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Lipedema diagnosis

One of Dr. Wright’s newer patients, Crystal, was diagnosed with Lipedema for the first time just 3 months ago, and she’s already feeling the joy and relief that comes with an official Lipedema diagnosis

“I felt a sense of relief and joy come over me instantly,” she says. 

Crystal was diagnosed by Dr. Wright with Stage 3, Type 3, and 4 Lipo-Lymphedema. Over the next 90 days post-diagnosis, she’s undergone two Lipedema surgeries and overcome a lifetime of challenges when it came to “her relationship with gravity”, as she calls it. She lost just over 70 pounds after the two surgeries and is relieved to be on a path of healing. 

Lipedema diagnosis

What is Lipedema?

Lipedema is a fat disorder, mainly affecting women, that causes an enlargement of both legs due to deposits of fat under the skin. It’s characterized as a “progressive disorder,” meaning it generally gets worse over time. In severe and more progressive cases, the trunk and upper body may also be affected, including the arms and upper back, and it’s often misdiagnosed and incorrectly treated as general obesity.

 

Nearly 17 million women in the U.S. and nearly 370 million women across the globe suffer from Lipedema. What is regularly associated with unruly weight gain in its initial stages can quickly spiral out of control if left undiagnosed. Often striking in a woman’s mid-20s, Lipedema is a disease that leads to the excessive buildup of fat cells primarily in the arms and legs. Going far beyond the appearance of extra pounds, those who suffer from Lipedema often present with pockets of fat on the limbs that appear disproportionate in comparison to the rest of the body.

Troubling Signs and Symptoms

Women suffering from this disease often report the association with lipedema pain symptoms that trigger difficulties dealing with everyday life activities. Excessive swelling often comes with pain, numbness, and bruising. In its advanced stages, Lipedema can impact mobility and provokes vascular and lymphatic swelling which can lead to further medical complications.

Lipedema diagnosis

Living with Lipedema Diagnosis

Lipedema is often misdiagnosed as standard obesity, leaving patients to deal with an endless cycle of disappointment and ongoing, painful lipedema symptoms. As they continue, their weight refuses to fall off. Unfortunately, Lipedema does not respond to a simple calorie restriction or increased exercise and ultimately requires surgical intervention in order to alleviate the appearance and pain of symptoms. 

Lipedema diagnosis

Patients often report that the road to their initial Lipedema diagnosis is an uphill battle. Women with Lipedema are typically diagnosed by their primary care provider with traditional obesity, and all treatment methods follow this diagnosis.

Unfortunately, as any Lipedema specialist will tell you, this treatment proves ineffective, and leaves women with Lipedema without answers, without a solution, and with continued pain and continued frustration as their, Lipedema continues to progress. Liposuction performed on the affected limbs is one of the most effective forms of treatment. Removing fat deposits that are diseased not only helps reduce swelling of the limbs but alleviates the pain that holds patients back from everyday activities. But before women with Lipedema and even consider these procedures and treatment options, they must first find a doctor who is an expert in this field and start with a proper diagnosis of the disease.

Getting Help & Lipedema Treatment

Just like Crystal, many women search for answers for years before getting an official diagnosis and validation for their struggles. “My body really needed this healing,” Crystal says. “I needed answers and I was craving [an] explanation why my body was fighting me.” While she contributes 15 pounds lost directly to her surgeries, she says she’s done the non-surgical work to get rid of additional lipedema swelling and fluid alongside surgery. She says she monitors what she eats and when, and eliminated a few types of foods that directly increase swelling, helping her lose more than 50 pounds on her own, and improving the outcomes of both her surgeries tenfold. 

She encourages other women who think they may have Lipedema to contact Dr. Wright and his team to get the same help she’s received. “If you have lipedema or lipo lymphedema like I do, go easy on yourself,” she says. “There isn’t anything you could have done to prevent it, but I’m living proof there are things you can do to live better and have a higher quality of life.”

Before tackling the issues and symptoms associated with lipedema, it is important to assess your vein health by working closely with a vein specialist. Vein issues and lipedema, both can cause painful, heavy legs, and tenderness, so it can be difficult to know if your symptoms are related to veins or solely to lipedema. An experienced vein specialist can get you on the right path to a diagnosis and treatment plan.

Common Vein Issues

Understanding the limits of vein treatment in lipedema

Many women with lipedema require lifelong use of compression garments, so the advantages of treating vein issues are somewhat limited. Plus, unfortunately, edema in the legs of lipedema patients generally does not significantly improve after vein treatment. However, lipedema reduction surgery can at least temporarily treat venous insufficiency. Vein issues and issues with the lymphatic system are connected.

3 Reasons to Treat Vein Issues before Lipedema

  1. Cross-over in symptoms of between vein issues and lipedema.
  2. Vein issues stress the lymphatic system.
  3. Always treat varicose veins before leg liposuction to prevent complications during the liposuction procedure.

Learn more about their relationship.

What is Lipedema?

Lipedema is a fat disorder, mainly affecting women, that causes an enlargement of both legs due to deposits of fat under the skin. It’s characterized as a “progressive disorder,” meaning it generally gets worse over time. Sufferers living with lipedema experience easy bruising and tenderness, pain in the affected areas, and significant disability in daily life. In severe and more progressive cases, the trunk and upper body may also be affected, including the arms and upper back. Little is known about the disorder, and it’s often misdiagnosed and incorrectly treated as general obesity.

What is lipedema reduction surgery?

Lipedema reduction surgery is a spin-off of liposuction focused on the reduction of lipedema tissues including fibrous tissue, fat, and extracellular contents. It is possible for lymphatics to be injured by a suction cannula during lipedema reduction surgery and/or cosmetic liposuction. Some argue whether this is possible, but studies show it can, and unfortunately, may happen for some. So, it is important if you have lipedema, or suspect you may have lipedema that you get a proper diagnosis and work closely with skilled surgeons well-versed in lipedema, lymphatics and lymphedema for the best possible outcomes and treatment plan before you proceed with any type of liposuction.

According to a study by Wright and Herbst, in patients with normal lymphatic function, and no severe injury to the lymphatic collectors, the lymphatic system almost always recovers and returns to a normal state. Suction lipectomy with small blunt cannulas and surgical techniques that focus on avoiding lymphatic damage have been reported to halt lipedema progression. A modification of suction lipectomy can result in alleviating or at least improving the swelling, leg heaviness and fatigue, the need for limb compression, and the need for lymphatic massage in women with lipedema. In patients with an impaired lymphatic function such as chronic lymphedema (or lipedema), careful suction lipectomy using techniques to avoid lymphatic injury can result in improved lymphatic function and a decreased rate of secondary infection or cellulitis in the affected limbs.

Lymphatics and Lipedema

There are well-documented changes in the lymphatics of women with lipedema. The lymphatics are dilated and tortuous. Here are the differences between lipedema and lymphedema:

What are measures that may protect lymphatics?

Protective measures to lessen risk of lymphatic injury include:

Effective techniques to lower the risk of lymphatic injury

The short answer is this issue is hard to study as it is not possible to examine on live patients. There is one study by Hoffman which showed a longitudinal cannula technique and tumescent solution caused less injury to the lymphatics post-mortem. There is some evidence that the preoperative mapping of venous and lymphatic structures can lower the risk of lymphatic injury. While there is clear evidence lymphatic injury can occur, there is no definitive proof of what surgical techniques can prevent lymphatic injury from liposuction or lipedema reduction surgery. Lymphatic injury complications are poorly recognized after suction lipectomy surgeries and therefore are less likely to be reported in the literature for both lymphedema and lipedema.

