7 Essential Questions About Lipedema

Dr. Burgos de la Obra was the pioneer surgeon in Spain to dedicate himself exclusively to the treatment of lipedema, and the first Spanish surgeon to use the WAL technique in a standardized way to treat it. He is currently the medical director of Lipemedical, the first Spanish medical team dedicated exclusively to the diagnosis and treatment of this disease.

What is lipedema?

Lipedema is a disease of the fatty tissue characterized by a progressive accumulation of pathological fat, predominantly in the legs, with limited response to diet or exercise and accompanied by various symptoms, among which we find:

  • Heaviness
  • Hypersensitivity to pressure
  • Pain
  • Tendency to hematoma formation with ease

It affects almost exclusively women and its causes are not entirely clear; there is an inherited genetic component, as well as a hormonal component, since it frequently begins or intensifies coinciding with a change in hormone levels (puberty, pregnancy, taking the contraceptive pill, menopause, etc.).

What are its main symptoms and signs?

  • Clear disproportion between legs (with a clearly greater fat volume) and trunk (thinner).
  • Feeling of heaviness and continuous pressure in the legs that worsens in hot weather, sometimes marked by pain at rest or after exercise.
  • Tenderness and pain to the touch in the legs, especially on the inside of the knee and ankle.
  • Loss of the normal shape of the knees, legs with columnar aspect without affectation of the feet. The fat presents a harder or nodular consistency than normal.
  • Onset or worsening in relation to hormonal changes (puberty, pregnancy or menopause).
  • There is no response to diet or exercise, the patient loses breast and trunk volume, but hardly reduces leg volume, which is associated with a frequent feeling of frustration and hopelessness.

How is it diagnosed?

The diagnosis of most cases can be made by an adequate clinical history (time of onset, symptomatology, no response to dietary measures, etc.) and a detailed physical examination (bilateral and symmetrical involvement, torso-leg disproportion, pain on palpation, free feet…).

Additional tests (Doppler ultrasound or lymphography) are only necessary in case of doubts with other pathologies. In case of compatible symptomatology, it is appropriate to be assessed by a specialist in lipedema to confirm the diagnosis, evaluate the degree of involvement and propose the most appropriate treatment.

What is the difference between lipedema and obesity?

Obesity affects both men and women and the accumulation of fatty tissue is global (torso-abdomen-extremities). Obesity does respond adequately to hypocaloric diet and exercise and is not associated with symptoms such as a tendency to bruising or pain.

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In the case of lipedema, it affects almost exclusively women with a disproportionate fat distribution in the legs, in addition, the legs respond very little to dietary measures or exercise and are accompanied by symptoms such as heaviness and pain.

How is the disease treated?

There are conservative treatments to try to control the progression such as the use of flat-weave compression stockings or continued aquagym.

However, the most definitive treatment is to eliminate the diseased fat cells by relieving the pressure on the fatty tissue. For this purpose, the most delicate technique is water spray assisted lipodecompression or WAL liposuction. For best results this type of surgery should be performed by surgeons with extensive experience in its treatment.

What is the goal of surgical treatment?

In my opinion the most important goal of lipodecompression is to improve quality of life: treat symptoms, stop progression and improve mobility.

In addition, the surgery performed by an expert in its treatment, allows to recover the anatomical shape of the legs allowing to obtain its defined shape in thighs, knees, calves and ankles.

What results can we expect from the surgery?

The surgical treatment of lipedema will reduce the pressure on the fatty tissue and this is associated with the appearance of a feeling of lightness and relief; in addition, the pain at rest or on palpation disappears completely in most cases.

After the first weeks of recovery will greatly increase the mobility and flexibility of the legs, since the fatty tissue around the joints is reduced and the weight they have to support decreases; this makes many people who have abandoned the sport can resume it again and do it much more easily, which favors the maintenance of the result in the long term.

At an emotional level there is also a marked change, leaving frustration behind and giving way to a renewed motivation to maintain an active life and healthy lifestyle habits. Surgery, in expert hands, opens the door to a new life without pain, without mobility limitations and with a significant improvement in the quality of life.