Two cases of lipedema are presented. They illustrate this clinical syndrome which occurs almost exclusively in women and presents as grossly enlarged legs, thighs and buttocks. The etiology remains uncertain. [ncbi.nlm.nih.gov]

CASE 3, A PATIENT IN STAGE 2: A 52-year-old woman presented with a 7-month history of ankle edema. [amjcaserep.com]

While lipedema presents itself in various ways, diagnosis is possible as early as pre-puberty when inner thigh pads present and at any age when fat gathers and drapes at knees. [lipedemasurgery.com]

• Pain

  This fatty tissue tends to accumulate fluid causing the affected areas to become swollen and painful. The skin over lipedemic fat bruises easily and is often tender or painful. [younaiplasticsurgery.com]

  Other symptoms may include:10 Painful fat: The fat on the legs and hips may ache and be sensitive or painful to the touch or to any pressure. In the past, sometimes the condition was called adiposis dolorosa, meaning “painful fat.” [dietdoctor.com]

  These fatty areas often resemble fatty tumors and are typically quite painful to the touch. The fat mainly deposits on the insides of the legs and knees, causing pain when the legs touch and rub together. [lymphedemasurgeon.com]

  Pain in affected areas likely Pain in affected areas No pain initially No pain Pain is likely Affected population: Best estimate is 11% adult women (study done in Germany) Unknown; best estimate is a few percent of adult women Low ≥30% of US adults [en.wikipedia.org]

  The use of bandages after the pain disappears is helpful in reducing edema. [ncbi.nlm.nih.gov]

• Swelling

  It's a condition that is not only an overgrowth of fat tissue, but it also has a vascular or lymphatic component with swelling. Lipedema causes swelling in the legs and develops the appearance of tree-like, column-like legs. [livestrong.com]

  Often, patients’ chief complaint is of swelling and enlargement of tissue around the ankle. On careful questioning, the “swelling” may not change much as the day progresses, and it may not subside overnight. [bestveintreatment.com]

  Elevating your legs periodically throughout the day may help relieve orthostatic swelling, which is caused by standing. This type of swelling is common during stage 1. [healthline.com]

  Lymphedema is asymmetric swelling of the limbs often only one arm or leg is affected. Lymphedema causes swelling down to the feet and hands whereas lipedema spares the hands and feet. [laserlipoandveins.com]

• Inflammation

  Reducing Inflammation Because inflammation is a factor in lipedema, controlling inflammation and avoiding inflammatory foods is an important part of management. [therapy-a.com]

  Management involves reducing salt intake, frequent, gentle exercise to promote circulation in the legs, as well as maintaining a healthy circulation to reduce inflammation. [lipedemasurgery.com]

  The Anti-Inflammatory style of eating is believed to be helpful in reducing inflammation in the body, which can help reduce pain and has other health benefits. [aptlr.com]

  The title of the paper is “Obesity and Chronic Inflammation in Phlebological and Lymphatic Diseases.” Dr. [leslynkeith.com]

• Weight Gain

  Lipedema occurs as disproportionate bilateral weight gain, most frequently in the lower body. This weight gain can affect the legs, hips, buttocks, arms, abdomen, and other parts of the body.. [norcallipo.com]

  With weight gain these cells do not increase in number, but rather increase in size. [torontophysiotherapy.ca]

  (Image: Milos Dimic/iStock/GettyImages) Imagine gaining weight and, regardless of your diet or exercise habits, you're unable to lose those pounds. [livestrong.com]

• Fatigue

  Fatigue and limited mobility Patients suffer from fatigue and are sometimes limited in their mobility. This can affect their daily functioning and lead to social isolation, psychosocial complaints and obesity. [huidtherapeut.nl]

  Results Lipedema is a foe because lifestyle change does not reduce lipedema fat, the fat is painful, can become obese, causes gait and joint abnormalities, fatigue, lymphedema and psychosocial distress. [ncbi.nlm.nih.gov]

  Leg heaviness and fatigue, which can lead to overall fatigue. Swelling in the affected area. Initially the swelling worsens during the day and resolves at night with elevation. [lipedema.net]

• Overeating

  Sean Younai, a board certified plastic surgeon in Beverly Hills, has over 25 years experience treating fat accumulations through advanced liposuction procedures. [younaiplasticsurgery.com]

