Lipededema

LIPIDEMA  is a progressive chronic condition occurring mostly in women that is commonly mistaken for obesity.   A symmetrical accumulation of fat in the subcutaneous tissue builds up causing large legs (or arms) generally without swelling in the feet or hands. Unlike obesity, the fat becomes isolated in the legs, thighs, and arms.  Other unaffected parts of the body are disproportioned in size (for example, the upper body can be much smaller than the lower body). It can cause tenderness, easily bruised skin on legs/ arms and difficulty walking, The initial concern is with how it looks however if not treated, it can cause significant health issues.  Fatty deposits become distributed in an irregular way and over time, these fat cells block vessels of the lymphatic system, causing poor drainage of the lymph fluid, leading to lymphedema. It is anticipated that hormones play a role because it mostly affects women and begins/ worsens at puberty, during pregnancy, following gynecological surgery, and at menopause.  It is also believed that genes can be involved. Some isolated cases have begun after a surgery involving anesthesia. Dieting and exercise will not reduce the fat in LIPIDEMA but it still plays a role in overall health. Treatment includes complete decongestive therapy (manual lymph drainage/ massage, compression, exercise, skin/ nail care) and surgically can be addressed with liposuction.

Unmanaged Lipedema can cause damage to the Lymphatic system and result in Lymphedema (buildup of fluid in the skin).

Lipedema often has characteristic look. The ankles can look severely swollen with no swelling in the feet. Some women that suffer from Lipedema might try to reduce how much they eat to the point of malnourished and even anorexia. A better approach would be to focus on eating healthy, to feel better, rather than trying a weight loss diet. Lipedema has been proven to respond best to compression. Because of the shape and soft tissue, it is often necessary to custom fit for compression garments. Compression has been shown to not only help prevent secondary Lymphedema or swelling but has also shown to reduce the buildup of new fatty tissue. Use of a compression pump is another preventive measure that has been effective to minimize symptoms.

Treatment includes complete decongestive therapy (manual lymph drainage/ massage, compression, exercise, skin/ nail care) and surgically can be addressed with liposuction.  

Manual Lymph Drainage: this is a type of light massage that encourages natural drainage of lymph and stimulates lymph flow.  A therapist performs movements that help propel lymph fluid through vessels to the lymph nodes, lymph ducts and eventually the cardiovascular system. 

Compression: this is utilized in order to keep fluid from building up in the extremities as well as reduce the pain that can be present with lipedema.  There are many levels of compression and styles of garments. It is highly recommended that a therapist assists with navigating these options to best work for you.  

Exercise: active movements help lymph move through the lymphatic system.  Any movements are helpful included seated exercises, standing exercises, walking short or long distances and riding a stationary bicycle.  

Skin/ Nail care: Swelling can cause poor skin and nail health including dryness, wounds, splitting of skin/ nails, fungal infections and cellulitis.  A daily regime is important to overall health and healing.

Compression pump: Regular use of a compression pump will help to stimulate venous and lymphatic flow and prevent accumulation of swelling. It will reduce the secondary edema. It has also been proven to prevent or slow down the accumulation of fatty tissue and edema.

Liposuction: Lymph sparing liposuction has been successful in reducing the fat deposits in Lipedema. Currently, it is only available in specialized hospitals like Duke, Johns Hopkins and MD Anderson. This video by NYC surgery explains the process. https://youtu.be/aMQQijVYmCQ

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Who can refer patients to our therapy center:

Physician | Oncologist | Vascular Surgeon | Case Manager | Nurse & Physician's Assistant | Podiatrist