Lipedema is a rare disease in which the process of fat distribution in the body is impaired. The most commonly affected areas are the hips, buttocks, and legs. In 30% of cases, it can affect the upper arms, particularly from the shoulder to the elbow.
A typical profile of a patient with lipedema is a disproportionately heavy lower body. One may have a thin or moderately full upper body with massive legs and buttocks, sometimes several times larger than the torso. The excessive weight rarely decreases even after intensive diets and constant physical activity.
The cause of lipedema remains unclear. This disease occurs in the vast majority of cases in women. Therefore, scientists believe that hormonal causes are central to lipedema, but this is not yet confirmed. Lipedema only occurs in men in cases of hormonal imbalance and liver diseases.
The first symptoms usually appear during puberty. Other hormonal changes, such as pregnancy and menopause, can also trigger lipedema.
It is an independent condition that requires a special approach to treatment. It should be considered an independent condition, requiring a special approach to treatment.
In the early stages, patients notice only an increase in limb volume, with the fat being painless. The absence of pain, one of the main symptoms of lipedema, complicates the diagnosis. Many patients and physicians attribute the changes in the body to weight gain.
With regular weight control, early-stage lipedema should not progress further.
At this stage, the patient’s overall weight begins to increase. This process triggers the growth of subcutaneous fat tissue on the legs, with “nodules” appearing in the affected areas, easily felt upon touch.
As the condition progresses, the lymphatic system becomes affected. The fat tissue produces so much lymphatic fluid that the lymphatic system cannot handle it, causing the fluid to accumulate in the tissues and aggravate the condition. In fact, this is a case of classic lymphedema, not due to impaired lymph drainage (as in lymph node removal) but because the lymphatic system cannot cope with the excessive lymph produced by the lipedemic fat.
Lipedema treatment can be divided into two methods:
Our experience has shown that surgical treatment is highly effective for patients with lipedema. We are one of the few teams in Russia specializing in lipedema treatment. Our extensive experience in managing lymphedema allows us to perform procedures while respecting lymphatic pathways without damaging them, which is crucial in lipedema treatment. The standard approach used in aesthetic liposuction is inappropriate for lipedema! It might worsen edema and lead to the formation of chronic lymphatic cavities.
A patient came to us after having hip reconstruction surgery for lipedema in another clinic.
In this case, the lymphatic system’s anatomy was not considered, leading to damage of lymphatic vessels from the lower leg. As a result, there was shin edema and a chronic lymph cavity at the bottom of the scar.
To confirm that the lymph in the cavity originates from damaged vessels, we performed an indocyanine green test by injecting it into the right foot. When aspirating the fluid from the cavity with a syringe, a bright glow is visible on the screen, definitively proving that the lymph originates from the damaged vessels.
Surgical treatment of lipedema requires a thorough study of the lymphatic system, as standard aesthetic liposuction carries high risks of complications and worsened edema.
It does not cure lipedema but helps improve patient well-being, partially control the disease, and alleviate symptoms.
Helps control weight and improve lymph drainage from the legs. It is important to be gentle on the knee joints, avoiding running and other high-impact activities. Swimming is preferable.
Helps reduce leg size, ease pain, and slow disease progression.
An important element of therapy, as its use reduces pain, improves mobility, and helps remove excess fluid from the limbs.
If you have any garments that no longer fit, we can tailor them to fit better and extend their lifespan.
Helps temporarily reduce edema, alleviate pain, improve mobility in patients with lipolymphedema, and prevent disease progression.
It is important to understand that manual lymphatic drainage cannot reduce fat tissue if it is already present in the leg.
This method is most effective when combined with wearing compression garments.
Dr. Ivashkov’s clinic has an experienced team of rehabilitation specialists and lymphologists who perform comprehensive decongestive therapy, including manual lymphatic drainage, bandaging, and individual garment selection.
Liposuction is the only radical treatment for lipedema. During the procedure, the surgeon removes all the overgrown subcutaneous fat tissue along with the lymphatic component.
According to global practice, 65% of patients require less conservative treatment after liposuction.
In patients who maintain their weight after liposuction, lipedema does not recur! This is because the number of fat cells in the body does not increase over a lifetime; only their size increases with weight gain. By radically reducing the amount of subcutaneous fat tissue, we remove a large number of fat-storing cells and relieve the lymphatic system, allowing it to function normally without overloading.
Untreated lipedema is not only an aesthetic issue but can also lead to lymphedema, osteoarthritis, decreased mobility, psychological disorders, and lowered self-esteem.
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