Lipedema

By Abdulaziz Ali - Medically reviewed by Prof. Zeynep Sevim, on Apr 21, 2024

What is Lipedema?

Lipedema is a chronic medical condition characterized by the symmetrical buildup of fat cells, primarily in the legs, thighs, and sometimes the arms. It's essential to distinguish between lipedema and typical weight gain or obesity. Key characteristics of lipedema include:

1. Pain and Tenderness: The affected areas can become tender, causing discomfort or pain.
2. Symmetrical Swelling: Lipedema typically affects both sides of the body. For instance, if one leg accumulates abnormal fat, the other will display similar symptoms.
3. Non-pitting Edema: Unlike other swelling forms, pressing the swollen area doesn't leave a lasting indent.
4. Resistance to Diet and Exercise: One of the defining features of lipedema is that the fat deposits don't significantly diminish with regular diet or exercise.
5. Bruising: People with lipedema often bruise easily in the affected areas.
6. Lack of Foot and Hand Involvement: Lipedema swelling usually stops at the ankles and wrists, leaving the feet and hands unaffected.

What Causes Lipedema?

Lipedema is a complex condition, and while its exact cause remains unknown, various theories and contributing factors have been proposed:

1. Genetic Predisposition: Evidence suggests that lipedema may run in families. Many individuals with the condition have relatives who exhibit symptoms, indicating a potential genetic link.
2. Hormonal Changes: Lipedema often appears or worsens during significant hormonal fluctuations, such as puberty, pregnancy, and menopause. This suggests that hormones play a role in its development or progression.
3. Inflammation: Some studies have pointed to chronic inflammation as a possible trigger or contributing factor to lipedema.
4. Impaired Lymphatic System: While not a direct cause, there's evidence that individuals with lipedema often have an inefficient lymphatic system, which could exacerbate the condition.

Will Dieting Reduce Lipedema?

While beneficial for overall health, dieting is not a direct solution for lipedema. Here's why:

1. Resistance to Traditional Weight Loss: The fat cells associated with lipedema are resistant to being metabolized by the body's usual methods. This means that while dieting can reduce overall body fat, the characteristic fat deposits of lipedema often remain unchanged.
2. Holistic Approach is Best: While strict dieting might not significantly reduce lipedema fat, a balanced, anti-inflammatory diet can help manage associated symptoms, improve overall health, and prevent further complications.
3. Consideration of Coexisting Conditions: Many individuals with lipedema also struggle with other health conditions, like obesity or lymphedema. In such cases, dieting can address these coexisting conditions, even if it doesn't directly tackle the lipedema fat.

What is the Difference Between Lipedema and Lymphedema?

Lipedema and lymphedema, though they sound similar and can even coexist, are distinct conditions:

1. Cause: Lipedema is characterized by abnormal fat deposition, particularly in the legs and arms. Lymphedema, on the other hand, is caused by a buildup of lymph fluid due to a compromised lymphatic system.
2. Symmetry: Lipedema usually presents symmetrically, affecting both sides of the body equally. Lymphedema can affect just one limb or different limbs asymmetrically.
3. Pitting: In lymphedema, when pressure is applied to the swollen area, it often leaves an indent (called "pitting"). Lipedema does not typically result in pitting.
4. Areas Affected: Lipedema typically stops at the ankles and wrists, sparing the feet and hands. Lymphedema can involve swelling in the feet and hands.
5. Pain Levels: Lipedema areas are often painful and tender to touch, while lymphedema may not be painful, although it can cause discomfort.

How is Lipedema Different From Obesity or Lymphedema?

• Lipedema vs. Obesity: While both conditions involve increased fat, obesity is a generalized increase in body fat. In contrast, lipedema has a characteristic pattern of fat deposition, usually sparing the hands, feet, and abdomen.
• Lipedema vs. Lymphedema: As mentioned, lymphedema results from a compromised lymphatic system, leading to fluid buildup. Lipedema involves abnormal fat cells and distribution unrelated to the lymphatic system, although both can coexist.

What Should I Expect From Lipedema Surgery?

Lipedema surgery often involves liposuction techniques tailored to address the abnormal fat deposits of lipedema. Here's what you can expect from the procedure:

Consultation and Evaluation

The process begins with a thorough consultation, where your surgeon will evaluate the severity of your lipedema, discuss your expectations, and recommend the best surgical approach.

Anesthesia

The surgery is typically performed under general anesthesia or local anesthesia with sedation, ensuring you're comfortable and pain-free during the procedure.

