Lipoedema (Lipedema)

Lipoedema is a hereditary disease that mainly affects women. It is not related to obesity or lifestyle.

It is manifested by the deposition of subcutaneous fat in the areas: hips, buttocks, thighs, and inner side of the knees.

The fat deposits are painful to the touch (hence the name Lipomatosis dolorosa), the patient feels a feeling of heaviness, pressure, and tension. The lower extremities tend to be colder.

Fat is deposited disproportionately only in these areas, while the hands and feet are not affected - this is how lipedema is distinguished from obesity and lymphedema.

The increased fatty tissue presses on surrounding structures, small blood vessels, and nerves.

This leads to persistent inflammation, and the increased vascular permeability causes swelling.

Many affected patients describe:

• heavy or tired legs (often after standing for long periods)
• pressure pain,
• a feeling of tightness
• sensitivity to touch

Lipoedema is classified into stages (I–III):

• Stage I:
  • Smooth skin, fat nodules are evenly distributed
• Stage II:
  • Uneven fat nodules, lumps are present on the skin
• Stage III: 
  • Prominent fat and skin flaps, thickening of the lower extremities 

We also know different types of lipedema:

• Type 1: Pelvis, hips and buttocks
• Type 2: Area from buttocks to knees, with the formation of fat deposits around the inner side of the knee
• Type 3: From buttocks to ankles (entire lower extremity except foot)
• Type 4: Shoulders also affected

Conservative and surgical methods are used in the treatment of lipedema:

• Conservative treatment consists of wearing compression stockings and lymphatic drainage. It is advisable to adjust the weight to the optimal BMI value.
• Surgical treatment is by liposuction.

Compression stockings must be worn continuously (23 hours a day), if even after one year of regular wearing, the pain does not subside, liposuction must be considered (it is the only method that reduces volume).