatment, these fat deposits will continue to transform in texture. During that time, they will move towards a fibrous consistency that begins to show underneath the surface of the skin. Unfortunately, this type of fat deposit is highly resistant to the efforts of diet and exercise. In some cases, dieting and exercise are completely ineffective. In conclusion, lipedema symptoms outline three stages of progression for this disease.

Lipedema Stages

Just as there are five types of Lipedema, medical professionals can also break the disease down into multiple stages of advancement. Lipedema symptoms occur in three lipedema stages with the first stage including tenderness, heaviness, and swelling in the affected limbs. While this stage is manageable with limb elevation and rest, it is still highly noticeable. The fat deposits in stage one are enlarged but overall retain a soft and smooth texture.

Stage II Lipedema shows fat deposits beginning to develop into firm nodules that create more noticeable indentations in the skin similar to the appearance of cellulite. Fibrous lumps, known as Lipomas, often begin to form between the skin and the muscle. Overall swelling and tenderness increase during this stage and are not as manageable with rest and elevation.

Stage III Lipedema involves large masses of fat deposits which cause deformation of the limbs they affect. Tissue hardening occurs and swelling does not reduce. At this stage, patients are faced with increased pain and discomfort that may lead to limitations on their mobility.

Treatment for Lipedema

While there is no known cure for Lipedema, there are several treatment options that can reduce the effects of the disease. Lipedema treatment options vary between non-surgical and surgical depending on the severity of the condition. Conservative, non-surgical options are generally the first step in managing Lipedema and are geared towards controlling swelling. These treatment options often include compression garments, lymphatic massage, and compression pumps. An attending physician will generally recommend a strict exercise routine to aid in overall circulation.

For those patients experiencing more advanced stages of Lipedema, liposuction has been shown to offer long-term relief. This lipedema treatment option can be particularly helpful for those patients who are suffering from mobility issues as a result of their Lipedema. Both Tumescent Liposuction and Water-Assisted Liposuction have demonstrated successful results in patients looking for improved mobility and overall relief from the pain of swelling. Additionally, liposuction may assist in joint realignment where fat deposits have pushed joints out of place over time. Similarly, these techniques may improve the appearance of disproportionate limbs at the point of fat accumulation.

Learn More

We may not know the exact cause of lipedema, but we can certainly treat the symptoms of lipedema! Patients who are interested in learning more about how liposuction can improve their quality of life when living with Lipedema are encouraged to schedule an initial consultation with Dr. Wright. A comprehensive approach to care means you’ll find answers to your questions in a setting that encourage open communication and takes a personalized approach to treatment.

Lipedema FAQs

Question: Do Compression Stockings have to be worn on both legs?

Answer

Yes, if you only have problems with one leg you only need to wear the compression stocking on the affected leg. You can also wear stockings on both as a matter of fashion.

Question: What type of Compression Hose should I choose? 

Answer 

You would want to cover the affected area so I would imagine thigh-high or pantyhose style would work best. At the minimum, if the veins are small you would use a 15mm Hg compression but 30mm works best. To determine the right size (eg. Small, medium, etc..) you need to measure with a soft measuring tape your ankle, mid-calf & maximal thigh circumference and look at a chart on one of the websites to find the right one. If you are wearing them for pain relief, try both, and whichever feels better would be appropriate