2 In TA liposuction, tumescent is infused in the subcutaneous tissues to cause the fat cells to swell and vessels to constrict then blunt micro-cannulas are used to suction the fat. 5 Commonly used liposuction methods for lipedema are tumescent anesthesia (TA) liposuction, and water assisted liposuction (WAL). ![]() Liposuction is the main surgical interventions for lipedema. 12 However, these benefits are short-lived, usually requiring repeat treatment within days. 2 Conservative therapy can alleviate some lipedema symptoms such as heaviness, pain, and secondary swelling. The conservative therapy includes promotion of individually adjusted healthy lifestyle, combined decongestive therapy (CDT), and other supportive measures, such as psychosocial therapy and orthopedic counseling. 1 – 3, 6, 11 Treatment is divided into conservative therapy and surgical interventions. The primarily focus of treatment is to reduce its related lower extremity symptoms, disability, and functional limitations to improve patients’ quality of life, as well as preventing disease progression. There is no known curative therapy for lipedema. In severe cases, lipedema may lead to absence from work or occupational disability. 1 – 3, 6, 7, 10 Lipedema poses a significant psychosocial burden for most patients, and associated effects often limit capacity for exercise. 10 As mentioned, in the later stages, secondary lymphedema can occur due to imbalance in the amount of fluid produced and drained by the lymphatic system. 4 Over time, the weight of the excessive fat build-up can cause the knees to knock inward or droop to the side of the leg, and impair the inability to walk. Untreated lipedema may result in secondary problems including osteoarthritis, reduced mobility, psychological impairment, and lowered self-esteem. 1, 6, 9 Symptoms of the condition include pain in the lower extremities, particularly with pressure, loss of strength, easy bruising, and deterioration in daily activity levels that can greatly impact the health and quality of life of the individual with lipedema. 2 – 5 The excessive fat deposits are typically unresponsive to traditional weight loss interventions such as physical activity or dietary measures. Lipedema targets both legs (and sometimes, also both hands) to the same extent and has a bilateral, nearly symmetrical presentation. 1, 7 However, patients with lipedema may develop secondary lymphedema (lipolymphoedema) if the fatty deposits compromise the lymphatic system. 1, 4, 7 – 9 The lymphatic system remains unimpaired in the initial stages and can keep up with the increased amount of interstitial fluid. ![]() 2, 6 However, although lipedema and obesity can co-occur, unlike obesity, lipedema usually targets the legs and thighs, without affecting the feet or hands, and the adipose tissue in lipedema is painful. ![]() The cause of lipedema is unknown, and it is likely that the condition is frequently misdiagnosed or wrongly diagnosed as lifestyle-induced obesity or lymphedema (i.e., localized fluid retention and tissue swelling). ![]() 2, 4, 5 The literature search for this report did not find epidemiological data for lipedema in Canada. 2 However, lipedema is believed to affect nearly 11% of adult women, 3 with noted significant differences in prevalence worldwide. 1, 2 Lipedema does not yet have a registered diagnosis in the International Classification of Diseases (ICD-10) of the World Health Organization (WHO), making it difficult to establish its prevalence. 1, 2 The condition is relatively rare and often seen in patients with a family history of the disease. 1 It occurs almost exclusively in females, although a few cases in men have been reported. Lipedema is a disorder characterized by large amount of subcutaneous fat in the upper and lower legs due to both hyperplasia and hypertrophy.
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