Surgical Technique

The most commonly used method for lipedema is tumescent liposuction, specifically designed to remove abnormal fat deposits while preserving lymphatic vessels and minimizing tissue damage.

Incision Sites

The surgeon will create small incisions in the affected areas to insert a cannula to break up and remove the fat.

The length of the surgery can vary depending on the extent of the lipedema and the areas being treated. It might last anywhere from one to several hours.

Immediate Aftercare

After the surgery, you'll wear compression garments to minimize swelling and support the treated areas as they heal.

Results

While you'll notice an immediate reduction in the size of the treated areas, the final results will become more apparent as the swelling subsides over weeks to months.

How Long Is The Recovery Time For Lipedema Surgery?

Recovery from lipedema surgery can vary based on the individual and the extent of the procedure. Here's a general timeline:

Initial Recovery (First Week):

• You may experience swelling, bruising, and mild discomfort.
• It's advisable to take several days off work and daily responsibilities.
• Walking is encouraged to promote circulation and reduce the risk of blood clots.

Intermediate Recovery (2-4 Weeks):

• Most of the acute swelling and bruising will begin to subside.
• You'll likely continue wearing compression garments to optimize healing.
• You can gradually resume non-strenuous activities and light exercises.

Long-Term Recovery (1-6 Months):

• Most patients can return to regular activities and vigorous exercises after 4-6 weeks.
• Residual swelling continues to reduce, and the full results of the surgery become evident.
• Regular follow-up appointments with your surgeon will ensure you're healing well and address any concerns.

Post-recovery Care:

• Maintaining a healthy lifestyle, including a balanced diet and regular exercise, is essential to ensure the best long-term results.
• Compression garments may be recommended, especially if there's residual swelling or you're prone to fluid retention.

Characteristics of Lipedema

Lipedema is a unique condition that's often misunderstood or misdiagnosed. To better understand it, one must be familiar with its distinctive characteristics.

Affected Areas

The fat accumulation in lipedema predominantly affects the lower body but can also impact the upper limbs. Here are the commonly affected areas:

1. Legs: From the buttocks to the ankles, often giving the legs a column-like appearance.
2. Thighs: Inner and outer thighs can be affected, sometimes leading to a "riding breeches" appearance.
3. Lower Legs: The fat deposition can lead to a cuff around the ankles, sparing the feet.
4. Arms: In some cases, the fat buildup extends to the arms, but it typically stops at the wrists, leaving the hands unaffected.

Symptoms and Stages of Lipedema

Lipedema progresses through different stages, with each stage exhibiting increasing severity of symptoms:

Stage 1:

• Skin is smooth but appears swollen.
• Underlying tissues have a soft, sponge-like consistency.

Stage 2:

• The skin starts to become uneven, resembling an orange peel texture.
• Larger fat lumps can be palpated underneath the skin.

Stage 3:

• Large, pendulous fat masses form in the thighs and over the knees.
• Mobility may be affected, and there's an increased risk of joint issues.

Common Symptoms Across All Stages:

• Pain and tenderness in the affected areas.
• Easy bruising.
• Heavy, swollen limbs.
• The gained fat is resistant to conventional weight loss methods.

Can Lipedema Fat Be Lost?

Lipedema fat is notoriously resistant to traditional weight loss measures. Diet and exercise, while beneficial for overall health and well-being, often have minimal impact on the characteristic fat deposits of lipedema. 

Surgical interventions, like specialized liposuction, are currently the most effective method for reducing lipedema fat. It's crucial to approach a surgeon familiar with lipedema, as the procedure requires specific techniques to preserve lymphatic vessels and reduce complications.

Can I Stop Lipedema From Progressing?

While there's no known cure for lipedema, certain measures may help manage symptoms and potentially slow its progression:

1. Compression Therapy: Wearing compression garments can reduce swelling, improve lymphatic flow, and relieve pain and discomfort.
2. Manual Lymphatic Drainage: This specialized massage technique promotes the drainage of lymphatic fluid, helping to alleviate swelling.
3. Maintaining a Healthy Lifestyle: A balanced diet, regular exercise, and weight management can help reduce inflammation and improve overall well-being.
4. Avoiding Prolonged Standing or Sitting: Changing positions regularly can help prevent excessive swelling.
5. Medical Monitoring: Regular check-ups with healthcare professionals familiar with lipedema can help monitor its progression and recommend suitable interventions.

It's crucial to remain proactive in seeking information, support, and appropriate treatments. Joining a lipedema support group can also be beneficial, providing an avenue for sharing experiences and gaining insights from others living with the condition.

