Lipedema

Lipedema affects up to 11% of women. It happens when fat is distributed in an irregular way beneath your skin, usually in the buttocks and legs. Although it begins as a cosmetic concern, it can eventually cause pain and other problems.  Lipedema can be mistaken for regular obesity or lymphedema.

Symptoms of Lipedema

The typical symptoms are a large lower half and column-like legs, which are often tender and bruise easily. For example, the top half of your body may be a size 8, but the bottom half may be a size 16.

As the condition progresses, fat continues to build up, and your lower body grows heavier. The lipedemic fat can later collect in the arms. 

Over time, fat cells block the vessels of your lymphatic system, which normally helps balance body fluid levels and protect against infection. This blockage prevents the proper drainage of lymph fluid, leading to a buildup of fluid called lymphedema.

If not treated, lymphedema can lead to problems such as infections, delayed wound healing, development of scar-like tissue called fibrosis, and hardened skin in the legs.

Causes of Lipedema

The cause is not known, but doctors suspect female hormones play a role. That's because the condition affects mostly women, and it often begins or worsens at puberty, during pregnancy, following gynecologic surgery, and around the time of menopause.

Scientists also believe genes are involved, because many women with the condition have family members with the condition.

Lipedema Treatments

Dieting and exercising will not reduce the fat involved in lipedema. But it's still important to do those things because they can help you lose weight from nonlipedema fat and reduce inflammation.  

A treatment called complete decongestive therapy can ease painful symptoms. Complete decongestive therapy involves:

Manual lymphatic drainage. A form of massage that uses gentle, rhythmic pumping movements to stimulate the flow of lymph around blocked areas to healthy vessels, where it can drain into the venous system. This helps relieve pain and prevent fibrosis.

Compression. The use of stretch bandages or custom-fitted panty hose, panties, or spandex shorts to increase tissue pressure in the swollen legs and lessen the odds of fluid building up again.

Exercise. Helps to reduce fluid buildup, boost mobility, and maintain or improve how well your legs work.

Thorough skin and nail care. Helps lower the risk of wounds and infection if you have lipedema associated with swelling.

Liposuction, specifically water-assisted liposuction  and tumescent liposuction, can remove the lipedema fat. The procedure uses a hollow tube that is placed under the skin to suction the fat tissue. Several sessions may be needed depending on the amount of abnormal fat.

WebMD Medical Reference Reviewed by Arefa Cassoobhoy, MD, MPH on September 29, 2015

Sources

SOURCES:

Fat Disorders Research Society: "Lipedema Description."

National Lymphedema Network: "LymphLink Question Corner."

Genetic and Rare Diseases Information Center: "Lipedema."

West Virginia University HealthCare: "Lymphedema."

Lymphology Association of North America: "What is Lipedema?"

UCDavis Health System: "Manual Lymphatic Drainage Massage (MLD)."

University of Rochester Medical Center: "Lymphedema Therapy: Complete Decongestive Therapy."

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