Assoc. Prof. Tarik Cavusoglu
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What is lipedema?

Lipedema is a painful disorder caused by the enlargement of subcutaneous fat deposits and affecting both legs. Patients with lipedema, also known as an excessive fattening syndrome, suffer from excessive fattening and enlargement of hips and whole legs. As a term that can be misunderstood, lipedema does not actually refer to existing edema but is about enlargement of the fat layer. The enlargement can extend to the ankle.

Lipedema can be seen in more than one person in a family, and it may be associated with hormone disorders and some chronic diseases. It causes an enlargement in both legs that cannot be attributed to a specific reason only. Lipedema is often confused with lymphedema. Lipedema is most commonly seen in women.

The first symptoms of lipedema are seen during adolescence and then progress with age. Some authors even say that lipedema is seen in 15% of women at different rates in society. In families of more than half of the lipedema patients, other women have the symptoms of lipedema as well. In other words, there is a familial predisposition in lipedema.

How is lipedema realized?

How the lipedema occurs has not been fully realized yet. Reviews of lipedema patients suggest a connection with estrogen (female hormone) because other women in their families also have the same disease. Having a genetic background, lipedema is a fat accumulation disease that involves the vascular, nervous, and lymph system. Lymphedema is also seen simultaneously in some patients at advanced stages of the disease.

In lipedema cases, fat deposits which have concentrated between the waist and ankle are seen at the beginning. This fat accumulation increases with weight gain. However, even in the weakest periods, there is a disproportion between legs and body. Patients with lipedema experience pain and swelling, which especially increases towards the evening.

When you sleep at night and get up in the morning, this swelling and edema become decreased. Fat accumulation, which occurs like small fat glands in the early stages of lipedema, can turn into large sagging fat masses over time. Lipedema patients have pain in their breasts during menstrual periods. Bruising occurs in lipedema patients even with the slightest trauma.

In patients with lipedema, blood circulation between fat layers decreases due to the intense fat accumulation (microcirculation decreases),and the decreasing blood flow reduces the speed of fat breakdown. In this way, more fat accumulation occurs. This vicious circle is also significant in the progression of the disease. According to the patient's reviews, the most common complaints are;

  1. Lipedema is seen almost only in women; the foot is not affected but hips and whole leg are affected bilaterally.
  1. In lipedema, no pitting occurs when you press on the swelling in your legs with your fingers.
  1. Lipedema patients feel pain when touched or pressed with fingers during the examination.
  2. The skin is bruised easily even with minor trauma in lipedema.
  3. Lipedema patients have little or no slimming in their legs even when they lose weight.
  4. When you touch the skin of lipedema patients in summer when their complaints become severe, it is seen that their skin is cold.

Treatment of Lipedema (Excessive Fattening Syndrome)

There is no medical treatment for lipedema. Promises of herbal treatment and lipedema diet result in disappointment. If there is a hormonal background in lipedema, then treatment for the hormonal disorder may be appropriate. Varicose and compression socks and physical treatment methods do not have much effect on the treatment of lipedema.

Paying attention to diet and consuming low-salt foods are some supportive factors for lipedema treatment. Today, the only effective treatment of lipedema is the lipedema treatment with vaser liposuction (lipedema treatment with ultrasonic liposuction) which provides removal of problematic tissue from the area without causing damage to the lymph vessels.

Lipedema Surgery Price in Turkey

Lipedema surgery prices vary depending on the procedure to be performed. Please call us for the price of lipedema surgeries with Vaser liposuction.

Lipedema Surgery

It is possible to treat lipedema with Vaser liposuction, which is a lymph protective method. With Vaser Liposuction, the necessary amount of fat can be taken without damaging the lymph vessels. This liposuction method, performed with special atraumatic cannulas, is one of the most respectful methods to the tissue.

Which department is interested in lipedema? Which department to go for lipedema treatment? Who performs lipedema treatment?

If you have the above-mentioned symptoms, we recommend you consult a Plastic Reconstructive and Aesthetic Surgeon about the tissue. After a short examination, we can provide you with detailed information and treatment recommendations.

Which hospitals perform lipedema treatment?

You can undergo treatment in hospitals which have Vaser liposuction instruments and Plastic Reconstructive and Aesthetic Surgeons with enough experience on the subject.