References

Crescenzi R, Marton A, Donahue PMC, Tissue sodium content is elevated in the skin and subcutaneous adipose tissue in women with lipedema: Obesity (Silver Spring), 2018; 26(2); 310-17.

Hoffmann JN, Fertmann JP, Baumeister RG, Putz R, Frick A. Tumescent and dry liposuction of lower extremities: differences in lymph vessel injury. Plast Reconstr Surg. 2004 Feb;113(2):718-24; discussion 725-6. doi: 10.1097/01.PRS.0000101506.84361.C9. PMID: 14758241.

Iker E, Mayfield CK, Gould DJ, Patel KM, Characterizing lower extremity lymphedema and lipedema with cutaneous ultrasonography and an objective computer-assisted measurement of dermal echogenicity: Lymphat Res Biol, 2019; 7(10); 525-30.

Peprah K, MacDougall D: Liposuction for the treatment of lipedema: A review of clinical effectiveness and guidelines, 2019, Ottawa (ON), Canadian Agency for Drugs and Technologies in Health.

Rasmussen 2022.[https://pubmed.ncbi.nlm.nih.gov/35707862/]  It also well reported that higher stages of lipedema are associated with impaired lymphatic functioning. ,7–9].

The Diagnosis and Treatment of Peripheral Lymphedema: 2016 Consensus Document of the International Society of Lymphology: Lymphology, 2016; 49(4); 170-84.

Wright TF, Herbst KL. A Case Series of Lymphatic Injuries After Suction Lipectomy in Women with Lipedema. Am J Case Rep. 2022 Jul 11;23:e935016. doi: 10.12659/AJCR.935016. PMID: 35811389; PMCID: PMC9284075.\
https://my.clevelandclinic.org/health/diseases/16872-chronic-venous-insufficiency-cvi
 https://www.mayoclinic.org/diseases-conditions/varicose-veins/symptoms-causes/syc-20350643#:~:text=Varicose%20veins%20may%20be%20caused,(superficial)%20can%20become%20varicosed.

Good news, these conditions are not life-threatening on their own. However, if undiagnosed or untreated, they will worsen over time and may contribute to several other secondary ailments and complications. If you have signs of swelling, and pain in your body, especially in your legs and arms, seek treatment starting with your primary care physician. Ongoing care of lipedema and lymphedema with a vascular expert lessens the risk of other serious problems.

Hearing the terms lipedema and lymphedema sound strange and Googling them can be downright scary.

For instance:

Remember, you are in control of how you manage your health and well-being. Educate yourself and do not hesitate tol ask for help. A great resource for emotional support from the comfort of your home is https://www.mind-diagnostics.org. A study by researchers at the University of California, Berkeley found online counseling can be just as effective as face-to-face therapy while being more convenient, affordable, and accessible.

Sources:
https://www.healthgrades.com/right-care/symptoms-and-conditions/lymphedema
https://my.clevelandclinic.org/health/diseases/8353-lymphedema
https://www.nhs.uk/conditions/postural-tachycardia-
syndrome/#:~:text=Postural%20tachycardia%20syndrome%20(PoTS)%20is,as%20postural%20orthostati
c%20tachycardia%20syndrome
https://www.aapmr.org/about-physiatry/conditions-treatments/pain-neuromuscular-medicine-
rehabilitation/degenerative-joint-disease
https://www.nhs.uk/mental-health/conditions/body-
dysmorphia/#:~:text=Body%20dysmorphic%20disorder%20(BDD)%2C,affects%20both%20men%20and%
20women.
https://www.betterhelp.com/study/Study_of_BetterHelp_eCounseling.pdf

In celebration of Lipedema Awareness month back in June, Dr. Wright and Dr. Herbst updated the world on the latest insights and understandings on Lipedema vs normal fat. Sponsored by Lipedema UK and Lipedema LIO ITALIA, we’ve summarized the key learnings and helpful information below. Don’t miss updates in the future on our “Lipedema in the News” section, and feel free to watch the full 1.5-hour webinar here.

What is Lipedema?

Lipedema is a fat disorder, mainly affecting women, that causes an enlargement of both legs due to deposits of fat under the skin. It’s characterized as a “progressive disorder,” meaning it generally gets worse over time. Sufferers living with lipedema experience easy bruising and tenderness, pain in the affected areas, and significant disability in daily life. In severe and more progressive cases, the trunk and upper body may also be affected, including the arms and upper back. Little is known about the disorder, and it’s often misdiagnosed and incorrectly treated as general obesity.

For anyone affected, diet and exercise alone aren’t effective ways to get rid of Lipedema fat; Lipedema fat has proved relatively immune to these lifestyle changes and won’t budge. While women are likely to experience some weight loss with a healthy diet and regular exercise routines, weight loss is usually mostly loss of non-Lipedema fat. In these instances, the painful, stubborn fat remains. This cycle becomes a difficult one to break for those with the disorder: Yo-yo dieting leads to more weight gain. More weight gain leads to increased pain and disability. Increased pain and disability make it more challenging to manage mobility and secondary obesity increases. Lipedema fat also appears to be relatively resistant to bariatric surgery, meaning many women are undergoing dangerous surgeries without experiencing the intended benefit of significant loss of lipedema fat.

Lipedema vs Normal Fat: What We Already Know

Lipedema adipose fat tissue is different from normal adipose tissue. When looking at this fat tissue in lipedema patients, we find a more fibrous, nodular, tender adipose tissue than in patients without lipedema. The look and feel of lipedema fat tissue can be physically seen when performing lipedema surgery in addition to under a microscope when analyzing the tissue components. It’s clearly a different type of fatty tissue, explaining why lipedema patients experience different side effects and symptoms than those with traditional obesity. 

A study published in the International Journal of Obesity in November 2021 (Ishaq et al) highlighted the cellular differences that signaled the differences in lipedema fat than traditional adipose tissue. 

The study had the following key findings:

 

Finding #1: Adipose Tissues Show Distinct Gene Signatures

This means that lipedema fat actually causes the body to turn on a different gene than we see in non-lipedema patients. Fat tissue from lipedema was compared to location, gender and age-matched tissue from non-lipedema patients. In the photo below, we see a heatmap gene expression of adipose tissue by Z-score fold-change value: red indicates upregulation and blue indicates downregulation.

Finding #2: The difference in lipid composition includes significantly increased lipids in lipedema

What does this mean? Lipedema fat has a different metabolism, characterized by a differing production of phospholipid production compared to normal fat.  Lipedema adipocytes are shown on the left half [Header Bright Red] and non-lipedema adipocytes are shown on the right side of the hierarchal plot of lipid composition [Green Header over columns]. 

Finding #3: Lipedema Fat has more stem cells than non-lipedema fat

In this study, stem cells [ADSCs] from lipedema fat were compared to stem cells of matched people without lipedema.  The stems in lipedema are increased in number.

Note: ADSCs are stem cells. They can continuously divide and renew themselves. The ADSCs stem cells can also become mature fat cells or other types of cells to sustain or grow fat tissue. This means that lipedema fat replicates their cells more than regular fat, increasing the growth of this painful, fibrous fat tissue in lipedema patients!