  Over time, the hyperplasia [over accumulation] of fat in the subcutaneous tissue can begin to affect the channels of lymphatics. Lymphangiography show the curved course of lymphatics, but, at least early on, the lymphatic flow is usually preserved. [laserlipoandveins.com]

  Limb fat over total body fat mass (p = 0.08) and trunk fat over total body mass trended down from baseline (p = 0.08) by DXA. [ncbi.nlm.nih.gov]

  Over time this results in firming or hardness of the tissues that is characterized by fibrosis. [lymphedema.com]

  Fibrotic changes associated with lymphedema can lead to thickened skin over the proximal phalanges of the toes or fingers. If you can’t tent or pinch the skin on the involved extremity, lymphedema is present (a positive Stemmer sign). [woundcareadvisor.com]

• Nausea

  Women with stage 3 lipedema were also more likely to have obstructive sleep apnea, nausea, constipation and flulike symptoms. [archivesofmedicine.com]

• Vomiting

  […] in this study included asymmetry of fat on the left or right side, unexplained weight loss, lumps in neck fat, difficulty swallowing, blurry vision, neck feels swollen, chest pain, burning pain, scalp or other lesions, thirsty all the time, tremors, vomiting [archivesofmedicine.com]

• Leg Pain

  *Herbs and supplements that help to address lipedema are: *Brown and green seaweed help to expel fluid from the legs. *Horse chestnut capsules relieve leg pain and swelling. *Bio-rutin improves circulation and keeps capillaries open. [alignlife.com]

  This is usually bilateral (affects both sides) and symmetrical (occurs evenly) The feeling of fatty ‘nodules’ underneath the skin Bruising occurs easily and is often unexplained Legs are sensitive to touch Deep throbbing pain in legs, pain in knee joints [allthingsholistic.net]

  […] are very sensitive to the touch Deep throbbing/achy pain in legs Pain in knee joints Legs feel heavy and swell throughout the day (especially after long periods of standing or sitting) but resolve overnight Fat on legs is soft and looks dimpled like [drkaratzias.com]

  Common symptoms of lipedema include the buildup of fatty tissue in the upper legs, pain, and easy bruising. Doctors use staging to describe how extensive a person’s lipedema is. [medicalnewstoday.com]

  Herbs and supplements that help to address lipedema are: *Brown and green seaweed help to expel fluid from the legs. *Horse chestnut capsules relieve leg pain and swelling. *Bio-rutin improves circulation and keeps capillaries open. [tbyil.com]

• Back Pain

  The patient was a 45-year-old woman with chronic back pain, worsening bilateral L5 radiculopathy, and degenerative disc disease. [ncbi.nlm.nih.gov]

  Back pain[edit] Physiotherapy is scientifically proven to be one of the most effective ways to treat and prevent pain and injury. [en.wikipedia.org]

  Studies show that patients with stage 1 lipedema may experience low body temperature, fatigue, muscle aches, low back pain, nasal congestion, visible veins on legs, bloating and early satiety. [scarpidisaesthetics.com]

  Of the patients that had no pain, one had stage 1, two had stage 2, and one had stage 2 with lipolymphedema. A majority of patients had pain in the joints (57 ± 0.5%), fat (49 ± 0.5%), back (44 ± 0.5%), legs (39 ± 0.5%) and muscle (37 ± 0.5%). [archivesofmedicine.com]

• Contusion

  The effects of diosmin (a benzo-pyrone) upon some high-protein oedemas: lung contusion, and burn and lymphoedema of rat legs. Agents Actions 1985; 17 : 14–20. 174. Suter A, Bommer S, Rechner J. [dx.doi.org]

• Lip Edema

  One unpublished epidemiologic study puts lip edema incidence in females at 11%. Some patients have a combination of lipedema and lymphedema. (See Viewing lipolymphedema.) [woundcareadvisor.com]

  Because in most cases fellow men do not recognize that the concerning suffers from a Lip?edema and the fat cushions did not develop due to predominance and lacking discipline. [lipocura.de]

  It is pronounced as lip-edema and lipo-edema – it can also be spelled lipedema, lipoedema, lipodema and Lipödem. [lipedema.net]

