Lipedema: A Chronic Condition Affecting Women
Lipedema is a chronic condition primarily affecting women due to its significant hormonal component. It predominantly manifests in the legs and, while it is gaining more attention, it has existed for a long time.
The condition consists of three main issues: lipodystrophy, which is an excessive accumulation of fat; difficulties in lymphatic return in the lower extremities, though it can also occur in the arms; and challenges in vascular return, as explained by Dr. Ruiz de Erenchun, head of the Plastic, Aesthetic, and Reconstructive Surgery Department at Quirónsalud Bizkaia Hospital.
Patients with lipedema experience exaggerated volume in their legs, along with discomfort, pain, and difficulty walking. “It is a bothersome and quite debilitating symptomatology in daily life,” asserts Dr. Ruiz de Erenchun, who is also a member of the Safety Committee of the Spanish Society of Plastic, Reconstructive, and Aesthetic Surgery (Secpre).
Often, lipedema goes unnoticed or is confused with other conditions like obesity. Besides the visible aesthetic effects, it can lead to “pain, discomfort, and functional impotence,” emphasizes Dr. Ruiz de Erenchun, highlighting the importance of proper treatment.
Distinguishing Lipedema from Lymphedema
It is crucial to clarify the common confusion between lipedema and lymphedema. The latter is solely related to difficulties in lymphatic return. “When lymphatic vessels struggle to return lymph or excess blood fluid to the heart, the extremities swell,” explains Dr. Ruiz de Erenchun, noting that lymphedema is particularly characteristic in patients who have undergone mastectomies involving lymphadenectomies.
Menopause is a triggering stage for lipedema due to hormonal imbalances that occur with the cessation of menstruation and the subsequent reduction in estrogen and progesterone secretion, both of which affect nearly all cells.
Symptoms and Diagnosis
Symptoms of lipedema include pain upon touch and at rest, whether standing or lying down. “As the legs swell, there is also a functional deficit. Patients find it increasingly difficult to move due to muscular compression. The joints progressively become more numb,” the specialist points out.
A precise diagnosis is essential for treating lipedema. Before any treatment, patients are advised to adopt general postural or hygienic measures, such as using compression garments to enhance lymphatic and vascular return, elevating their legs at home, maintaining a healthy diet, and exercising. “Moreover, any weight loss will be beneficial,” emphasizes Dr. Ruiz de Erenchun.
After assessing the type of venous and lymphatic difficulties, it can be determined if a patient is a candidate for surgical treatment.
Effective Treatment Focused on Health
Dr. Ruiz de Erenchun emphasizes that treatment prioritizes health and aims to improve quality of life. “This is not a surgery for aesthetic purposes, but purely curative and reparative,” he states, underscoring the treatment’s goal of enhancing not only health but also the aesthetic appearance of the legs.
From a surgical perspective, the treatment for lipedema involves liposuction, which essentially removes the excess fat to alleviate swelling and improve lymphatic and vascular return, thereby reducing symptoms, explains Dr. Ruiz de Erenchun.
Liposuction is currently the best treatment option for lipedema, depending on the patient, the severity of the condition, and their commitment to postural measures, diet, and exercise. The procedure can be repeated if necessary after some time.
Regarding the intervention, the specialist considers it straightforward, although no surgery is without risks. “Patients must adhere to safety anesthetic criteria,” he notes. Typically performed under epidural anesthesia, the procedure lasts about one and a half to two hours. Patients are fitted with compression garments post-surgery and can usually go home the same night or the following day.
Post-operative care includes avoiding strenuous activity for several days and undergoing massage therapy to reduce inflammation in the legs.
Notable Benefits
Post-surgery, patients experience significant functional benefits, which is the primary goal of treatment, along with aesthetic improvements. “However, patients are primarily concerned with alleviating pain, discomfort, and regaining the ability to walk and exercise, allowing them to lead a normal life without limitations,” observes Dr. Ruiz de Erenchun, who aims for pain relief and improved mobility for his patients.
It is essential to monitor patients for a period after the procedure. “We follow up with patients for up to a year to assess their progress, ensure there are no complications, and confirm adherence to post-operative guidelines, which mainly involve wearing compression garments and gradual weight loss,” emphasizes Dr. Ruiz de Erenchun.
For individuals suspecting they may have lipedema but have not received a proper diagnosis or treatment, it is crucial to consult a physician promptly to evaluate risks and benefits. “It is vital not to be misled and to seek reputable centers and specialists in plastic and reconstructive surgery,” he stresses. Ensuring treatment is conducted under optimal conditions will help avoid complications, and if they arise, they can be appropriately managed at the facility where the procedure was performed.