Lipedema and Lymphedema
Lipedema, a condition where fat is distributed in an irregular way beneath the skin, can be confused with lymphedema, a condition where lymph fluid drainage is blocked and builds, but they are not the same. Lipedema can lead to lymphedema, however.
At Northern Michigan Vein Specialists, we treat patients with these conditions in Traverse City, Cadilac, Manistee, Big Rapids, MI, and the surrounding areas.
lipedema Vs. lymphedema
Lipedema involves irregular fat under the skin. Lipedema begins high on the legs and descends as it builds.
Lymphedema involves accumulation of lymph fluid due to improper drainage through the lymph vessels and nodes. Lymphedema does not involve fat, although it may accumulate in later stages. Lymphedema affects both the legs
What is lipedema?
Lipedema occurs when the fat that is under the skin is distributed in an irregular way, making the lower half of your body and legs large. Lipedema is thought to affect about 11 percent of women. It begins as a cosmetic concern, but can lead to more severe problems.
Symptoms of lipedema
A person suffering from lipedema may have a lower half that is twice as large as their upper half. This applies both to the torso and down into the legs. The legs lose shape and become like two columns. A woman with lipedema may be a size 10 on top and a size 20 on her lower half.
As lipedema continues, the fat builds, making the lower body heavier and heavier. Eventually, fat can also start to collect in the arms.
Patients will often have tenderness or pain in the fat, and they tend to bruise easily.
If left untreated, the fat cells begin to block the vessels of the person’s lymphatic system. This is the body’s system for flushing viruses, bacteria, and waste from the body. This buildup of fluid is called lymphedema, and can lead to infections, poor wound healing, hardened skin in the legs, and other problems.
Doctors sometimes confuse lipedema for obesity or lymphedema. But lipedema affects the legs and thighs, not the entire body like obesity. And unlike lymphedema, which starts in the lower legs, lipedema starts in the upper legs.
causes Of lipedema
Lipedema is both an excess buildup of fat cells in a particular area, and the expansion of those fat cells. Why this happens is unknown. But because this is basically a condition that affects women, it is assumed that hormones play a role. Other clues that point to this are that lipedema begins or worsens at puberty during pregnancy, after gynecologic surgery, and around the start of menopause.
There also seems to be a genetic factor, as different family members often have the condition.
What are the stages of lipedema?
Lipedema has four stages:
- Stage 1 — The skin looks normal, but has a spongy consistency when touched.
- Stage 2 — Large fat deposits with indentations begin to form on the legs, especially around the knees and ankles.
- Stage 3 — Fat deposits on the legs are bulky, and begin to hang over the hips, knees, and ankles. Legs feel stiff and fat beneath the skin
- feels harder and more fibrous.
- Stage 4 — Fat deposits are now so large and extreme that the entire lymphatic system is affected. This causes severe swelling, protruding growths, and the skin can leak.
Although it seems counterintuitive, diet changes and exercise will not reduce the fat in lipedema. Treatment is called decongestive therapy. It involves these steps:
- Manual lymphatic drainage — This form of massage focuses on stimulating the flow of lymph around blocked areas to healthy lymph vessels. This allows the lymph to drain into the venous system and relieves pain and prevents fibrosis.
- Compression — Custom-fitted pantyhose, panties, spandex shorts, and stretch bandages can be used to increase tissue pressure in the swollen legs and decreasing future fluid buildup.
- Liposuction — Tumescent liposuction is used to remove the lipedema fat. A saline solution that includes lidocaine and epinephrine is injected into the target areas to constrict the fat and blood vessels. Then a hollow tube with suction, called a cannula, is inserted through a small incision and the fat is suctioned out. Several liposuction sessions may be required to remove the abnormal fat.
- Exercise — Although this won’t reduce the fat, exercise is important to reduce fluid buildup, improve mobility, and maintain leg function.
What is lymphedema?
Lymphedema is swelling that occurs in the arms or the legs due to a collection of too much lymph fluid. It typically affects the arms or legs, but can occur elsewhere.
causes Of lymphedema
Lymphedema is commonly caused by damage to your lymphatic system or blockage in the system. There are two types of lymphedema:
This form is caused by another condition or disease that damages your lymph nodes or lymph vessels. These are some of those causes:
- Cancer or radiation treatment for cancer
- Infection in the lymph nodes
- Lymph node removal
- Injury to the lymph nodes
This form is much less common. It is a genetic problem where the person’s lymph nodes or vessels are missing or are poorly developed.
Symptoms Of lymphedema
- Swelling of part or all of your leg or arm, including the digits.
- A feeling of heaviness or tightness
- Restricted range of motion
- Aching or discomfort
- Recurring infections
- Hardening and thickening of the skin (fibrosis)
What are the stages of lymphedema?
There are four stages to this condition:
- Stage 0 — Also called latent lymphedema, there are no visible changes, but the lymph transport is impaired. Patients may have tightness in the skin or heaviness.
- Stage 1 — This is mild lymphedema. It includes mild swelling that will begin in the furthest part of the limb, such as the hand or foot, and slowly moves up the limb. Gravity causes this pooling during the day, and it may disappear at night when the limbs are raised.
- Stage 2 — Moderate lymphedema causes the skin to acquire a spongy appearance and it pits less than in Stage 1 because the skin is gradually thickening due to fibrosis. Fatty tissue will likely be accumulating below the skin due to inflammation from the lymph fluid building in the tissues. \
- Stage 3 — Also known as severe lymphedema, the skin becomes very hard and scaly and enlarges significantly. The skin can begin leaking, a condition known as lymphorrhea through breaks in the skin. Skin folds become a problem and infections develop in them. The limbs become very heavy and impact movement.
There is no cure for lymphedema, but it can be treated and kept in lower stages. These are treatment approaches:
- Compression garments — Fabric sleeves apply pressure onto the affected limb. This helps the lymph fluid to circulate are remove waste products.
- Compression devices — These sleeves are attached to a pump that automatically applies and then releases pressure onto the limb on a timed schedule to prevent lymph fluid buildup.
- Bandages — Wrapping the area can help push the lymph fluid toward the trunk of the body and out of the limb.
- Massage — Lymphatic massage helps to move fluid from areas of swelling to other areas where working lymph vessels can carry it away. Patients are also taught how to do this massage themselves.
- Exercise — Exercises may help promote lymph drainage and they will strengthen the affected limb.
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