Vergleich Lipödem und Lymphödem
lipedema
6 Minutes

Lipolymphedema: Lipedema puts pressure on the lymphatic system

Do you suffer from lipoedema? Then you know that this chronic fat distribution disorder can have a significant impact on your everyday life. If the diseased fatty tissue also puts pressure on the lymphatic system, this can lead to lipolymphedema. The result is increased pain, swelling and restricted movement, often caused by water retention. This is usually accompanied by a strong feeling of tension and heaviness in the affected areas of the body.

In addition to the physical limitations of lipolymphedema, women with the condition are almost always exposed to high levels of psychological stress. It is not uncommon for their self-esteem to suffer, as the changed body image and unusual proportions trigger feelings of discomfort and shame. The combination of all these physical and psychological complaints can also lead to anxiety and depression. If the condition progresses and remains untreated, lipolymphedema can reduce or even jeopardise a person’s ability to work.

The good news is that lipedema does not necessarily lead to lipolymphedema. In many cases, lipolymphedema can be prevented with early lipedema treatment. This requires a clear diagnosis by a specialist.

In this article, we would like to inform you about the condition ‘lipolymphedema’, explain the warning signs your body may be showing and help you find the right doctor. We at LIPOCURA® would also like to encourage you, because you are not alone in your suffering. This article will also tell you how and where to get help.

How does lipolymphedema develop?

To understand how lipolymphedema develops, it helps to first look at lipedema, a chronic fat distribution disorder. If unusual fat deposits have formed on the arms or legs, for example, and these cause pain when pressure is applied, lipedema may be present. In this condition, the diseased fat cells multiply uncontrollably in the affected areas of the body.

Typical accompanying symptoms include:

  • skin problems caused by friction between skin folds,
  • an increased tendency to bruise
  • and changes in connective tissue.

In some cases, the diseased fatty tissue of lipedema can also exert pressure on the lymph vessels and impede lymph transport. This causes lymph fluid to accumulate and prevent it from draining away, leading to swelling and hardening of the tissue. Specialists refer to this as secondary lymphedema. The opposite is primary lymphedema, which occurs, for example, when there is a genetic malformation of the lymph vessels or the lymph nodes have been removed during cancer surgery. If lipedema has already been diagnosed, lipolymphedema is a combined condition.

In the early stages of lipedema, lymph transport usually still functions very well. However, the vessels are subjected to increasing strain, which leads to degeneration over the years. This causes protein-rich fluid accumulations to form, which ultimately cause the tissue to harden.

However, lymphedema can also have other causes. It can result from infections, injuries or other diseases and their treatment. The main cause is cancer therapy, which requires the lymph nodes to be irradiated or removed. Obesity can also trigger secondary lymphedema.

Distinction from lipedema

Lymphedema and lipedema are two different conditions. Lipedema causes fat deposits that are resistant to exercise and diet. The painful, symmetrical swelling can occur in various areas of the body – usually evenly on both arms or legs.

In lymphedema, the swelling is caused by accumulations of lymph fluid that cannot be adequately drained. It usually occurs asymmetrically, affecting only one arm or one leg.

In a combination of lipedema and lymphedema, known as lipolymphedema, the swelling also occurs symmetrically, as the underlying lipedema appears to be equally pronounced in both extremities. An experienced doctor can determine which of the above conditions is present by means of various signs and tests. Find out more in the next section.

How can lipolymphedema be recognised?

In lipolymphedema, the backs of the hands or feet are swollen on both sides. In classic lipedema, however, the fingers and toes do not usually swell. For a more detailed diagnosis, the specialist performs a test called the Stemmer sign. In cases of lipolymphedema, the skin fold over the back of the fingers or toes can only be lifted slightly or not at all.

According to current knowledge, lipolymphedema occurs predominantly on the arms and legs. The reason for this is thought to be our upright posture and gravity, which has a particular effect on the legs and hanging arms (e.g. when walking).

