Lipedema: symptoms, is the operation effective?

Lipedema symptoms is the operation effective

Due to poor fat distribution, women who suffer from lipoedema see their legs become deformed over the years.

What is lipoedema? A sickness ?

“Lipoedema is a syndrome, not a disease explains Dr. Jean-Paul Belgrado of theBrussels Lymphology Research Unit. It is characterized by several clinical signs such as non-harmonious distribution of fatsa fragility of the capillary vessels of the skin easily leading to small bruises when the person bumps, a particular flexibility of the knee joints and ankles or elbows, and superficial venous insufficiency with easily varicose veins and stretch marks particularly near the joints. To be distinguished from obesity. In obese people, fat distribution affects the entire body. “In the case of lipedema, early in the patient’s history, fat deposits are concentrated symmetrically at the hips, inner thighs and buttocks notes Dr. Jean-Paul Belgrado, researcher and lymphologist. In addition, the fat in lipedema is decompacted unlike obesity where it is compacted.

What are the symptoms of lipoedema?

“Women who suffer from it see their leg deform with the years. It starts with the hips.” explains the researcher.

► During adolescence, “the hips and then the thighs are progressively the seat of fat deposits relatively higher than the average for girls of the same age. These women have a trunk which remains slender and a relatively undeveloped chest.

► Around 18 years oldfat deposits invade the root of the thigh which gains volume.

► At 30 years old, these deposits go down towards the knees and the leg. The quilted appearance of the skin of the thighs is characteristic. Ankles and wrists remain thin. The feet are not very large compared to average.

► From 30 to 40 years old, the fat progresses from the thighs towards the legs, still leaving the ankles quite thin and the feet intact. The back of the arms begins to be invaded by the accumulation of fat.

► Between 40 and 50 years old : signs of lymphedema appear (swelling caused by slowing down or blockage of lymph circulation).

Other signs emerge: small alopecia and of mild thyroid disorders.

Lipedema diagram © Adobestock/Journal des Femmes Santé

What are the tests to diagnose lipoedema?

“The clinical examination at the search for characteristic signs is the first line rulesays Dr. Belgrado. The more the person accumulates, the more evidence we have to think of lipedema.” Otherwise there is no exam or test allowing lipedema to be confirmed with certainty. What’s more “if the person is overweight, it is sometimes difficult to distinguish between obesity or lipedema masked by obesity specifies the researcher.

Characteristics : women who cannot lose fat at the specific level like hips, thighs, buttocks and legs despite intense physical activity and/or a controlled diet. “Some very motivated patients go on drastic diets and a lot of physical activity, with the consequence of seeing the remaining fat deposits in the affected areas even more unsightly compared to the trunk, breasts and arms which sometimes become very thin.”

What are the causes of lipoedema?

They are not clearly established but seem multifactorial. “There is a hormonal involvement but also collagen and family arrangements therefore genetic, notes the researcher. We seek to collect as much information as possible and observe the phenomena so that one day we may perhaps understand the causes.” Collagen surrounds fat cells; it does not seem to play its full mechanical role in cases of lipoedema.

What are the treatments for lipoedema?

Poorly understood by scientists, lipedema is difficult to treat. “The weapons exist but are still too weak” testify the two experts. The therapeutic possibilities available are more or less effective depending on the stage of development lipedema and the patient’s expectations.

One of the best sports is aquagym.

Is the operation effective in cases of lipoedema?

For many women with lipedema, surgery appears to be the definitive solution. But “if the liposuction (or liposuction) gives encouraging results in the first years when physical treatment and a controlled diet are combined, the fatty deposits eventually return observes Dr. Liesbeth Vandermeeren, plastic surgeon. As to gastric bypass (reduction of the stomach) proposed by certain surgeons, “he is often disappointing in patients suffering from lipedema because fat disappears everywhere except in the “damned” places. Furthermore, surgery is not trivial. “Liposuction cannulas, although very advanced in recent years, can damage several lymphatic collectors during each intervention” continues the surgeon. If the patient has underlying lymphatic insufficiency, a real secondary lymphedema can give way to fat deposits a few years after liposuction. “It is essential that patients call on surgeons who have extensive experience in these risky clinical situations and that the interventions focus on the hips, buttocks, outer thighs but avoid the inner thighs and legs as much as possible where the majority of the major lymphatic collectors pass.”

What are the natural treatments for lipoedema? Without surgery?

► “Jeanstherapy”: Being tight in non-elastic jeans is a good thing when you have lipedema, at least in the thighs and hips: “Women who suffer from it have a lymphatic system that does not function very well, the compression will create alternating pressures when walking and promote the penetration of fluids which stagnate between the fatty deposits in the lymphatic system.”

► Compression stockings: You must wear class 2 or 3 compression stockings made to measure for each woman when visiting a doctor. “There compression combined with reasonable liposuction remains the best way to limit the progression of this syndrome and improve the situation.”

► Foam bandages : “We apply bandages combining 2 cm thick foam with very short elastic bands to create a semi-rigid straitjacket around the limb.” The patient is equipped with these bandages to perform physical exercise on treadmills or in the fitness room.

► Food : It is advisable to limit the consumption of pro-inflammatory foods like sugars when you suffer from lipedema. Salt must also be reduced because “he seems to be involved in this syndrome” argues Dr. Belgrado.

► Sports: “It’s not because lipedema is resistant to physical activity that we must find the excuse not to do itsay the two specialists. On the contrary, physical activity prevents weight gain which worsens lipoedema.One of the best sports is aquagym, especially when it is achieved with neoprene wetsuits (like those you can find in the swimming section of sports stores).

► Psychological monitoring : Women with lipedema suffer psychologically from this syndrome which deforms their body despite all the efforts they make to try to stop the phenomenon. “It is essential to listen to them, respect them and not leave them alone. It is also important that they get help from professionals such as psychologists.”

Thanks to Dr Jean-Paul Belgrado and Dr Liesbeth Vandermeeren from the Brussels Lymphology Research Unit. Comments collected in 2019.