Stages of Lipedema

Lipedema is analyzed at four stages:

  1. The first stage of lipedema: There is normal-looking skin, thick and fattened legs.
  2. The second stage of lipedema: Skin irregularities are added to the thick and fatty legs.
  3. The third stage of lipedema: Fat deposits have occurred locally in the thick legs with skin irregularities.
  4. The fourth stage of lipedema: There is also a problem in lymph vessels. There may also be edema extending until ankles and feet.

Lipedema Types

  1. Type 1 of lipedema: There is a deformity covering the upper leg and hip.
  2. Type 2 of lipedema: Enlargement and fattening are covering the upper leg, hips, and knees.
  3. Type 3 of lipedema: Upper legs, hips, knees, and ankles are deformed.
  4. Type 4 of lipedema: Upper legs, hips, knees, ankles, and arms are deformed.

How is lipedema diagnosed?

Lipedema is usually diagnosed after listening to the patient's complaints, disease history, and physical examination. Most of our patients are women, and it is seen that one or more family members have these problems. Tenderness, pain, easy bruising, and edema which do not recover with resting occur in the legs starting from adolescence, and it is so typical that this swelling is not seen in feet and toes. Unless lipedema progresses and turns into lymphedema, no pitting is seen on the skin when the legs are pressed on with fingers. Excessive fat and enlargement of the legs in a non-obese woman suggest lipedema.

When ultrasonography (USG) and Magnetic Resonance Imaging (MRI) are performed on lipedema patients, the fat layer is seen to be increased without thickening of the skin. While there is an increase in adipose tissue thickness in lipedema patients, fluid accumulation is not observed. Doppler ultrasonography findings are normal in lipedema patients. Lipedema is most frequently confused with lymphedema.

How to understand the difference between lymphedema and lipedema?

During the examination, painless edema is seen in one leg in lymphedema while both legs are affected in lipedema. Lymphedema is painless, but there are both pain and tenderness in lipedema. In lymphedema, when the foot is raised, the edema decreases at rest. There is edema in the feet and toes in lymphedema. Lipedema may turn into lymphedema over time. In lymphedema, unlike lipedema, thickening and deformity of the skin can also be observed over time.

Lipedema Treatment in Turkey

Since lipedema is a disease of unknown cause, it is not possible to be treated with medication. The purpose of liposuction in lipedema treatment is to improve the patient's current appearance and to prevent turning into lymphedema.

Supplementary treatments used in lipedema treatment

Compression treatment in lipedema (varicose socks and bandages)

The purpose of using varicose socks, compression clothes, and bandages in lipedema treatment is to reduce edema. Some people say that their leg pain decreases when they wear varicose socks.

What are exercise treatments in lipedema?

Physical activity and exercise both provide weight loss and increase lymphatic and venous flow by the pumping effects of leg muscles. The acceleration of blood circulation means the regression of edema. We recommend such activities as walking, swimming, walking in the pool, and cycling.

Is lymphatic massage useful for lipedema patients?

Lymphatic drainage with lipedema massage is a form of treatment that aims to reduce edema and pain and it is generally applied by physiotherapists. This type of treatment is not required in the early stages of lipedema. However, as the lipedema progresses and especially when the lipo-lymphedema occurs where edema appears on the dorsum, lymphatic drainage or massage with hands can provide great relief.

Vaser Liposuction in Lipedema Treatment

In patients with lipedema, removal of the thick fat tissue under the skin can provide the patient with life comfort in terms of physical activity and an aesthetic advantage, as well as reducing pain and tenderness complaints. Vaser liposuction performed in the early stages of lipedema gives much more successful results.

Frequently Asked Questions About Lipedema

1- What is lipedema?

Lipedema is a disease that is not well known by society and unrelated physicians but affecting 17 million women in the United States and more than 370 million women worldwide. Lipedema is a disorder where there is an abnormal accumulation of fatty tissue, usually below the waist, that leads to progressive leg growth. This chronic disorder can sometimes affect the arms.

Lipedema is a serious medical condition with many critical complications. Increasing volume and fibrous tissue cause blockages and obstructions in lymphatic flow. Other complications include joint deformities, varicose veins, general body pain, and "tingling" type ailments. Additionally, patients report psychological problems ranging from lack of self-esteem to depression.

2- How can I understand that I have lipedema?

