Dr. Josef Stutz
Lipedema is a symmetric fat disorder in women which affects legs and arms. Due to the fat bulges at the proximal inner thigh there is an abduction of the leg axis that leads to a change in the walking appearance and to an unnatural physiological strain on the leg joints (knock knee). Using liposuction, the fat bulges can be reduced and the leg axis corrected.
Lipedema is a symmetrical fat-distribution condition, primarily in the legs, less often in the arms. Mainly, only women are affected by lipedema. The hypodermic fat tissue increases over the course of time, to what extent cannot be predicted. The physical alteration is usually noticed by the affected patients towards the end of puberty as a disproportion. We have to assume that, next to a familial disposition, there are also hormonal causes responsible for the lipedema.
It is characteristic for lipedema, that there is a symmetrical augmentation of fat tissue in the legs from the iliac crest to the ankles and, respectively, in the arms from the shoulder to the carpus. The feet and hands, however, are always free of increased fat tissue. In later stages, the patients develop a disposition for orthostatic edema, especially in the hotter season and increasing throughout the day. Additionally, there is a noticeable disposition for hematoma through minimal traumas as well as an increased painfulness to the touch. There is no linear connection between the extent of the increased fat tissue and the pathology of the discomfort.
Lipedema can turn into a lymphostatic edema, thus a lipo-lymph edema. This is due to a dynamic insufficiency of the lymphatic drainage in the extremities. The unbalanced state of afflux and drainage leads to a chronic failure of the lymphogenic transportation capacity and later to fibrosis of the cutis and to the development of lymphedema with a liposclerosis as an expression of a chronic final condition, resistant to therapy, after about 15-20 years.
There is no reliable epidemiological data regarding the frequency of lipedema. The literature refers to 10-15%. Lipedema is not a specific form of obesity. The increase of fat tissue in obese patients is distributed over the entire body.