Additionally, Lipedema Stem Cells contain Fat Droplets and have More Fat Droplets per cell than non-lipedema fat cells. The number of fat droplets, percentage of fat-positive cells, and the number of fat droplets per cell were significantly increased in lipedema adipocytes compared to controls. Lipedema fat cells had more fat in them, and the presence of fat droplets in stem cells (ASCDs) indicates maturation toward an adipocyte. 

Finding #4: Cell Cycle Gene like Bub1 are upregulated in Lipedema

Cell-cycle genes involved in regulating cell growth and proliferation are dysregulated in lipedema ADSCs and may contribute to the increased adipocyte number, and maldistribution and accumulation of dystrophic fat in lipedema. Because of the lack of regulation, lipedema cells again are able to replicate and grow at a higher speed and frequency than non-lipedema fat.

For example, Bub1, which is one of the cell cycle genes, is turned on more or upregulated in lipedema.

What does all of this mean?

First, and most validating for people with lipedema, these findings prove that lipedema fat and normal fat are not the same. Adipocytes and stem cells from individuals with lipedema are structurally different and behave differently from cells of normal fat tissue. Second, diet and general nutrition do not affect lipedema fat in the same way it does for non-lipedema fat. Given the same nutritional support, lipedema-derived stem cells proliferated compared to normal fat-derived stem cells. And third, the faster growth of lipedema fat compared to non-lipedema fat can be explained at a cellular level. The different cell biology of the lipedema cells that leads to hyperproliferation of fat tissue may explain disproportionate growth compared to other adipose tissue.

Nature vs. Nurture

While these lipedema vs normal fat findings are exciting for lipedema providers, and even more validating for patients seeking insights and treatment options, one question still remains: Is the biology of lipedema fat different because of genetic differences or is the difference in the fat cell biology of lipedema a product of an altered environment? 

Start Your Life-Changing Journey 

Even with all the challenges presented by lipedema, there are those who you can trust. Dr. Wright continues to strive for better education, research, and coverage for the lipedema community. Do not let these challenges bring you down even further; let Dr. Wright and his expert team help you to reduce the symptoms of lipedema and live your life fully! Dr. Wright can help find the right procedure to help manage your lipedema symptoms. Don’t let lipedema take over your life; contact us today!

Lipedema is a fat disorder, mainly affecting women, that causes an enlargement of both legs due to deposits of fat under the skin. It’s characterized as a “progressive disorder,” meaning it generally gets worse over time. Sufferers living with lipedema experience easy bruising and tenderness, pain in the affected areas, and significant disability in daily life. In severe and more progressive cases, the trunk and upper body may also be affected, including the arms and upper back. Little is known about the disorder, and it’s often misdiagnosed and incorrectly treated as general obesity.

For anyone affected, diet and exercise alone aren’t effective ways to get rid of Lipedema fat; Lipedema fat has proved relatively immune to these lifestyle changes and won’t budge. While women are likely to experience some weight loss with a healthy diet and regular exercise routines, weight loss is usually mostly loss of non-Lipedema fat. In these instances, the painful, stubborn fat remains. This cycle becomes a difficult one to break for those with the disorder: Yo-yo dieting leads to more weight gain. More weight gain leads to increased pain and disability. Increased pain and disability make it more challenging to manage mobility and secondary obesity increases. Lipedema fat also appears to be relatively resistant to bariatric surgery, meaning many women are undergoing dangerous surgeries without experiencing the intended benefit of significant loss of lipedema fat.

Lipedema vs. Obesity

Unlike common obesity, Lipedema is comprised of fat deposits and swelling that typically does not affect the feet or hands; it’s as if patients are wearing a tight bracelet or rope at their wrists or ankles that causes every above to swell and everything below to remain unaffected. At more progressive stages, the swelling increases and leads to a diagnosis of lymphedema, which makes it even less likely Lipedema is diagnosed and treated promptly and adequately.

Despite the strong impact of Lipedema on millions of women across the world, only limited research exists to determine its cause. In many cases, the genetic background can provide some context, but enough research has yet to offer a comprehensive understanding of the disease. 

Dr. Wright and his team at St. Louis Laser Lipo & Vein Center have put together a helpful list of Lipedema Do’s and Don’ts for living with this difficult disease.

DO: Take This Cold Medication Regularly

Guaifenesin, best known by the brand name Mucinex©, and often prescribed as an over-the-counter expectorant to treat the common cold, may help reduce lipedema swelling and inflammation.

To our knowledge, there are no published, controlled studies showing the use of Guaifenisn to treat lipedema or lymphedema. However, there are abundant reports from clinicians and lipedema patients stating Guaifenisn helps lipedema. In our limited clinical experience, about 20 – 30 % of lipedema patients report reduced pain and/or swelling when taking this medication. Plus, there are reports of Guaifenisn being used for pain relief to treat other diseases. Guaifenesin has shown modest but significant analgesic and anti-inflammatory effects in neck and back pain and some other conditions. It is thought guaifenesin may be working as a  muscle relaxant effect that occurs in these conditions. Mucinex / guaifenesin may help pain or it may work as an expectorant in lipedema tissue and thin out extracellular proteins. However, there are no studies to support these theories in lipedema.

Guaifenesin for Lipedema: Dose and Use

Guaifenesin is approved for safe use at 600 mg twice a day (or 1,200 mg twice a day) for no more than 2,400 mg per day. Studies in the use of Mucinex for other medical conditions report it takes a least a week to see effects. I recommend lipedema suffers try this medication for two weeks to see if they notice any positive changes in addition to their consistent treatment plans including compression, supplements, and a healthy diet as prescribed. May not be suitable for people with a persistent cough due to asthma, bronchitis, emphysema, or smoking, or who have a cough that is producing excessive amounts of phlegm. Talk with your doctor first before using Mucinex if you are pregnant or breastfeeding.

DO: Use Diosmin to Combat Lipedema

Diosmin is a flavonoid extract made from orange peels used to treat vein disease. Diosmin helps reduce inflammation along vein walls in people with chronic venous insufficiency and it can also have very positive results for people with lipedema and lymphedema.

Benefits

In a recent case study, Diosmin had positive results when used in combination with other supplements, diet, compression, and other anti-inflammatory measures to non-surgically manage lipedema. Based on these studies, and my experience prescribing Diosmin to patients, I recommend Diosmin as part of an overall conservative management treatment plan for lipedema and lymphedema.

Where to Get Diosmin for Lipedema

In the United States, Diosmin is sold under the brand name Vasculera, which is available in pharmacies by prescription from a physician. Vasculera is approved by the FDA as a medical food.

Diosmin is also available as a supplement without a prescription. We recommend Vein Formula, as we trust its formulation. Be sure to order any supplements from a reputable website for the best safety and quality. Link https://vitasupportmd.com/products/vein-formula-1000

DON’T: Treat Lipedema with Fat Freezing 

Fat freezing—also known as cryolipolysis (or Cool Sculpting) uses cold temperature to reduce fat deposits in certain areas of the body. The procedure is designed to reduce localized fat deposits that do not respond to diet and exercise. It is not intended for people who are obese or significantly overweight. Currently, there is no published research on cryolipolysis for lipedema. Most lipedema fat is not the type of localized fat deposit for which this procedure is intended. Cryolipolysis can cause Paradoxical Adipose Hyperplasia (PAH). This condition can aggravate symptoms, and lead to worsening of lipedema.

