Originally defined by Dr. Hines and Dr. Allen of the Rochester, Minnesota Mayo Clinic in 1940, lipedema is a disease of the body’s subcutaneous fat, primarily in the extremities. While this disorder is fairly well-known in Europe, knowledge of lipedema is much less prevalent in the United States. However, awareness is on the rise, and a greater emphasis has been put on understanding this disease and the benefits of early diagnosis and treatment.
While we don’t know the exact cause of lipedema, we do know there is a genetic link to the disorder, and it almost exclusively appears in women. It is a fat disorder, primarily manifesting in the extremities. Often, lipedema is affected by hormonal changes, including pregnancy and menopause, and it rarely occurs before puberty. Lipedema is categorized into five types, depending on the area of the body where the fat is affected:
- 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
Occasionally, lipedema fat can develop in the lower abdomen or lower back of some women, though this is irregular and has yet to be classified into a type of lipedema.
Fat disorder mostly affecting women
Fat accumulation creates disproportionate figure
No known cure for lipedema
Different types of lipedema describe different affected areas
Symptoms can be treated with Liposuction
Lipedema gets worse if ignored
Contact St. Louis Lipo for help treating lipedema
Symptoms of Lipedema
Because lipedema fat is caused by a disorder of the subcutaneous fat, it manifests in ways that differ from normal. Lipedema fat accumulates disproportionately from other areas of the body, rapidly outgrowing other sources of fat. Depending on where the lipedema is occurring, this can give sufferers two body syndrome – the rest of their body may be slim, but the affected area grows more pronouncedly large. People with lipedema can frequently size disparities of up to 10 clothing sizes between their top and bottom.
As lipedema progresses, the fat experiences inflammatory changes. While initially, the fat is softer than normal fat, eventually inflammation makes the lipedema fat firm and nodular, causing swelling and tenderness in the patient. Over time, the lipedema fat becomes more fibrous, taking on a consistency similar to bean bags, and it creates nodes and valleys on the surface of the skin. As many people with lipedema have discovered, lipedema fat is very resistant to weight-loss techniques.
Although lipedema and lymphedema are separate medical conditions, the more advanced stages of lipedema can cause a secondary lymphedema condition, where the lymphatic system has trouble functioning properly, leaving lymph fluid in the extremities. Primary lymphedema usually only affects one extremity, but secondary lymphedema caused by lipedema can affect multiple limbs and is sometimes called lipo-lymphedema.
Not to be confused with the types of lipedema, the disease goes through three unique stages. This progression starts at Stage I, where symptoms of tenderness, heaviness, and swelling in the affected limbs are generally manageable with elevation and rest. The fat at this stage is enlarged, but still soft and smooth. During Stage II, the fat begins to develop into firm nodules, causing indentations in the skin that appear similar to cellulite. Fibrous fatty lumps called lipomas can form between the skin and muscle. Throughout the day, swelling and tenderness increase, and they no longer fully disappear with rest and elevation. Finally, Stage III sees very large masses of fat which deform the affected areas. More hardening occurs in the fat and connective tissues, and swelling is a constant factor. Pain may become debilitating and limit activity, and the fat may limit mobility as well.
Additionally, Stage II and III lipedema tend to lead to a vicious cycle with lipo-lymphedema, where the accumulation of fat obstructs lymph flow, which in turn causes an increase in lipedema as the lymphatic system struggles to clear out lipids and free fatty acids from the tissue.
Treatments for Lipedema
The treatment of lipedema is divided into two types: conservative, non surgical, treatments and surgical treatment. Conservative treatments are the first step in management of lipedema and primarily geared toward controlling the swelling and symptoms of the disease. Conservative treatment includes compression garments to promote local lymph circulation and control swelling. Lymphatic massage and intermittent compression pumps can be helpful with relief of heaviness and aching if used daily. Exercise, especially water exercises, can both aid circulation and maintain muscle mass. Diets that encourage lower levels of systemic inflammation may help symptoms, but lipedema fat is very resistant to weight loss.
Surgical Treatments for Lipedema. For individuals whose symptoms are not adequately controlled with conservative treatment or for those who lipedema is effecting their mobility liposuction has been shown to provide long term relief. There are two types of liposuction which have been shown improve symptoms and mobility tumescent lymph sparing liposuction and water assisted liposuction [WAL]. Multiple publications have demonstrated a long lasting relief of pain, swelling and improved mobility in patients treated with both types of lymph sparing liposuction. [ 1]. Water Assisted Liposuction has been shown to improve or correct joint misalignment and mechanical gait abnormalities that are caused by lipedema.  Lymph sparing liposuction has been also shown to improve the disproportionate body shape of lipedema sufferers.