Make a list of your symptoms and, if possible, look at your old photos and find the changes in your body shape. You can make an appointment with your doctor to be examined specifically for lipedema. If you are overweight due to overeating or an unhealthy diet, follow a diet program. It will be easier to diagnose lipedema when you are close to your normal weight.

In lipedema cases, there is an excessive bilateral and symmetrical fat accumulation in the legs and hips that is not proportional to the body, extending to the ankles. Since fat accumulation and edema in lipedema tend to stop at the ankles, the feet are not affected. Patients have disproportionate fatty units on the outer surfaces of the thighs and typically on the upper arms. Lipedema is a serious medical condition and can cause many health problems if not treated.

3- What is the difference between lipedema and lymphedema?

Most of the time, physicians who are not experts in lipedema make a diagnosis of lymphedema on patients when they come with complaints of leg pain. Lymphedema is caused by dysfunction of the lymphatic system, while lipedema is thought to be primarily an adipose tissue disorder (lipodystrophy). Lymphatic dysfunction may develop in lipedema patients over time. The transformation process from lipedema to lymphedema is sometimes referred to as lipo-lymphedema.

  • In lipedema, swelling ends in the ankle, lipedema does not affect the foot. Feet are also swollen in lymphedema. In fact, the starting point in primary lymphedema is usually the feet and it progresses upward. In secondary lymphedema, the starting point is the thigh and it progresses downward.
  • Bruising with minor traumas is the symptom of lipedema, it is not seen in lymphedema.
  • Lipedema affects both legs. Involvement in lymphedema is asymmetrical and it affects one leg.
  • Pain is the dominant symptom in lipedema. Pain occurs only by touching the legs. Pain symptoms can be seen in lymphedema as well, but not as significant as in lipedema.
  • An examination finding called the "Stemmer sign" is also used in the diagnosis of lymphedema. Stemmer's Sign is a specific finding for lymphedema, it is not used for lipedema. The "Stemmer Sign" is used when the skin on the dorsum cannot be pinched with the thumb and index finger.

4- Why has no doctor told me I have "lipedema"?

Since lipedema is a relatively newly discovered disease and not included in the old classical medicine curriculum, it is not a well-known disease by physicians who are not specifically experts in the field.

5- What should I do if I suspect lipedema?

You should contact a Plastic Reconstructive and Aesthetic Surgeon who is interested in the subject of lipedema and confirm whether you have lipedema or not. Afterwards, you will be given detailed information about your treatment options and the disease.

6- Are lipedema socks and compression clothes effective in lipedema?

Compression clothes and lipedema socks increase the flow of blood and lymph fluid in the lymphatic system, helping to delay fluid retention/edema and the onset of lymphedema. Therefore, wearing compression clothes is partly useful. Many lipedema patients say that lipedema corsets reduce pain and increase their mobility. Although lipedema clothes are effective for reducing edema and symptoms of lipedema, it is not therapeutic.

7- Which method do you use in lipedema treatment?

The method we prefer for lipedema is Vaser Liposuction (VaserLipo). Vaser Liposuction is the process of making fat tissue fluid by using sound waves and removing them with thin and atraumatic cannulas without damaging lymph channels and vascular structures. With this method that requires special training and experience, the intense fat deposits in the legs are reduced and the legs are sharpened.

8- What are the symptoms of lipedema?

Lipedema is characterized by disproportionate fat accumulation in the legs. It is characterized by fat deposits surrounding the thighs, hips, knees, calves, and ankles. However, lipedema does not affect the feet. The arms are involved in most patients, but it usually occurs in the later stages of lipedema. In some patients, it is also seen in the hips with cellulite and lumpy appearance, which is a part of lipedema. Tissue growth in lipedema is caused by subcutaneous edema and fat accumulation.

9- Who tends to have lipedema?

Although the reason for lipedema is not known, there seems to be a genetic predisposition to the disease, as most of the lipedema patients have a family history. Lipedema predominantly affects women, whether they are obese or not. Because lipedema is affected by hormones, it is typically triggered in adolescence; however, it may worsen during or after pregnancy, following menopause and gynecological surgery.

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Assoc. Prof. Tarik Cavusoglu Answers Your Questions
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+90541 932 4689

Assoc. Prof. Tarık ÇavuşoğluAssoc. Prof. Tarık ÇavuşoğluPlastic, Reconstructive, and Aesthetic Surgery Specialist
0541 932 4689