DO: Adopt a Mediterranean Diet & Active Lifestyle (Instead of Keto!)

Researchers from Stanford University found both diets improved blood glucose and led to comparable weight loss. However, this study shows keto may elevate LDL cholesterol, lacks essential nutrients, and is more difficult to maintain over time.

Study: During the study, 30 adults with prediabetes or type 2 diabetes followed the Mediterranean diet and the keto diet for 12 weeks each. Both diets served non-starchy vegetables and avoid added sugars and refined grains, but there are three key differences between them: the Mediterranean diet incorporates legumes, fruits, and whole grains – keto does not.

Results:

Note: Please work with a doctor or nutritionist to choose a dietary pattern that fits your needs and preferences. The potential harms of higher LDL associated with keto cannot be dismissed.

Exercising can help to activate the lymphatic drainage system in a patient’s limbs through the foot and calf muscle pump. Workouts that aren’t too strenuous help to move the excess fluids out of affected limbs, as well as reduce additional fat buildup.

The lymphatic system differs from the blood circulatory system in that it does not have a muscle “pump” to move fluids into the lymphatic system and eventually return back into circulation. Because of this, good lymph flow depends on proper joint and muscle activity. This is especially true if the lymphatic system is compromised. Individuals suffering from lipedema can receive a great benefit when engaging in diaphragmatic breathing exercises. These exercises are especially beneficial when they are combined together with other parts of a decongestive regimen.

Because fat disorders and lymphedema can often feed into one another, exercise is a great option to help combat both. With its dual purpose of clearing out excess lymph fluid and burning fat, exercise offers exactly what patients need to deal with these disorders.

Types of Exercise

The best types of exercise to help treat lipedema and lymphedema are low-impact exercises and aren’t too strenuous, as strain can increase fatigue and pain levels. Low impact exercises help protect joints. Workouts should also focus on exercises that do not increase lactic acid build-up. 

The types of exercise used should be focused on the individual patient’s needs and ability. Additionally, it is important to use compression garments when exercising whenever possible. Compression garments help to promote blood circulation and lymph fluid flow, which can be severely inhibited in patients who suffer from fat disorders and lymphedema.

Living with Lipedema? Start Your Life-Changing Journey 

Even with all the challenges presented by lipedema, there are those who you can trust. Dr. Wright continues to strive for better education, research, and coverage for the lipedema community. Do not let these challenges bring you down even further; let Dr. Wright and his expert team help you to reduce the symptoms of lipedema and live your life fully! Dr. Wright can help find the right procedure to help manage your lipedema symptoms. Don’t let lipedema take over your life; contact us today!

References

Albert-Adrien Ramelet, MD, Pharmacologic Aspects of a Phlebotropic Drug in CVI-Associated Edema

First Published January 1, 2000 Research Article https://doi.org/10.1177/000331970005100105

https://scholar.google.com/scholar?q=diosmin+effect+on+lymphatic+function&hl=en&as_sdt=0&as_vis=1&oi=scholart

https://www.ncbi.nlm.nih.gov/pubmed/8919263

Int Angiol. A lymphatic function of Daflon 500mg., 1995 Sep; 14(3 Suppl 1):36-8

Recommended Sources of Diosmin: https://vitasupportmd.com/

LIPEDEMA DISEASE LINKED TO FAMILY HISTORY

3 independent studies find lipedema is an inherited condition.

As reported by The Cleveland Clinic [#} on its website, the exact cause of lipedema is unknown, but the condition runs in families and may be inherited. This statement is supported by three independent studies conducted by leading research teams in Europe who validated lipedema is a genetic condition. Lipedema appears to primarily affect females, presumably driven by estrogen as it usually manifests at puberty. Lipedema disease is different from obesity and is often misdiagnosed as primary obesity because these conditions commonly overlap.

Researchers hope to continue to study as many families as possible with multiple cases of lipedema to create a stronger genetic linkage and determine the biochemical makeup of this disorder. Having this data may help researchers identify the gene that causes lipedema to increase understanding and improve treatment for this painful condition.

Fig 1. Bauer and etal. study reaffirms relatives of lipedema patients also suffer with lipedema. In most cases, grandmothers and mothers were affected the most, followed by aunts, sisters, and cousins.

KEY RESULTS / FINDINGS

The familial nature of the condition suggests that lipedema can demonstrate heritability[1]. The exact nature of the form of inheritance is difficult to determine.

Of lipedema patients who participated in a study, 73% reported they had one or suspected multiple family members also had lipedema. Most frequently affected was the mother (38%), followed by grandmother (17%), aunt (8%), sister (6%) and cousin (5%).

A study from 2010 showed that within six families of more than three generations with lipedema disease, a genetic autosomal-dominant hereditary pattern [2]was found.

Frequent studies of mother-to-daughter mode of inheritance led researchers to theorize lipedema is a genetic disorder.

Fig 2. The largest family pedigrees (with a minimum of three living affected members in at least two generations) are demonstrated in Figure 2.

Family clusters of lipedema where more than one family member has the condition indicates a genetic component with a possibly X-chromosome[3] dominance inheritance pattern.

All affected family members were female first- or second-degree relatives of female patients.

One family had six living affected members in three generations, two families had five affected members, two had four affected members, and one further family had three living affected members.

As lipedema appears to be most common at puberty, it is reasonable to assume that hormonal influence underlies the marked female limitation shown in studies to date.

Estrogen is also considered to play a key role in regulating the manner of development of the condition.

Study participants:

Between all three studies, women ages 16-83 (average age, late 30s)

Do you suspect you or a loved one may have lipedema? We can confirm your condition and start you on your journey to feeling better. Contact us to schedule an appointment, today.

References

Bauer AT, et al. Plast Reconstr Surg. 2019 Dec;144(6):1475-1484  https://pubmed.ncbi.nlm.nih.gov/31764671/

Ghods M, Georgiou I, Schmidt J, Kruppa P. Disease progression and comorbidities in lipedema patients: A 10-year retrospective analysis. Dermatologic Therapy. 2020;e14534. https://doi.org/10.1111/dtch.14534

Child AH, Gordon KD, Sharpe P, Brice G, Ostergaard P, Jeffery S, Mortimer PS. 2010. Lipedema: An inherited condition. Am J Med Genet Part A 152A:970–976. https://pubmed.ncbi.nlm.nih.gov/20358611/  and https://www.researchgate.net/publication/346917917_Disease_progression_and_comorbidities_in_lipedema_patients_A_10-year_retrospective_analysis/figures

 

 # Cleveland Clinic Lipedema https://my.clevelandclinic.org/health/diseases/17175-lipedema

[1] Heritability is a measure of how well differences in people’s genes account for differences in their traits

[2] Autosomal dominant inheritance is a way a genetic trait or condition can be passed down from parent to child.

[3] The X chromosome is one of two sex chromosomes. Humans have two sex chromosomes, the X and Y. Females have two X chromosomes in their cells, while males have X and Y chromosomes in their cells.