• Suggestibility

  Its etiology is unknown but in analogy to central obesity, chronic low-level inflammation in adipose tissue has been suggested. [ncbi.nlm.nih.gov]

  Pitting edema over her feet suggested associated lymphedema, and the bilateral edema also suggested that the right lymphangitis was not the only cause of lymph-edema (Figure 7). [amjcaserep.com]

  In two clinics specializing in lymphology and edema, 10% to 20% of clinic patients were diagnosed with lipedema, suggesting a prevalence of 0.06% to 0.07%.1,2 A positive family history has been reported in 20% to 60% of patients diagnosed with lipedema [accesssurgery.mhmedical.com]

  However, contradicting this theory are studies that suggest lipedema sufferers do not typically have visible fluid buildup (as assessed by MRI). [torontophysiotherapy.ca]

• Denial

  The dedicated and compassionate Los Angeles insurance bad faith attorneys at Gianelli & Morris have made it part of their mission against bad-faith insurance denials to fight for coverage for those who suffer from lipedema. [gmlawyers.com]

  Unfortunately, the combination of misconceptions about obesity and lipedema, along with the use of a code for suction lipectomy, which is often employed for cosmetic indications, has resulted in almost universal insurance denials. [drkaratzias.com]

  […] and Novel Reduction Strategies -How Yoga Helps the Lymphatic System -Fat Disorders & Retirement-Navigating the Next Chapter of our Lives -From Childhood Isolation to Mystery Diagnosis to Immeasurable Happiness -7 D's in Living with Dercum’s Disease: Denial [eventbrite.com]

• Anger

  […] lip as if in anger and immediately depart. gar nigaah-e-shauq1 ko mahv-e-tamaasha2 dekhiye qahr3 ki nazroN4 se masroof-e-sazaa5 ho jaaiye1.eye of desire/love 2.engrossed in gazing 3.anger 4.looks 5.busy in punishing The poet lover is engrossed in gazing [urdushahkar.org]

  Added to the body image problems, these symptoms cause feelings of dejection, anger and sadness to the point that depression often develops. [steptohealth.com]

  I literally burst out laughing when I read that but anger and despair soon set in! This book is a life-saver! It confirms what we know. [amazon.com]

  They described feelings of anger and misery, as the healthcare professionals did not apologize for their disrespectful treatment. [tandfonline.com]

• Excitement

  Laura Baker, Dercum’s patient, says, “We need more healthcare professionals to take an interest in this rare disorder and these fellowships are an exciting new development for Dercum’s patients.” [businesswire.com]

  I was personally so excited to see all the amazing winners of color, like Spike Lee (finally!) Ruth Carter, Regina King, and Mahershala Ali. [lipladyfab.com]

  I am So excited to announce that Surgery #1 is scheduled for April 15th 2020 in Mulheim Germany in the Lipoclinic by Dr.Heck! [gofundme.com]

  Albano will have her surgery soon and is excited to have her life and her limbs back. Once a patient has the lipedema surgery it will take about a year to 18 months to see the full effect of the slimming. [abc30.com]

  This will be my first appointment with her and I’m very excited to be seeing her. I will update you all with what I learn once I return to Portland. [youcaring.com]

• Irritability

  *Opt for natural cosmetics that do not irritate the skin. When bathing, use a soap with an acid pH value in order to prevent dry and cracked skin. [alignlife.com]

  The treatment was completed after 20 weeks with total epithelizsation, without maceration and irritation, without additional spreading of the chyloderma field, without wound infections, with fast and full relief of the pain. [ncbi.nlm.nih.gov]

  Skin irritation and intertrigo can develop in the skin folds such as the groin and between the thighs. [dermnetnz.org]

  The transition between the pool and the bike for me is a long one, because as someone with Lipedema and Lymphedema, it is important for me to shower off right after the swim (to get any chemicals off my skin that might cause irritation; and to then get [lipedemafitness.blogspot.com]

• Vertigo

  […] difficulty swallowing, blurry vision, neck feels swollen, chest pain, burning pain, scalp or other lesions, thirsty all the time, tremors, vomiting, thrombophlebitis, visible veins on arms, tick bite, chronic sinusitis, warts, myoclonus, dry eyes, dry mouth, vertigo [archivesofmedicine.com]

