Lipodema, or fat swelling, is a congenital disease that manifests itself as the excessive accumulation of adipose tissue on the limbs. Mainly affects lower limbs, but in 30% of patients affected by this disease also upper limbs. Characteristically, it does not affect feet and hands. An additional symptom is increased sensitivity to touch, tendency to bruises and petechiae, and in advanced cases pain in the limbs.
Despite the inborn nature of the disease, it does not affect children, the first symptoms appear during puberty. Disease only affects women. Faster progression is associated with pregnancies, and full manifestation occurs in the perimenopausal period, which may indicate the influence of hormones on its development. In addition, fat swelling often occurs in the family, so you can assume that the disease has a genetic basis.
Lipodema was first described in 1940, but the latest research have shown that it occurs even in a dozen or so percent of the female population.
The disease is progressive and we can distinguish three stages of its development.
Along with the diseases’ progress, as a result of the occurrence of microcirculation failure, lymph edema is added to the fatty edema, which further increases the deformation of the limbs.
Conservative treatment consisting of lymphatic massage and compression therapy, that is, wearing special compression products, reduces the symptoms of ailment, although it is not very effective and does not stop the development of the disease at all. Of course, Lipodema often occurs in overweight women, but equally applies to slim women who are dissatisfied with the appearance of their legs. Such women have a characteristic appearance – a slender face, torso and waistline, and slender feet, and disproportionately thick thighs or thighs and calves.
Diet and exercise do not bring the effect of slimming legs, which causes frustration in patients.
Several years ago, German doctors changed their approach to treatment of fatty edema. They came to the conclusion that conservative treatment, i.e. pressure and massage, can only eliminate the components of additional lymphatic disorders but does not combat the cause, i.e. do not reduce the amount of constantly growing body fat.
That’s why fat swelling started to be treated surgically by means of liposuction. In the case of lipodema, liposuction is not a cosmetic treatment, but a treatment for a disease that is designed to improve the quality of life of patients and prevent disability in the future.
The cause of the disease is most likely genetic and is associated with a mutation of genes, even liposuction does not combat the cause, but reverses the disease progression, improving the quality of life. Therefore, the liposuction procedure may require repeating in a few or about a dozen years.
Depending on the condition, it is often required to remove up to even a dozen liters of fat from the limbs. In such cases, the procedure is carried out in several stages to minimize the risk of complications. Most often, the procedure is performed in a one-day setting, under local anesthesia combined with sedation and intravenous analgesia.
The most delicate or causing the smallest traumatization of tissues is liposuction carried out using the Vaser methods – ultrasound assisted liposuction and Body-Jet – liposuction assisted by a water jet.
Liposuction is currently considered not as an alternative to conservative treatment, but is the treatment of choice for lipodema.
dr Thomas Drazba i Michał Kłos -ŚUM