June is Lipedema Awareness month, one in which the Lipedema community focuses (even more than usual) on how to reach women who have lived with this painful and distressing disease. While we’ve seen great strides in awareness, insurance coverage, and slightly greater recognition of this disease in the medical community, we continue to fight an uphill battle as women are underdiagnosed or completely dismissed when discussing their struggles and side effects with their providers. As a result, our team has put together some of the most important and impactful information for all of you, and we’re kicking off the month with a webinar from a team of lipedema experts.

Join us on Tuesday, June 7th, 2022 at 8 pm ET to listen to our panel discuss Recognizing Lipedema and Treatment Options. This is a FREE event! 

Register here, or listen to the recording following the webinar at tactilemedical.com/education.

Drs. Steve Dean, Thomas Wright, and Tony Gasparis with Julie Green, OTR/L CLT-LANA, WCC, CLWT discuss lipedema – the pathophysiology, association with vein disease, conservative treatments, and surgical options available for patients. 

What Is Lipedema Reduction Surgery?

Lipedema reduction surgery is different from cosmetic liposuction. Studies have shown that women with Lipedema have impaired lymphatic function. Lymphatic fluid promotes the collection of fat cells, which can cause the obstruction of lymphatic capillaries (branch-like blood vessels). Extra care must be taken to avoid injuring the lymphatic system and making an already stressed system worse. Using blunt cannulas generous and special surgical techniques, studies have shown that lymphatic function can actually improve after this type of liposuction in women with Lipedema. The goal of lipedema reduction surgery is to remove the fibrous tissue and maximally reduce the lipedema tissue. It is a debulking surgery, not a cosmetic surgery.

There are two specialized liposuction techniques that have been shown in studies to benefit individuals with lipedema: water-assisted and tumescent liposuction. In addition to the surgical equipment used, it is important to choose a surgeon with experience and one that is cautious when performing lipedema surgery. These factors can have an important influence on protecting lymphatic flow and function.

Who Is an Ideal Candidate for Lipedema Surgery?

Despite affecting an estimated 11% of women around the world, Lipedema is not yet widely known. Fat cells, (also referred to as adipose tissue) provide the human body with both cushioning and insulation. Lipedema affects the accumulation of these fat cells in the body, resulting in bulging, irregular fat in the affected areas. The legs are the most commonly affected area, but sometimes spreading occurs in the torso, and in many cases, excessive clustering of fat cells is noticed in the arms as well. Regardless of the affected area, the symptoms are equally debilitating, and unfortunately, these fat cells are equally resistant to both diet and exercise programs. 

Unlike Lymphedema or general obesity,  Lipedema has a tendency to affect both limbs equally and generally becomes more apparent over the course of time. Lipedema’s progressive nature makes getting a proper Lipedema diagnosis and treatment imperative and extremely time-sensitive – as the disorder progresses so does the pain, immobility, and discomfort.

In addition to the characteristic disproportionate fat accumulation, there are specific physical signs and symptoms of Lipedema. Do any of the following Lipedema symptoms sound like something you regularly experience?

3 Stages of Lipedema

Overall, Lipedema appears in a series of three stages. Do any of these sound like you?

Stage 1: The patient’s skin is flat and stretched over pearl-sized nodules.

Stage 2: The patient’s skin is indented, covering a layer of fat cells that look like pearl to apple-sized masses. 

Stage 3: Skin is indented, sometimes with much larger bulges, and skin covers pearl-sized nodules in combination with excessively large fat masses, causing lobules along the legs, hips, and thighs and frequently extending to the torso or upper arms.

Photo credit: Linda Anne Kahn at Integrative Treatment of Lipedema

Below are conditions that can be confused with and can affect people with Lipedema. Because there can be so much overlap in appearance and symptoms, only clinicians with the training and experience to diagnose and treat these conditions can differentiate them. 

When is the best time to get lipedema surgery?

There are two categories of treatment, surgical and non-surgical. Insurance providers require patients first try non-surgical treatment options before they’ll consider approving lipedema surgery, and Lipedema providers should be able to walk patients through this. While Lymph-sparing liposuction is the only treatment option that can provide permanent results by removing the lipedema fat, non-surgical options can help slow progression and are also necessary post-surgery (so it’s still important to practice them!).

Learn More About Stages of Lipedema Here!

Non-Surgical Treatment Options

To the dismay of patients, wearing medical-grade, tight compression garments 24-hours per day, seven days per week, is the key to improving circulation for the lymphatic system, making this a go-to prescription from Lipedema experts. Compression garments come in a variety of strengths and will be prescribed based on the stage and type of affected areas. The tighter the compression, the better.

A healthy and consistent lifestyle of clean eating and low-impact exercise to address obesity will also help with Lipedema. A diet focused on low-carb and low-sugar has proven successful. Low-impact exercise such as walking, water aerobics, yoga, or gymnastics has also reported success. Patients must avoid yo-yo dieting while also permanently losing or, at the very least, maintaining their weight. What works for one patient may not work for another. Diet and exercise recommendations and healthy practices are essential, but ultimately should be based on the individual with the understanding that weight gain is not an option. 

Some patients opt-in to Manual Lymph Drainage massage (MLD), a gentle skin massage used to stimulate the circulation of the lymphatic system. While experts have yet to find significant evidence that MLD helps with Lipedema directly, some patients prefer it for its “hands-on” nature to addressing their symptoms.

Lymph-Sparing Liposuction for Lipedema

For patients in the later stages of Lipedema, the pain and disruption to daily life are not permanently addressed with compression garments, diet, and exercise alone. Traditional liposuction that uses general anesthesia, radio frequencies, ultrasound, or lasers are possibly damaging to the lymphatic vessels, and as such are not an option for Lipedema patients, either. However, Lymph-sparing liposuction is safe, using surgical techniques that avoid lymphatic injury, and the use of local tumescent anesthesia reduces the risk of complications. Generally, the most painful areas should be treated first, starting high on the legs and then moving downward in future surgeries.

Learn More About the Risks and Safety of Lymph-Sparing Liposuction Here!

What Results Can I Expect from Lipedema Surgery?

Perhaps the most noticeable benefit of lymph-sparing liposuction is how it is able to reduce the amount of subcutaneous fat tissue in the body. Lipedema reduction surgery not only significantly reduces fat tissue, but also removes fibrous tissue, making the limbs lighter, smaller, less tender, and smoother. It is critical to follow your physician’s guidelines to reduce any swelling and inflammation before the treatment. This is done by wearing compression garments and wraps along with receiving manual lymph drainage for several weeks following lipedema surgery and beyond. Patients wear medical-grade compression clothing for at least 8 weeks, and manual lymph drainage and massage are typically recommended as an ongoing and regular treatment. 

Your tissue will be decongested, allowing your liposuction treatment to be as successful as possible. Some slight swelling and bruising may return immediately following the procedure, but this is expected and should subside over time. Some patients also report numbness as their nerves in the treated areas respond to treatment. Numbness may last for several months and up to one year, but when compared with the reduction in fat tissue, patients still see this as a huge improvement. Compression is critical to be maintained after the lipedema surgery as well, as the lymphatics are reestablished. The lymphatic function is often improved.

Lipedema Reduction Surgery Risks

One of the most beneficial aspects of lymph-sparing liposuction is that the treatment does not rely on general anesthesia. While general anesthesia is used for a variety of treatments, it can cause complications for individuals with lipedema. In fact, it can cause complications in as high as 0.3% of liposuction treatments when used. Instead, lymph-sparing liposuction uses tumescent anesthesia to avoid these unwanted complications. In fact, general anesthesia can cause serious complications and even death in up to 0.3% of liposuction treatments when used. Patients are conscious for the duration of treatment, while the tumescent liquid acts as a local anesthetic in the treatment area. Patients take pain kills ahead of time to help with discomfort, and through the process feel little pain, and if anything, pressure in the area being treated. 