  Additional symptoms included vertigo, headaches, hearing loss, not sleeping well at night, difficulty swallowing, fluctuations in body temperature, and bloating. [omicsonline.org]

• Dizziness

  A feeling of dizziness may be present. There seems to be a reduction of venous return in the legs when standing which can lead to fainting; this may be prevented by walking. There is little or no loss of weight with rigorous diet. [lymphedemapeople.com]

We can assess your circulation in our non-invasive cutting edge vascular lab as part of your workup to ensure that any issues with blood flow can be addressed, and it is part of your workup at our centers. [lipedemasurgery.com]

Consideration for the following differential diagnosis for lipedema can be helpful when embarking upon further workup to determine proper clinical management. Figure 3 Algorithm for workup in patients presenting with lower extremity enlargement. [dovepress.com]

Further diagnostic tests are usually reserved for special cases that require additional workup. Lipedema is a chronic, progressive disorder marked by the individual variability and unpredictability of its clinical course. [ncbi.nlm.nih.gov]

Treatment The typical treatment for lipedema is initially conservative therapy with complete decongestive therapy by a trained Lymphedema therapist. [lymphedemasurgeon.com]

Comprehensive Lipedema Treatment in Los Angeles The only known permanent lipedema treatment is a technique called lymph sparing liposuction surgery. [younaiplasticsurgery.com]

Non Surgical Treatment Medical treatment is largely ineffective. [lipedemasurgery.com]

The treatment continued for a month. [ncbi.nlm.nih.gov]

Active treatment for lipedema is required because early diagnosis and treatment can determine the patient's long-term prognosis. [ncbi.nlm.nih.gov]

Prognosis Regarding mortality, the prognosis of uncomplicated lipoedema is good; however, regarding healing, the prognosis is poor unless adequate treatment is provided. [sanare.ie]

Obesity is an important risk factor for the severity and prognosis of lipedema. Further studies for a better understanding of the pathogenesis of lipedema and in the end possible curative treatments are urgently needed. [unboundmedicine.com]

The etiology remains uncertain. Although infrequently diagnosed, lipedema is not rare. We report success treating such patients with properly measured and fitted compression garments. [ncbi.nlm.nih.gov]

In this review, we sought to review and identify information in the existing literature with respect to the epidemiology, pathogenesis, clinical presentation, differential diagnosis, and management strategies for lipedema. [ncbi.nlm.nih.gov]

As a result, the true number of women with lipedema, or its epidemiology, is unknown. [lipedema.org]

Lipedema Foundation: Another 501(c)3 non-profit organization founded in 2015 to fund collaborative research that addresses the biology, genetics, and epidemiology of lyipedema. [airosmedical.com]

This review aims to outline current evidence regarding lipedema epidemiology, pathophysiology, clinical presentation, differential diagnosis, and management. [onlinelibrary.wiley.com]

Epidemiology Although there is no epidemiological data on the prevalence of lipedema, Földi described a prevalence of 11% in women, is extremely rare in men. Herpertz reports that lipedema accounted for 15% of patients in a lymphedema clinic. [diseasesdic.com]

The pathophysiological basis is edematization of the tissues. Lymphedema involves an impairment of lymph drainage with resultant fluid build-up. [ncbi.nlm.nih.gov]

Furthermore, consistent information on lipedema pathophysiology is still lacking, and an etiological treatment is not yet available. [onlinelibrary.wiley.com]

Abstract PURPOSE: To enhance the learner's competence in caring for patients with lipedema through understanding the differential diagnoses, pathophysiology, and treatment/management options. [doi.org]

This lesson addresses these issues by describing the presentation, pathophysiology, diagnosis and management of lipoedema in primary care. [elearning.rcgp.org.uk]

This blockage prevents the proper drainage of lymph fluid, leading to a buildup of fluid called lymphedema. [webmd.com]

Compression prevents recurrence of lymphedema, and in some lipedema patients can reduce the pain of the affected fat. There is currently no known uniform medical procedure to cure lipedema. [lipedemasurgery.com]

Tumescent liposuction is the most effective treatment for Lipedema, and it can prevent recurrence for an average of five years. [stanfordhealthcare.org]