Lipedema
Understanding a chronic disease of female adipose tissue
Lipedema is a chronic disease of fatty tissue, affecting almost exclusively women.
It is characterized by an abnormal, symmetrical and painful accumulation of fat, mainly in the legs and sometimes the arms, with a typical sparing of the feet and hands.
Too often confused with obesity, lipedema is a recognized medical condition, responsible for a major functional, aesthetic and psychological impact.
What is lipedema?
Lipedema is associated with:
an enlargement of fat cells,
local chronic inflammation
capillary fragility (easy bruising),
a progressive alteration of lymphatic drainage
Unlike obesity, diets and physical activity have little impact on the affected areas.
Suggestive clinical signs
Symmetrical increase in limb volume
Spontaneous pain or pain upon pressure
Sensation of heavy legs
Frequent bruising
Worsening at the end of the day or in the heat
Respect for the feet (sign of the bracelet)
The stages of lipedema
Stage I: smooth skin, diffuse increase in volume
Stage II: fatty nodules, uneven skin
Stage III: significant deformities, functional impairment
In advanced stages, lipo-lymphedema may be associated.
Diagnosis of lipedema
The diagnosis is primarily clinical, based on:
the interrogation,
the specialized physical examination,
exclusion of obesity and primary lymphedema.
Imaging examinations are useful in some cases, but not systematic.
Treatment of lipedema
Conservative approach
Medical compression
Lymphatic drainage
Adapted physical activity
Nutritional support
These treatments relieve the symptoms, without treating the cause.
Surgical treatment: specialized liposuction
Liposuction specifically for lipedema is currently the only treatment that allows for a lasting reduction of pathological fatty tissue.
Key principles:
atraumatic techniques (tumescent, PAL, WAL, selected indications VASER®),
respect for the lymphatic system
progressive surgery, often in several stages.
Post-operative compression garments are essential.
Objectives of the surgery
✔ Lasting reduction in volume
✔ Significant pain reduction
✔ Improved mobility
✔ Improved quality of life
Key message for patients
✔ Lipedema is a real and recognized disease
✔ This is neither a lack of willpower nor simply being overweight
✔ A specialist diagnosis is essential
✔ Appropriate care can transform quality of life
Lipedema management in Quebec and Canada
The management of lipedema requires specific surgical expertise, integrated into a comprehensive and personalized approach.