Lipedema reduction surgery also makes sure to avoid any additional risks for the treatment. This type of liposuction procedure limits the amount of fat tissue that will be removed at once, and a follow-up appointment is scheduled for the day following the procedure to ensure the treatment and recovery are going as planned. While that may not seem like a benefit at first, it will actually make sure your body does not take any additional trauma than what is needed. The general amount of fat tissue that can be safely removed is around 5.0 liters. Smaller cannulas are also used to also keep down the risk of trauma to the body and an already compromised lymphatic system.

Start Your Life-Changing Journey 

Even with all the challenges presented by lipedema, there are those who you can trust. Dr. Wright continues to strive for better education, research, and coverage for the lipedema community. Do not let these challenges bring you down even further; let Dr. Wright and his expert team help you to reduce the symptoms of lipedema and live your life fully! Dr. Wright can help find the right procedure to help manage your lipedema symptoms. Don’t let lipedema take over your life; contact us today!

Despite affecting an estimated 11% of women around the world, Lipedema is not yet widely known. Fat tissue, (also referred to as adipose tissue) provide the human body with both cushioning and insulation. Lipedema affects the accumulation of these fat cells and adjoining connective tissue in the body, resulting in bulging, irregular fat in the affected areas. The legs are the most commonly affected area, but sometimes spreading occurs in the torso, and in many cases, excessive clustering of fat cells is noticed in the arms as well. Regardless of the affected area, the symptoms are equally debilitating, and unfortunately, these fat cells are equally resistant to both diet and exercise programs. 

Unlike Lymphedema or general obesity,  Lipedema has a tendency to affect both limbs equally and generally becomes more apparent over the course of time. Lipedema’s progressive nature makes getting a proper diagnosis and treatment imperative and extremely time-sensitive – as the disorder progresses so does the pain, immobility, discomfort and appearance of Lipedema nodules.

 

3 Stages of Lipedema

Stage 1: The patient’s skin is flat and stretched over pearl-sized nodules.

Stage 2: The patient’s skin is indented, covering a layer of fat cells that look like a pearl to apple-sized masses. 

Stage 3: Skin is indented, sometimes with much larger bulges, and skin covers pearl-sized nodules in combination with excessively large fat masses, causing lobules along the legs, hips, and thighs and frequently extending to the torso or upper arms.

If one of these stages sounds like you, and you checked off multiple items on the list above, you may have Lipedema, but it’s impossible to say for sure. The only way to know for sure is to get a proper Lipedema diagnosis, which in itself is an important process.

Learn More About Lipedema Stages Here!

What is a lipedema lobule

In stage 3 lipedema, lobules develop in the skin.  The presence of a lobule is one of the most important physical changes to occur in the skin that differentiates stage 2 and stage 3 lipedema.  Originally described by Dr. Schmeller, a lobule is defined as a “hanging flap of skin,” also called an “extrusion of skin that protrudes or sticks out from the expected smooth contour of the skin.” Lobules can be seen from a distance.  The lobules can occur in many areas on the body in lipedema patients, but the classic areas are just below the knees, or subpatellar lobules, lobules that hang over the knees, Inner thigh lobules, lateral thigh lobules, and upper arm lobules. Some lipedema expert thinks these lobules are diagnostic of lipedema. [1, 2 ].  

 
 
This original definition was put forth in Dr. Schmeller and Dr. Meier-Vollrath’s 2008 paper, “Pain with Lipedema: An Attempt to Approximate” and was published in German the Journal LymphForsch. Similar to nodules, they describe lobules as characteristic of lipedema – and especially stage 3 lipedema. The lobules can occur in many areas of the body, but the classic areas are just below the knees (subpatellar lobules), lobules that hang over the knees, inner thigh lobules, lateral thigh lobules, and upper arm lobules. Some lipedema experts think these lobules are diagnostic of lipedema. [1, 2].
 

Lipedema Nodules and Fat

Lipedema is categorized as lipomatosis, also known as a subcutaneous fat disease that is characterized by abnormal fibrosis of the subcutaneous fat tissue.  Fibrosis (also known as fibrotic scarring), is a pathological wound healing in which connective tissue replaces normal tissue, eventually leading to the formation of permanent scar tissue. The fibrosis of Lipedema fat tissue gives it a hard, nodular feeling when touched. 

How to Determine If You Have Lipedema Nodules

Lipedema nodules are felt and not usually seen. In lipedema, the skin surface is soft, but just below the surface, the nodules can be felt as harder areas. Early-stage Lipedema (Stage 1) has small nodules the size of small seeds or peas, which often appear pearl-size. Middle-stage Lipedema (Stage 2) has larger nodules that feel the size of walnuts or gumballs. Later stage Lipedema (Stage 3)  is characterized by the presence of lobules. The nodules in Stage may be the same size as the nodules in Stage 2, or they may be larger nodules up to the size of a plum.

The Lipedema nodules felt on the skin are important criteria for diagnosing Lipedema. Nodular or bumpy subcutaneous fat occurs with other conditions or diseases such as cellulite or obesity and other fat disorders, however, subcutaneous nodules must be present to diagnose lipedema. These nodules represent excess and slightly disorganized fibrosis of the subcutaneous tissue. Inflammation of the adipose tissue in lipedema is likely the cause of this fibrosis.

In these cases, fibrosis tissue in Lipedema patients swirls around the adipose tissue, but it usually won’t completely encapsulate it. If the adipose tissue is completely encapsulated by fibrous tissue, eventually it leads to a lipoma. Women with lipedema have an increased number of lipomas, but most of the bumps felt on the skin are nodules, rather than lipomas. 

There are other lipomatosis diseases that cause similar side effects as Lipedema to be aware of through the diagnosis process. Dercum’s disease, for example, is characterized by multiple painful subcutaneous lipomas. Madelung’s Disease also has subcutaneous nodules (but not many lipomas), however, these cases occur more in the upper half of the body. Overall, subcutaneous nodules are present in all patients with lipedema but they also occur in other subcutaneous fat diseases or lipomatosis.

Removing Lipomatosis Nodules

In the earlier stages of Lipedema (Stage 1 and most patients in Stage 2), the subcutaneous nodules are removed with lipedema reduction surgery, which involves modification of cosmetic liposuction using tools and techniques which minimize harm to the lymphatics. In lipedema patients with larger or more adherent nodules, the nodules have to be manually extracted.

In these cases, a small incision is made over the nodules that resist removal with a suction cannula and are gently milked out of the skin. Obviously, surgeons don’t want to cause any more trauma than is absolutely necessary, however, there are instances where this method is the only way to get larger, more adherent nodules removed. Dr. Wright has several videos of the extraction process you can view here.

Think you have Lipedema nodules?

Below are the different tests you may experience during this time, and it’s important to keep them in mind as you select your doctor. Moving forward, thoroughness will be your best friend; we highly recommend “interviewing” different Lipedema experts to find someone you trust, someone who can provide at least some of these diagnostic tests, and someone who is well versed in treatment options.