Side Effects of Lipedema Surgery

Like any surgical procedure, lipedema surgery often involves specialized liposuction techniques and has potential side effects. It's essential to be informed about them to make an educated decision about the surgery:

• Swelling.
• Bruising.
• Pain and Discomfort.
• Numbness or Tingling.
• Scarring: Although incisions for lipedema surgery are small, there's still a potential for scarring. Most scars are minimal and fade with time.
• Infection.
• Seroma or Hematoma: Fluid or blood can accumulate at the surgical site, requiring drainage.

Lipedema Surgery Results

Lipedema surgery aims to alleviate the symptoms and improve the appearance of the affected areas. Here's what you can expect in terms of results:

1. Reduced Pain: 84% of patients report improved quality of life and significant pain relief post-surgery.
2. Improved Mobility: Removing lipedema fat can enhance mobility and reduce associated joint strain.
3. Cosmetic Enhancement: The surgery often results in a more contoured appearance, enhancing the patient's self-confidence.
4. Long-lasting Results: With proper post-operative care and lifestyle maintenance, the results of lipedema surgery can be long-lasting. 

How To Prepare for Lipedema Treatment in Turkey?

If you're considering undergoing lipedema treatment in Turkey, adequate preparation is essential to ensure a smooth experience:

1. Consultation: Engage in a detailed consultation, either virtually or in person, to discuss your expectations, potential risks, and the surgical approach.
2. Travel and Accommodation: Organize your travel plans. Consider staying a few days post-surgery for any follow-up appointments.
3. Insurance: Ensure appropriate medical and travel insurance covers the procedure and any potential complications.
4. Pre-operative Guidelines: Follow any pre-operative instructions provided by the clinic. This might include stopping certain medications, fasting, or undergoing pre-surgery tests.
5. Post-operative Care: Ensure you understand the post-operative care guidelines. Consider bringing a friend or family member to assist you post-surgery.

Frequently Asked Questions (FAQs)

What Happens if Lipedema is Not Surgically Treated?

If not treated, lipedema can progress, leading to increased pain, reduced mobility, and potential joint issues.

What aggravates lipedema?

Factors like prolonged standing or sitting, excessive weight gain, and hormonal changes can aggravate lipedema symptoms.

What happens if lipedema is left untreated?

Untreated lipedema can lead to increased pain, mobility issues, lymphedema, and psychological distress.

What not to do with lipedema?

Avoid prolonged standing or sitting, tight clothing restricting circulation, and excessive weight gain.

Do I have lipedema or just fat legs?

Lipedema has distinct characteristics like pain, tenderness, and specific fat distribution patterns. Consult a physician for a definitive diagnosis.

How do I slim my lipedema legs?

Lipedema fat is resistant to diet and exercise. Specialized liposuction is often recommended for significant reduction.

Can you lose lipedema fat naturally?

Lipedema fat is notoriously resistant to natural weight loss methods, making surgical intervention more effective.

What are Stage 3 lipedema legs?

Stage 3 involves large, pendulous fat masses, especially over the knees, with possible mobility and joint complications.

How do you test for lipedema?

A clinical examination by a knowledgeable physician is primary, but imaging tests like MRI or ultrasound can also be used.

Is lipedema hard or soft?

Lipedema fat is typically soft in the early stages but can become firmer as the condition progresses.

Can lipedema be cured?

There's no cure for lipedema, but its symptoms can be managed and alleviated.

Can lipedema be prevented?

There's no known prevention for lipedema, but early diagnosis and treatment can manage its progression.

Will lipedema worsen over time?

Lipedema can progress if left untreated, moving through its various stages.

Can lipedema be treated with diet and exercise alone?

While diet and exercise can improve overall health, they often have a limited impact on lipedema fat.

Does insurance cover lipedema?

Coverage varies by insurance provider and region. It's best to consult your insurance policy or representative.

Can liposuction completely remove lipedema fat?

While liposuction can significantly reduce lipedema fat, it may not remove it entirely, and there's potential for recurrence.

Can pregnancy worsen lipedema?

Hormonal changes during pregnancy can aggravate lipedema symptoms in some women.

Can lipedema cause other health complications?

If untreated, it can lead to mobility issues, joint complications, and lymphedema.

Is lipedema a rare condition?

Lipedema is underdiagnosed, making it seem rare, but it's believed to affect many women.

Can weight loss help reduce lipedema symptoms?

General weight loss can help alleviate some symptoms but often doesn't significantly impact the characteristic fat of lipedema.