External characteristics
Lipedema
Lymphedema
Lipolymphedema
Body proportions
Symmetrical swelling Asymmetrical swelling Rather symmetrical swelling
Back of hand/foot swollen
No Yes, on one side No
Wrinkle formation Transition between fingers/toes Yes No Yes, on one side
Stemmer's sign Negative Predominantly positive Predominantly positive
  • Explanation of Stemmer’s sign. In the Stemmer’s sign test, the doctor pinches the skin on the foot or back of the hand of the second toe or index finger of the affected limb between their thumb and index finger. If the skin cannot be lifted or can only be lifted to a limited extent, lymphedema is present. This type of diagnosis is named after the French phlebologist Robert Stemmer, who first used the examination method in the 1970s.

How and where can lipedema be diagnosed?

Disproportionate tissue changes and tension or pressure pain can have various causes. If you suspect you have lymphedema, you should consult a specialist – especially if you have already been diagnosed with lipedema. By examining the affected areas of the body and using specific tests and their experience, doctors can clearly diagnose any tissue disorders. This also includes the aforementioned Stemmer’s sign and an ultrasound examination.

For an initial examination, you can consult your family doctor as usual. The general practitioner will either be able to diagnose lymphedema or lipolymphedema themselves or will refer you to a colleague who specialises in this field. Choosing the right doctor is crucial for the success of the treatment. Qualified medical professionals include phlebologists, for example. They are often referred to as vein doctors and are able to distinguish between different diseases or rule them out with certainty.

Furthermore, a lymphologist specialises in diseases of the lymphatic system and can treat lymphatic drainage disorders in a targeted manner. If lipedema is also present, a specialist in plastic and aesthetic surgery may also be consulted. This is because long-term treatment of chronic fat distribution disorders is often only possible through liposuction in cases of lipedema. This involves the surgical removal of the diseased tissue.

Once diseased fatty tissue has been removed, it does not usually grow back. Removal not only improves the body image, but also relieves the lymphatic system and allows lymph fluid to flow freely again.

What can I do as a patient?

If you have lipedema, your specialist will suggest various methods for treating the condition. These include compression bandages and wearing custom-made compression garments. Other conservative treatment methods include manual lymphatic drainage, special skin care to prevent inflammation, and exercises tailored to the condition.

If lipedema is the cause of lymphedema, conservative therapies can somewhat contain the swelling, but not reduce it. In this case, only liposuction for lipedema can bring about lasting improvement. Liposuction for lipedema can change the shape of the legs and generally reduce symptoms. However, if the lymphatic system is already permanently damaged, lymphedema can cause increased swelling despite liposuction.

Affected women can also take action themselves. Contact and exchange with other patients is particularly helpful here. In self-help groups such as the non-profit association for oedema patients Lymphselbsthilfe e.V., you can find support, useful tips and answers to questions.

In addition, a healthy diet to prevent obesity, which exacerbates symptoms, can contribute significantly to the success of treatment. This also applies to appropriate physical activity that supports lymph flow. You can also reduce the risk of further spread of the oedema by avoiding intense heat, for example by refraining from sunbathing or visiting saunas.

Conclusion: Professional support on your lipolymphedema journey

Lipolymphedema is a serious condition that, if left untreated, can have lasting consequences for your well-being, mobility and quality of life. Don’t let it get that far. At LIPOCURA®, we know exactly how you feel. That’s why we want to provide you with the best possible support on your lipedema journey at our specialist centres. We care not only about your physical health, but also your mental well-being, as the two are closely linked.

Our experienced and specialised doctors are at your side every step of the way and will advise you on your individual situation. With over 15 years of experience in the field of lipedema treatment and around 2,000 liposuction procedures performed annually, you will be supported by an experienced team of specialists. They are accompanied by specially trained LIPOCOACH® and LIPOPHYSIO® specialists. LIPOCURA® supports you from the initial consultation to aftercare and beyond.

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