 

Note: There is no single test to diagnose Lipedema. Tests, however, are important to rule out a related disorder.

Find Out More About Lipedema Nodules Here!

Stemmer’s Sign Test

The Stemmer’s Sign is the inability to pinch the skin between the toes or fingers. As mentioned in our last section, Lipedema in advanced stages can be complicated by secondary Lymphedema and may have a stemmer’s sign. This test can help Lipedema experts determine if this is the case for you. 

Venous Doppler Ultrasound 

A Venous Doppler Ultrasound is a very useful test for the diagnosis of Lipedema and to locate potential nodules. Lipedema has many similarities to venous insufficiency, so this can also help rule out or confirm venous insufficiency.  The Venous Doppler Ultrasound can readily detect venous insufficiency if done properly and by having the patient stand while completing it. A standing venous Doppler ultrasound is a painless, non-invasive, and inexpensive test that provides a lot of useful information about venous circulation. The Doppler ultrasound not only helps determine the presence of underlying venous problems, but it also gives critical information for managing Lipedema. If venous insufficiency is present, it is important that treatment is given as the resulting increased venous pressures can greatly aggravate Lipedema.

Lymphoscintigraphy

This is generally only used in complicated cases, where clinical diagnosis is not clear. This is a nuclear scan that assesses the lymph system. It may come back as normal in patients with Lipedema and may show the characteristic “corkscrew” changes with Lymphedema. In most cases of Lymphedema, lymphoscintigraphy shows delayed uptake. So lymphoscintigraphy can be very helpful to determine if and how significant a role lymphedema is playing in an individual’s symptoms, especially when there are widespread issues of swelling in the body.

We’re here to help!

Now that you’ve reviewed the signs and symptoms of Lipedema, determined that you identify with at least some of them, and you’ve familiarized yourself with other commonly related diagnoses, it’s time for the final step – finding a Lipedema specialist who can perform one of the diagnostic methods above. Each Lipedema doctor will have their own preferred method of diagnosing their patients and typically will include a physical exam, patient questionnaires, and then additional testing and ultrasounds to further support the physical exam. 

A treatment plan should be discussed and developed between you and your Lipedema doctor, but you can read more about the non-surgical and surgical options that we recommend to our patients. While these will always depend on specific cases and patient needs, it can give you an idea of what options may be available to you. Our hope for all women with Lipedema, whether they are our patients or not, is that we can provide valuable tools and knowledge so that more women can make it to this point and take the next step in living a more mobile, healthy, and enjoyable life. 

 

 

Sources
1. Pain with lipoedema Attempt to approximate W. Schmeller, I. Meier-Vollrath Capio Hanse-Klinik, Department of Liposuction and Operational-Aesthetic Dermatology, Lübeck, Germany LymphForsch 12 (1) 2008; 8-12
link https://pubmed.ncbi.nlm.nih.gov/28677175/  
2.
Prevention of Progression of Lipedema With Liposuction Using Tumescent Local Anesthesia; Results of an International Consensus Conference Matthias Sandhofer, MD. DermSurg-2019. link https://pubmed.ncbi.nlm.nih.gov/31356433/

Meet Dr. Thomas Wright!

Through efforts led by LE&RN (the Lymphatic Education & Research Network), the Senate has passed a bill for the LD Commission (Lymphatic Disease Commission) to increase research and lymphatic education. The bill passed in the Senate last month, with a vote of 68-31. Now that it’s passed in both houses of Congress, it is now on President Biden’s desk to be signed into law. This is exciting and unprecedented news for men and women suffering from lymphatic diseases!

Video: LE&RN’s Appeal to Congress video here.

Lymphatic Disease

The following language is taken directly out of the recently passed bill and is a direct reflection of the hard work and dedication of advocates in this community. NHLBI refers to the National Heart, Lung, and Blood Institute and NIH refers to the National Institute of Health, two of the nation’s medical research agencies that support scientific studies for advancing knowledge and discovery in health.

Lymphedema (LE)—The agreement directs NHLBI to increase support for research on LE and to establish a Research Condition Disease Categorization category for research related to lymphedema.

National Commission on Lymphatic Diseases—The agreement directs NIH to establish a National Commission on Lymphatic Diseases and to engage with relevant Institutes, Centers, and external stakeholders in establishing this Commission. The agreement directs NIH to provide an update on progress to establish the Commission within 60 days of the enactment of this Act.

Lymphedema

Why is passing the Lymphatic Disease Education bill so important? 

This is the latest step in pushing for resources for deeper research into the causes, best treatment practices, and even genetic dispositions for lymphatic diseases that are not yet clearly identified across healthcare. A National Commission on Lymphatic Diseases pushes Lymphatic Diseases to the forefront of national research as a priority, and ultimately this gives experts in this field a seat at the table to tell Congress what we need in order to provide the best care to patients. Most exciting, the bill now directs NIH to establish this Commission within the next two months after President Biden signs! 

Takeaways from the bill: 

Understanding Lymphedema Diseases

Lymphedema is a condition that occurs when lymphatic fluid, a transparent liquid composed of fat, water, salts, and proteins, begins to pool and accumulate in the arms and the legs. The initial and most predominant symptom indicating the presence of Lymphedema is significant swelling of these extremities. Medical experts point to damaged lymph vessels as the cause of fluid retention leading to Lymphedema. When lymphatic fluid isn’t able to properly circulate through the human bloodstream via lymph nodes and vessels, retention quickly occurs. Other potential causes for fluid retention are linked to infections, genetics or underlying medical conditions especially cancer and its treatment. Keep reading to learn more about the treatment of Lymphedema in St Louis.

Lymphatic Disease

Types of Lymphedema

It is widely understood and accepted that Lymphedema can be an inherited medical condition and as a result, is recognized under three distinct categories. Congenital Lymphedema refers to symptoms that develop in early childhood. Lymphedema Praecox refers to symptom development that occurs during adolescence, while Lymphedema Tarda refers to symptoms that show up in patients later in life. Lymphedema quite commonly develops in patients as a result of a traumatic injury damaging lymphatics. This type of trauma is generally linked to the removal of lymph nodes during surgical procedures related to cancer treatment or radiation. Infection is a second factor closely linked to the development of Lymphedema.

Skin Lymphostatic Fibrosis 

This is a widespread side effect in patients with lymphedema, where the skin hardens over time. In the early stages of lymphedema, swelling is soft to the touch. However, over time, the swelling hardens the skin due to the development of connective tissue fibers underneath the skin of the affected areas.

Papillomatosis

The growth of numerous papillomas, more commonly referred to as warts.

Dermal Sclerosis

Hardening and tightening of the skin and connective tissues.

Leg Swelling

Leg swelling is one of the most common symptoms of lymphedema and prompts patients to seek treatment.

Lymphedema

Lymphedema is a progressive condition that can quickly transform into a more serious medical issue. The risks of leaving Lymphedema untreated can include a heightened vulnerability to infection leading to lymphangitis and cellulitis. Similarly, Lymphedema can commonly lead to fibrosis or hardening and scarring of the skin and subcutaneous fat cells. This condition has the potential to impede the overall circulation of lymph fluid causing physical movement to become a painful task. These conditions comprehensively increase the pressure put on veins working to move blood through the body towards the heart.

