By lipedema, a chronic and progressive inflammatory pathology is known, which generates in those who suffer from it a feeling of heaviness, edema, and swelling, which does not improve with rest. It is essential to recognize and diagnose it correctly so as not to delay your treatment and worsen the conditions

The legs represent a symbol for each of the women. Have them splendid for each summer or occasion to wear a dress that exhibits a concern and occupation before each event. However, there is a problem that makes many women feel embarrassed to show them and also generates many health problems: lipedema.

It is a progressive chronic inflammatory disease, which affects 11% of women in the world (it is rare in men) and is characterized by a disorder in the distribution of fat that mainly affects the lower limbs, although it can also reach the upper limbs, and is accompanied by edema and pain.

It is essential to recognize and diagnose it correctly since it is common to be confused with obesity and lymphedema (abnormal accumulation of fluid in the soft tissue due to an obstruction in the lymphatic system), which delays treatment and worsens conditions.

The lipedema is characterized by a disorder in the distribution of fat that primarily affects the lower limbs

The high ignorance that exists on this problem and the failures in the diagnosis impose a more comprehensive and committed approach, which is why this topic will be one of the main focuses of the XVIII International Congress of Phlebology and Lymphology of the Argentine College of Venous and Lymphatic Surgery, which will take place from June 6 to 8 in Buenos Aires, with the participation of more than 25 international specialists.

How to recognize lipedema?

One of the main characteristics of this pathology is the pain and the difficulty to move the joints that this excessive accumulation of fat causes.

It is a chronic condition in which fat accumulates progressively in the lower extremities (iStock)

“The distribution of fat is symmetric, but it has a pathognomonic characteristic: it respects the feet and hands, in the case of the involvement of both limbs,” said Mabel Bussati, president of the Argentine College of Venous and Lymphatic Surgery and organizer of the Congress…

Although its origin is still unknown, the specialist explained that genetic, family, hormonal, inflammatory or metabolic causes intervene in some cases.

The signs of lipedema are variable: feeling of heaviness and swelling, which does not improve with rest, and edema

“The deformity of the limbs is always symmetrical, unlike lymphedema that is unilateral or bilateral, multiple telangiectasias (spider veins) appear in the affected areas and spontaneous hematomas due to capillary fragility,” Bussati added.

He also stressed that “it entails a dynamic insufficiency of the lymphatic system, with an accumulation of interstitial fluid, which in the progress of the disease can evolve towards a lipolinfedema, which is nothing less than a dangerous combination of lipedema and lymphedema.”

With the progress of lipedema, the temperature of the skin becomes cold and the color is pale. In addition, “the pain is aggravated, both palpation and spontaneous pain, which in severe forms does not subside with common analgesics, since the lipomatous masses compress the nerve endings and pain receptors”, the specialist completed.

In more advanced stages, very bulky limbs affect the joints, which causes severe pain and difficulty in mobilization, as well as vicious postures that complicate the picture.

The patient usually suffers from multiple telangiectasias in the affected areas and spontaneous bruising (iStock)

“The deformities of the members produce different degrees of disability and psychological stress because patients have altered body image and affect self-esteem, which can lead to anxiety, depression, sleep disorders and, in severe cases, evolve towards dementia, “he said.

In the scarce number of affected men, it is located mainly in the upper trunk (Popeye syndrome) and is related to alcoholism and liver disorders.

Diagnosis and treatment

The diagnosis is fundamentally clinical, through inspection and palpation. Meanwhile, the specialist stressed that “auxiliary diagnostic methods allow the establishment of concomitants of other diseases, so it is important to have the endocrinological profile of the patient and know what are the comorbidities that present, to treat them.”

As it is a chronic condition, it has no definitive cure, but it does have treatment, which prevents the progression of the disease to invalidating forms.

The lipedema does not change with the diet, but it is important to maintain control of weight and body mass index

Bussati explained that the treatment is divided into medical and kinesic. “It is very common, for lack of knowledge of the disease, that the patients with lipedema are treated with a diet. Lydema does not change with the diet, but it is important to maintain control of weight and body mass index. -she emphasized- Physical activity is fundamental to combat sedentary lifestyle.

And after emphasizing that “the exercises should be according to sex, age, occupation and pathology they present”, the expert recommended as “ideal” the walk, bicycle and especially water gymnastics, since in the water the joints do not suffer the impact, so that it does not affect the body weight and the mass of water exerts compression on the adipose masses. “The exercise should aim to strengthen the muscular impulse pumps that improve venous and lymphatic return,” he said.

Likewise, combined physical therapy, that is, manual lymphatic drainage, intermittent sequential pressure therapy, adequate compression, and exercise are essential. Like the taping (neuromuscular bandages), it dramatically improves the venous lymphatic drainage and the pain of the lipedematous masses.

In the early stages, the picture can be confused with cellulite (iStock)

” The surgery, reserved for a smaller number of patients, can be performed by a team trained in these conditions, for example, liposuction of the adipose masses,” Bussati said.

The XVIII International Congress of Phlebology and Lymphology of the Argentine College of Venous and Lymphatic Surgery will take place in conjunction with the VII International Interuniversity Congress of Advances in Phlebology, Lymphology and Aesthetics and the III International Congress of Phlebology and Lymphology of the Phlebology and Lymphology Association of the Province of Buenos Aires and is oriented to the training and professional updating of doctors of all specialties in general, and especially to phlebologists, lymphologists, vascular surgeons, general surgeons, interventionists, specialists in diagnostic imaging, surgical instrumentation, kinesiologists and nurses.