Diagnosis Prior to Treatment

A physical exam will be carried out and the results compared to the patient’s medical history and profile. A venous doppler ultrasound is commonly utilized to assess the potential for venous insufficiency which can also lead to increased swelling of the limbs. To verify the presence of Lymphedema, a physician may choose to perform a Lymphoscintigraphy. This procedure involves the injection of a radioactive solution into the potentially affected area of the body to decisively map the path of lymphatic fluids in a targeted region. The option for the physician to perform a Lymphangiography involves the replacement of the radioactive solution with a medicinal dye.

Home Care Strategies

Patients suffering from Lymphedema are at a greater risk of developing infections and there are some simple home care strategies that help diminish the overall risk factor. Those suffering from Lymphedema should always completely dry affected limbs after showering or swimming. Wearing protective shoes and clothing reduces the risk of cuts or injuries while the addition of compression garments is highly recommended in the promotion of healthy blood circulation. Sitting with the legs uncrossed is another simple strategy towards promoting improved lymphatic flow. Maintaining a dedicated exercise routine along with a healthy diet has been shown to help reduce the risk of injury or infection related to Lymphedema.

Seeking Lymphedema Treatment

While there is no permanent cure for Lymphedema, complications, and progression of the disease can be managed effectively with a combination of Lymphedema treatment St Louis options. Compression garments are the primary method recommended for managing Lymphedema. Compression stockings, sleeves, leggings, and gauntlets provide the first line of defense when it comes to promoting healthy blood circulation. Manual lymphatic drainage or massage can aid in the management of Lymphedema as well. This technique works to manually move the lymph out of congested areas. When this type of massage is combined with compression bandages the treatment method may be referred to as Complete Decongestive Therapy.

For patients with more severe cases of Lymphedema, intermittent compression pump lymphedema therapy may prove effective. These compression pumps actively work to move trapped lymphatic fluid through the lymphatic circulatory system.

March is Lymphedema Awareness month, a time to put on your light blue ribbon and find creative ways to participate in educating the world on lymphatic diseases. The highlight of the month, World Lymphedema Day, falls on March 6th this year. The Lymphatic Network hosts a wide range of events all around the world for the community to participate in, both digitally and in person. Sign up for events and presentations on their home page, or use their guide to getting involved and participating on World Lymphedema Day. All month long, the clinical, patient, and advocacy communities, as well as the private sector, join forces to increase awareness of this chronic condition.

World Lymphedema Day was established by the United States Senate in 2016 in response to a Senate bill written by the Lymphatic Education & Research network. Advocates celebrate annually each March, with the primary focus on educating the world on all lymphatic diseases: primary and secondary lymphedema (LE), lipedema (LI), lymphatic filariasis (LF), lymphatic malformations (LM), and the full lymphatic continuum (LC) of diseases impacted by the lymphatic system.

World Lymphedema Day

Understanding Lymphedema

Lymphedema is a condition that occurs when lymphatic fluid, a transparent liquid composed of fat, water, salts, and proteins, begins to pool and accumulate in the arms and the legs. The initial and most predominant symptom indicating the presence of Lymphedema is significant swelling of these extremities. Medical experts point to damaged lymph vessels as the cause behind fluid retention leading to Lymphedema. When lymphatic fluid isn’t able to properly circulate through the human bloodstream via lymph nodes and vessels, retention quickly occurs. Other potential causes for fluid retention are linked to infections, genetics or underlying medical conditions especially cancer and its treatment. Keep reading to learn more about the treatment of Lymphedema in St Louis.

World Lymphedema Day

Significant Symptoms Associated with Lymphedema

Individuals suffering from Lymphedema often report experiencing swelling of the limbs which tends to be more significant on one side of the body as compared to the other. Additionally, those struggling with Lymphedema may experience fatigue, heaviness, tightness, or lack of flexibility affecting the limbs that are swollen. Inflammation and redness of the arms and legs are common symptoms associated with Lymphedema.

Types of Lymphedema

It is widely understood and accepted that Lymphedema can be an inherited medical condition and as a result, is recognized under three distinct categories. Congenital Lymphedema refers to symptoms that develop in early childhood. Lymphedema Praecox refers to symptom development that occurs during adolescence, while Lymphedema Tarda refers to symptoms that show up in patients later in life. Lymphedema quite commonly develops in patients as a result of a traumatic injury damaging lymphatics. This type of trauma is generally linked to the removal of lymph nodes during surgical procedures related to cancer treatment or radiation. Infection is a second factor closely linked to the development of Lymphedema.

Reasons for Seeking Treatment

Lymphedema is a progressive condition that can quickly transform into a more serious medical issue. The risks of leaving Lymphedema untreated can include a heightened vulnerability to infection leading to lymphangitis and cellulitis. Similarly, Lymphedema can commonly lead to fibrosis or hardening and scarring of the skin and subcutaneous fat cells. This condition has the potential to impede the overall circulation of lymph fluid causing physical movement to become a painful task. These conditions comprehensively increase the pressure put on veins working to move blood through the body towards the heart.

Diagnosis Prior to Treatment

A physical exam will be carried out and the results compared to the patient’s medical history and profile. A venous doppler ultrasound is commonly utilized to assess the potential for venous insufficiency which can also lead to increased swelling of the limbs. To verify the presence of Lymphedema, a physician may choose to perform a Lymphoscintigraphy. This procedure involves the injection of a radioactive solution into the potentially affected area of the body to decisively map the path of lymphatic fluids in a targeted region. The option for the physician to perform a Lymphangiography involves the replacement of the radioactive solution with a medicinal dye.

Recommended Home Care Strategies

Patients suffering from Lymphedema are at a greater risk of developing infections and there are some simple home care strategies that help diminish the overall risk factor. Those suffering from Lymphedema should always completely dry affected limbs after showering or swimming. Wearing protective shoes and clothing reduces the risk of cuts or injuries while the addition of compression garments is highly recommended in the promotion of healthy blood circulation. Sitting with the legs uncrossed is another simple strategy towards promoting improved lymphatic flow. Maintaining a dedicated exercise routine along with a healthy diet has been shown to help reduce the risk of injury or infection related to Lymphedema.

World Lymphedema Day

Seeking Lymphedema Treatment

While there is no permanent cure for Lymphedema, complications, and progression of the disease can be managed effectively with a combination of Lymphedema treatment St Louis options. Compression garments are the primary method recommended for managing Lymphedema. Compression stockings, sleeves, leggings, and gauntlets provide the first line of defense when it comes to promoting healthy blood circulation. Manual lymphatic drainage or massage can aid in the management of Lymphedema as well. This technique works to manually move the lymph out of congested areas. When this type of massage is combined with compression bandages the treatment method may be referred to as Complete Decongestive Therapy.

For patients with more severe cases of Lymphedema, intermittent compression pump lymphedema therapy may prove effective. These compression pumps actively work to move trapped lymphatic fluid through the lymphatic circulatory system.

Learn More During the World Lymphedema Day

Swelling of the arms and legs is generally the first symptom of Lymphedema but can also be linked to underlying venous insufficiency. When this is the case, seeking vein treatment options can significantly improve symptoms associated with Lymphedema. Dr. Wright and his team at the St. Louis Laser Lipo and Vein Center provide comprehensive Lymphedema therapy plans that take a patient’s full medical profile into consideration. When you’re looking for solutions to treat symptoms of Lymphedema of underlying vein disease, make sure to contact us to set up an initial consultation.